Victorian State Budget - Dental Services

The Victorian Treasurer, The Hon John Brumby today delivered the 2006/07 State Budget, and within Budget Paper No.3 (see 15th and 16th pages of the chapter - numbered as pages 93 and 94 in the document), he revealed that an additional $3.5m would be added to the Dental Services budget, taking expenditure from $126.3m in 2005/06 to $129.8m in 2006/07.

Waiting lists are projected to reduce by one month over the coming year from an average of 25 months to 24 months for restorative dental care, and from 27 months to 26 months for dentures.

The ratio of emergency to general dental care is not expected to reduce over the coming year from its present level of 53:47.

Consultation invited on new Therapeutics Regulation

Documents detailing the proposed joint regulatory scheme for the new Australia New Zealand Therapeutic Products Authority (ANZTPA) have recently been released for public consultation.

ANZTPA is inviting submissions on the proposed regulatory scheme or "draft Rules" for medicines and medical devices; a description of the proposed Grouping Order for medicines; draft guidelines on transition provisions for product licensing; the key components of the draft Administration Rule; and the consultation document on the proposed fees and charges.

The closing date for submissions on the consultation documents is 15 August 2006.

NSW bans soft drinks in school canteens

The NSW Government has moved to ban soft drinks from school canteens following the findings of a new health report that details a disturbing rise in the levels of childhood obesity.

This measure, which will clearly have impact on oral health also, was announced on 24 May 2006 by the NSW Premier, Morris Iemma, Minister for Health, John Hatzistergos and the Minister for Education and Training, Carmel Tebbutt.

The release notes that "One glass of soft drink contains almost 10 teaspoons of sugar, and this survey shows that almost six in 10 boys and four in 10 girls drink more than one glass of soft drink a day".

The Victorian Minister for Education, Lynne Kosky announced a similar ban in Victorian school canteens, which was reported in an ADAVB Blog posting on 24 April.

Feedback invited on Draft Board Policy and Code

The ADAVB has issued two Alerts this week to members who subscribe to this email service, inviting feedback to help us prepare submissions on

• review of the DPBV Code of Practice on After Hours Services: and
• the Draft DPBV Policy re dental students with an "incapacity"

Some members who originally subscribed to the Alert! service have dropped off the mailing list due to failure to check their email accounts (usually Hotmail or Yahoo accounts) within specified time limits. Others have not yet availed themselves of the service, which draws immediate attention to matters requiring attention in the practice.

Members wishing to renew their lapsed subscription or to open a new subscription to ADAVB Alerts can do so here.

New Council to take office on 19 June

Nominations for vacant positions on the Branch Council for the period July 2006 to June 2008 closed at 5.00 pm on Monday 15 May. At that time, seventeen formal nominations had been received by the Branch for the seventeen vacant positions.

In accordance with Rule 39(1) where, “in the event of the nominations being not more in number than the positions to be filled, those who have been nominated in accordance with the above shall be deemed to be elected, and shall assume and commence office on the expiration of the term of office of the outgoing members of the Council”, the following seventeen nominees have been declared elected without ballot. Congratulations to:

Dr Andrew Barnes
Dr Mark Bowman
Dr Chris Callahan
Dr Stephen Cottrell
Dr Pamela Craig
Dr David Curnow
Dr Bob Cvetkovic
Dr Anne Harrison
Dr Neil Hewson
Dr David Houghton
Dr Matthew Hopcraft
Dr John Matthews
Dr Greg Morris
Dr Ming Ann Ong
Dr Anne Stewart
Dr Jonathan Tversky
Dr Gary Yip

These new Councillors will meet on 19 June to elect the new officer bearers for the coming year, and they will all take office from the end of the June General Meeting, which is also scheduled for 19 June.

Special thanks to Drs Vlad Hardi and Dr Suzanne Hanlin, both of whom are retiring from Council having served in various offices, including that of President, and also to Dr Tim Cutler, who whilst retiring from Council, continues to serve as a member of the Finance & Audit and PPF Policy Advisory Committees.

Welcome to newly elected Councillors Dr Bob Cvetkovic, Dr Ming Ann Ong and Dr Gary Yip.

Australian HES article re graduate entry

The Australian's Higher Education Supplement today carries a story - Dentists slam graduate plan - based on the ADAVB submission to The University of Melbourne Council in response to the possible impact of their 'Growing Esteem' proposals on the Bachelor of Dental Science course and access to dental services in Victoria.

ADA Inc. responds to Federal Budget

The Australian Dental Association Inc. (ADA) has issued two media releases in response to the Federal Budget.

BUDGET FAILS TO PROVIDE LEADERSHIP TO IMPROVE ORAL HEALTH, SAY DENTISTS

ABILITY TO MEET THE DEMAND FOR DENTAL SERVICES

"Yesterday’s Budget missed an important opportunity to provide leadership to improve the oral health of the Australian population", said ADA Federal President, Dr Bill O’Reilly.

“Dentists are disappointed that yesterday’s Budget failed to recognise that thousands of Australians are in urgent need of dental care. The ADA believes that much more needs to be done in the areas of higher education, workforce and oral health promotion, as well as the delivery of dental care to Australia’s war veterans, older Australians, Indigenous Australians and those with anomalies of the dentition”.

More Budget news re Superannuation

Some further Budget announcements of note for dentists relate to the following superannuation benefits:

• Self-employed to receive 100% tax deduction and co-contributions
• Aged-based limits abolished

The self-employed are to be treated the same as employed people in that the $5000 +75% deduction rule is being removed. In addition, the co-contribution will be extended to post-tax contributions made by the self-employed.

Also, the Maximum Deductible Contribution (MDC) limits are to be abolished from 1 July 2007 and replaced with a new annual contribution limit of $50,000. There is to be a transitional period for those 50 and over who currently have an MDC of $100,587, but more details are still awaited on this. Those under 35 will enjoy a $35,000 increase in their MDC, and 35 to 49 year olds will have an approximately $10,000 increase.

The ability to make deductible superannuation contributions is to be extended to age 75 (up from age 70).

Thanks to Moneywise and Challenger for drawing these changes to attention.

Practice activity patterns of dentists in Australia

According to a report just published by the Australian Institute of Health and Welfare (AIHW), dentists are increasingly focused on preventive and maintenance care with more Australians keeping more of their natural teeth as they age.

These changes in oral health, demographics and use of services are expected to continue to affect the practice activity patterns of dentists, the report says.

Dr David Brennan of the AIHW's Dental Statistics and Research Unit based in the Australian Research Centre for Population Oral Health at the University of Adelaide, said retention of natural teeth is becoming increasingly common, as early detection of dental problems becomes more routine.

"This raised expectation for retaining a healthy natural dentition for life is likely to see sustained demand for the services of dentists both currently and into the future", he said.

The report, Practice activity patterns of dentists in Australia: trends over time by age of patients, presents findings from a random sample of dentists, collected at five-year intervals between the 1993-94 and 2003-04.

While check-up was the most common reason for a dental visit (48.4%, 41.1% and 43.2% at each survey interval), the percentage of patients seeking pain relief decreased over time from 31.4% to 26.7%.

The percentage of patients who were seeing the dentist for follow-up or maintenance care increased for all patients. The numbers of different diagnostic services also increased over time among most patient age groups, but especially among the 65 and overs, which increased from 46 diagnostic services per 100 visits to 67 diagnostic services per 100 visits, reflecting increased rates of both dental examinations and x-rays. Crown and bridge services also increased.

The Federal Budget and Dentistry

The following constitutes a preliminary analysis only of the impact of yesterday's Federal Budget on dentistry and dentists.

The first point worth noting is that there is still no Commonwealth funded dental scheme to help reduce waiting lists. If any additional (meagre) funds are to flow towards needy public patients it will be via the adjustments to private health insurance, which around 10% of health care card holders still use. These changes were previously reported in this Blog yesterday and on 27 April.

The caps on student Fee-Help loans are to be lifted from $50,950 to $80,000 for new and existing students. From next year, dental students and their medical and veterinary colleagues, will be able to take out loans of up to $100,000. This a welcome move given that the number of full fee places is growing and the debt faced by prospective full fee students doing the current 5-year undergraduate degree is over $150,000 (before living expenses).

Changes to superannuation benefits including the abolition of reasonable benefits limits and introduction of a universal contribution limit of $50,000 p.a. are noteworthy, as are adjustments to small business taxation. For assets acquired from today, a 200% diminishing value depreciation rate will apply, rather than the previous 150% rate. Members should talk to their accountants about this.

Depending on income level, the other obvious budget benefit is the adjustment to income tax rates. This area is already comprehensively covered in the mainstream media.

As expert commentary is published, additional budget implications will be highlighted in subsequent Blog posts.

ADA Inc. submission on Graduate Entry

The ADA Inc. has recently made a submission to the Federal Department of Education Science and Training regarding graduate entry issues raised in a recent discussion paper on the Bologna Model.

The conclusion to that submission notes that:

"the ADA’s response to the DEST Discussion Paper is mixed, with a particular concern relating to one of the key aspects of the Bologna Process – the move towards an ndergraduate/graduate mode of study. If implemented, this has the potential to impact negatively on the delivery of dental care and its accessibility by many in need.

Although the Bologna Process highlights medium and long-term challenges (and opportunities) for the Australian higher education system, there are anumber of short-term considerations with respect to the education of dentists that the ADA regards as requiring immediate action by the Australian Government. These have been outlined previously and can be summarised as follows:

• Will the proposed system produce a ‘better’ dentist than those that are currently graduating from undergraduate courses?

• Can Australia afford the impact the introduction of the Bologna Process may cause?

• Will the introduction of additional years of tuition fees to gain a second degree adversely impact on:

- the number of graduates undertaking practice in the public sector;

- the selection of students that will embark on the course offered, and

- the future cost of dental care?

Some of the ADA’s concerns would be addressed if:

• Funding for dentist training was related to cost and not banded with medical and veterinary training;

• More Commonwealth Supported Places were made available for dentist training; and

• Commonwealth Supported Places were allocated to the second degree to ensure fairer selection and to ensure that graduates did not enter the workforce with substantial student debts.

The ADA urges the Australian Government to give full consideration to these issues. While Australia must consider higher education reforms in the broader international context, immediate concerns must be this country’s first priority."

ADAVB 2006 Convention Sold Out !

ADAVB has experienced unprecedented interest in this year's convention and the event is now fully sold out. A recording of the event will be available for purchase in July.

Delegates are still welcome to attend the ADX Dental Expo being conducted by the Australian Dental Industry Association of course. This event runs from Friday 26 - Sunday 28 May at the Melbourne Exhibition Centre. Register for this event online via the ADA website.

Over 250 delegates have already registered to attend the ADAVB Dental Assistants Convention which is being held on Saturday 27 May, and ample seats remain available for this program at this stage.

The next major CPD event for ADAVB members this year is on 24 August and has the theme The Traumatised Central Incisor - The Full Story.

Speakers include Dr Luke Moloney, Dr James Lucas, Dr Michael Woods, Dr Robert De Poi, Dr Gordon Burt, Dr Ennio Rebellato, Dr Stephen Cottrell, and Dr Chris Evans, who will review the consequences of trauma, treatment options and the possible outcomes. This event attracts up to 6 hours Scientific CPD credit.

AMA's Informed Financial Consent Advice

The AMA has published guidance for their members about their patients' right to know, and their responsibility to ask about, how much their treatment costs and what they might have to pay.

More about Private Health Insurance changes

The Commonwealth Department of Health and Ageing has published further information about the Federal Government's proposed private health insurance reforms. These developments were first noted in the Blog post of 27 April.

"The changes that have been agreed include:

• the introduction of legislation to allow, but not require health funds, to offer Broader Health Cover products;
• the proposed mainstreaming of the Outreach Hospital in the Home services will be suspended pending the introduction of Broader Health Cover;
• the regulation of products, rather than health funds, which will involve the private health insurance rebates attaching to products rather than a health fund registration;
• the introduction of uniform safety and quality criteria so that in the future all privately insured services will be provided by an accredited facility and/or suitable qualified provider;
• the removal of Lifetime Health Cover (LHC) loadings for members who have held private health insurance on which they have paid a loading for 10 years continuously;
• Medicare Australia, as part of business as usual, will write to people who do not have private health insurance and are about to be affected by LHC, reminding them of their LHC deadline and that they may incur a LHC loading;
• a requirement being placed on health funds to provide, for each product they sell, standard product information about:
  - premiums;
  - waiting periods;
  - exclusions;
  - hospital and medical gaps; and
  - excesses.
• support for the establishment by the Private Health Insurance Ombudsman of a website that will allow people to compare health funds and their products and provider arrangements. The standard product information will be required to be provided to the Ombudsman for publication on the website; and
• the implementation of risk equalisation (reinsurance) reforms that will include:
  - the implementation of a modified industry model for risk equalisation;
  - a high cost claims pool; and
  - the treatment of single parents as 1 Single Equivalent Unit."

Certain of these changes are expected to have direct impact on the way some dental services are funded. Historically dental services were only covered under ancillary benefits tables, but from 1 April 2007 "health funds will be able to offer products that pay benefits for services that are part of, prevent, or substitute for hospital services, removing the current boundary that exists between “hospital” and “ancillary” insurance".

New food labelling system welcomed

The ADAVB today welcomed the anouncement by Federal Health Minister Tony Abbott, that a new food labelling system will be introduced to tackle obesity. Hopefully this new standard will also address the dental "friendliness" of foods and drinks.

This announcement was made in a speech to the Queensland Obesity Summit, held at Parliament House in Brisbane yesterday.

Graduates choose rural life

Two dental graduates have chosen to begin their careers in Warrnambool (population 30,000). Dr Ismeeta Nundalallee and Dr Lauren Baxter are working at the Lady Bay Dental Clinic and finding the rural lifestyle and professional challenges refreshing. They also believe that they are benefiting more than their peers who have chosen to practice in metropolitan areas.

The two young graduates receive continual support and mentoring from practice dentists Dr Richard White and semi-retired Dr Tom Walpole.

A story about these two recent graduates will appear in a forthcoming Branch Newsletter.

Health promotion priorities submission

The Victorian Department of Human Services recently published a discussion paper on Health Promotion Priorities for Victoria, and invited submissions from interested persons.

The ADAVB submission in response to this initiative is now available.

Our submission calls for a higher profile to be given to oral health promotion - either by adjustment of the Department's currently proposed priority areas, or the addition of one or more extra areas which can accommodate the need for more oral health promotion.

Dental caries and periodontal (gum) disease are amongst the most prevalent and expensive health conditions, and yet most such disease is preventable. Oral health risk factors are similar to those for chronic and systemic diseases like diabetes and heart disease. This makes it an ideal area for health promotion interventions.

Once the Department has finalised its health promotion priorities for the period 2007-2012, we will publish update information here.