ORAL DISEASE PREVENTION

· Oral diseases are almost all preventable, and reduction of the demand for dental treatment is best achieved in the long term by preventive and early intervention strategies.

· This requires a long range view of policies and initiatives designed to have greatest impact on the oral health of the community e.g. fluoridation, oral hygiene and dietary measures.  It also requires an approach which urges individuals to accept personal responsibility for their own health, and to avoid behaviour that will lead to disease and the need for treatment

· Hospital admission rates for dental conditions are amongst the top five ambulatory care sensitive conditions in rural Victoria.  This means that amongst the causes of hospitalisation that shouldn’t be necessary, dental conditions were very prominent.  Data on hospital admission rates for 0-4 year olds shows that 90% of these admissions are due to high levels of dental decay.  (Department of Human Services 2001).  The data also showed that rural areas (usually unfluoridated) have higher rates of decay and higher rates of hospital admission due to dental conditions.  The 2002/03 ACSC update reveals that dental conditions were a more frequent cause of hospitalisation than angina, asthma and congestive cardiac failure.

· Annual checkups for children and residents of aged care facilities are a key element in effective disease prevention.  Currently, neither group receives anything like this level of support.

ACTION 

Oral Health Promotion

· Extend the Oral Health Promotion Strategy until 2010, and increase the profile of oral disease prevention messages using popular media

NB  All costings s.t.c.

$5m

Preschool

· Provide all preschool children with free dental examinations and oral hygiene instruction 

$7m

Gerodontics / Special Needs

· Domiciliary vans and associated teams provided to support treatment for those in residential care or unable to attend clinics in both rural and metropolitan areas

· Facility fee negotiated with the Commonwealth for mobile services provided to residential aged care facilities

$2m

$1m

School Dental Services

· Increase staffing levels and treatment funding to permit all eligible primary school children to receive annual checkups and treatment as required

$20m

FUNDING and ACCESS

· Some progress has been made in reducing waiting times, but there are still large numbers who are waiting an average of 2 years for treatment, with many rural patients waiting up to 5 years!

· As at December 2005 (the latest Departmental figures available publicly) waiting times for public dental treatment in the region were

o Ballarat - 53 months; Maryborough – 42 months; Horsham - 49 months; Daylesford – 35 months

· Other regional areas with worse waiting times include:

o Moe – 64 months; Sale – 59 Months; Warrnambool – 60 months; Portland – 66 months

· The consequence of these extended delays is that treatment needs that could be addressed by simple restorative measures become much more complex, or worse, become so extreme, that extraction or hospitalisation is required.

· The 2006/07 State Budget increased dental funding by only $3.5m, which in a total budget of $126m will barely keep pace with inflation.

· Projected waiting times for general dental care in the State Budget 2006/07 remain an average of 24 months as at June 2007, down only one month from December 2005.

· Insufficient numbers of both public and private sector dentists are available in regional areas.

· The cost of public dental treatment is generally borne by the States, although the Commonwealth argues that they provided an unidentified amount to the States that was intended for use on dental services.  Whilst the Commonwealth seems unlikely to change its view about a national scheme, it may be willing to consider enhanced funding for special needs groups, and we therefore urge the parties contesting the Victorian State election to seek special purpose Commonwealth grants for specific target groups e.g. rural children, people in residential care, koori communities.

· The mobile dental vans used for the School Dental Service include units that are well over 20 years old.  Upgrade and replacement plans need to be implemented urgently for these units.

ACTION

· Earmark additional funding for dental treatment. Reduce the waiting list from an average of 24 months (as at December 2005) to less than 12 months by funding an expanded voucher scheme to allow private sector dentists to assist in treatment of public patients.

· Increase the annual cap for each eligible person’s publicly funded care from $600 to $700, and ensure that voucher rates reflect the costs of service delivery

· Fund an outreach project to deliver dental treatment and oral health promotion programs to indigenous communities in Victoria

· A more rapid program of van replacement is required to provide suitable treatment facilities for eligible children throughout the State.

NB  All costings s.t.c.

$30m p.a.

$10m

$1m

$2m

WORKFORCE EDUCATION AND TRAINING

· All parts of the dental workforce are experiencing shortages, especially in rural and regional areas.  This is a problem of both overall numbers, and distribution, with a higher ratio of dental care providers to the population in metropolitan areas. 

· Given the long lead times to produce graduates, policy decisions need to be taken addressing medium and long term targets, with a view to ensuring that the Australian community has access to the workforce required to meet its oral health treatment needs.

· Recent Commonwealth announcements regarding additional training places excluded Victoria, with most extra places being earmarked for NSW and Queensland.

· Graduate entry plans at The University of Melbourne, which is currently the only dental school training dentists in Victoria, may add two years to the time taken for a student to complete a registerable dental qualification, and will also significantly increase the cost of obtaining a dental degree for those not provided with a Commonwealth Supported Place.

· HECS fees for Bachelor of Dental Science (BDSc) courses are in the highest band, with candidates in 2006 being charged $8170 p.a. or a total of $40,850 for the 5-year degree.

· Current higher education policy allows up to 35% of the undergraduate population to be full-fee paying.  The projected annual cost of a full-fee place in 2007 is $33,100 at undergraduate level - a total of $165,500 for the 5-year course (without taking living expenses into account). 

· These high fee levels act as a disincentive to prospective students and to new graduates seeking employment in the public sector, as it tends to encourage them to not only work in the private sector but to seek high incomes in order to more quickly eliminate their significant debts.

· We therefore urge the parties contesting the 2006 State Election to implement measures designed to attract at least an extra 25 students (especially from rural backgrounds) to study dentistry each year.

· This plan should be further augmented by a scholarship scheme which bonds students to a year of public sector employment in an area of rural need for each year of scholarship benefit provided.

· There is also a need for culturally sensitive handling of the treatment needs of Aboriginal and Torres Strait Islanders, and for members of their own communities to become involved in dental careers.  A scholarship and accommodation assistance scheme for dental assistants in the first instance, and later for dental therapists, is therefore proposed. 

ACTION

· Establish extra BDSc places for at least 25 students per year

· Implement a rural student scholarship scheme ($30,000 each) for up to 10 candidates who agree (and are bonded) to work in rural and remote areas (a dental intern plan) for at least one year

· Aboriginal dental assistant scholarships and accommodation support

· Fund a mentorship project officer and promote mentor arrangements for new graduates

NB  All costings s.t.c.

$5m

$0.3m

$0.3m

$0.2m

ORAL DISEASE PREVENTION

· Oral diseases are almost all preventable, and reduction of the demand for dental treatment is best achieved in the long term by preventive and early intervention strategies.

· This requires a long range view of policies and initiatives designed to have greatest impact on the oral health of the community e.g. fluoridation, oral hygiene and dietary measures.  It also requires an approach which urges individuals to accept personal responsibility for their own health, and to avoid behaviour that will lead to disease and the need for treatment

· Hospital admission rates for dental conditions are amongst the top five ambulatory care sensitive conditions in rural Victoria.  This means that amongst the causes of hospitalisation that shouldn’t be necessary, dental conditions were very prominent.  Data on hospital admission rates for 0-4 year olds shows that 90% of these admissions are due to high levels of dental decay.  (Department of Human Services 2001).  The data also showed that rural areas (usually unfluoridated) have higher rates of decay and higher rates of hospital admission due to dental conditions.  The 2002/03 ACSC update reveals that dental conditions were a more frequent cause of hospitalisation than angina, asthma and congestive cardiac failure.

· Annual checkups for children and residents of aged care facilities are a key element in effective disease prevention.  Currently, neither group receives anything like this level of support.

ACTION 

Oral Health Promotion

· Extend the Oral Health Promotion Strategy until 2010, and increase the profile of oral disease prevention messages using popular media

NB  All costings s.t.c.

$5m

Preschool

· Provide all preschool children with free dental examinations and oral hygiene instruction 

$7m

Gerodontics / Special Needs

· Domiciliary vans and associated teams provided to support treatment for those in residential care or unable to attend clinics in both rural and metropolitan areas

· Facility fee negotiated with the Commonwealth for mobile services provided to residential aged care facilities

$2m

$1m

School Dental Services

· Increase staffing levels and treatment funding to permit all eligible primary school children to receive annual checkups and treatment as required

$20m

FUNDING and ACCESS

· Some progress has been made in reducing waiting times, but there are still large numbers who are waiting an average of 2 years for treatment, with many rural patients waiting up to 5 years!

· As at December 2005 (the latest Departmental figures available publicly) waiting times for public dental treatment in the region were

o Ballarat - 53 months; Maryborough – 42 months; Horsham - 49 months; Daylesford – 35 months

· Other regional areas with worse waiting times include:

o Moe – 64 months; Sale – 59 Months; Warrnambool – 60 months; Portland – 66 months

· The consequence of these extended delays is that treatment needs that could be addressed by simple restorative measures become much more complex, or worse, become so extreme, that extraction or hospitalisation is required.

· The 2006/07 State Budget increased dental funding by only $3.5m, which in a total budget of $126m will barely keep pace with inflation.

· Projected waiting times for general dental care in the State Budget 2006/07 remain an average of 24 months as at June 2007, down only one month from December 2005.

· Insufficient numbers of both public and private sector dentists are available in regional areas.

· The cost of public dental treatment is generally borne by the States, although the Commonwealth argues that they provided an unidentified amount to the States that was intended for use on dental services.  Whilst the Commonwealth seems unlikely to change its view about a national scheme, it may be willing to consider enhanced funding for special needs groups, and we therefore urge the parties contesting the Victorian State election to seek special purpose Commonwealth grants for specific target groups e.g. rural children, people in residential care, koori communities.

· The mobile dental vans used for the School Dental Service include units that are well over 20 years old.  Upgrade and replacement plans need to be implemented urgently for these units.

ACTION

· Earmark additional funding for dental treatment. Reduce the waiting list from an average of 24 months (as at December 2005) to less than 12 months by funding an expanded voucher scheme to allow private sector dentists to assist in treatment of public patients.

· Increase the annual cap for each eligible person’s publicly funded care from $600 to $700, and ensure that voucher rates reflect the costs of service delivery

· Fund an outreach project to deliver dental treatment and oral health promotion programs to indigenous communities in Victoria

· A more rapid program of van replacement is required to provide suitable treatment facilities for eligible children throughout the State.

NB  All costings s.t.c.

$30m p.a.

$10m

$1m

$2m

WORKFORCE EDUCATION AND TRAINING

· All parts of the dental workforce are experiencing shortages, especially in rural and regional areas.  This is a problem of both overall numbers, and distribution, with a higher ratio of dental care providers to the population in metropolitan areas. 

· Given the long lead times to produce graduates, policy decisions need to be taken addressing medium and long term targets, with a view to ensuring that the Australian community has access to the workforce required to meet its oral health treatment needs.

· Recent Commonwealth announcements regarding additional training places excluded Victoria, with most extra places being earmarked for NSW and Queensland.

· Graduate entry plans at The University of Melbourne, which is currently the only dental school training dentists in Victoria, may add two years to the time taken for a student to complete a registerable dental qualification, and will also significantly increase the cost of obtaining a dental degree for those not provided with a Commonwealth Supported Place.

· HECS fees for Bachelor of Dental Science (BDSc) courses are in the highest band, with candidates in 2006 being charged $8170 p.a. or a total of $40,850 for the 5-year degree.

· Current higher education policy allows up to 35% of the undergraduate population to be full-fee paying.  The projected annual cost of a full-fee place in 2007 is $33,100 at undergraduate level - a total of $165,500 for the 5-year course (without taking living expenses into account). 

· These high fee levels act as a disincentive to prospective students and to new graduates seeking employment in the public sector, as it tends to encourage them to not only work in the private sector but to seek high incomes in order to more quickly eliminate their significant debts.

· We therefore urge the parties contesting the 2006 State Election to implement measures designed to attract at least an extra 25 students (especially from rural backgrounds) to study dentistry each year.

· This plan should be further augmented by a scholarship scheme which bonds students to a year of public sector employment in an area of rural need for each year of scholarship benefit provided.

· There is also a need for culturally sensitive handling of the treatment needs of Aboriginal and Torres Strait Islanders, and for members of their own communities to become involved in dental careers.  A scholarship and accommodation assistance scheme for dental assistants in the first instance, and later for dental therapists, is therefore proposed. 

ACTION

· Establish extra BDSc places for at least 25 students per year

· Implement a rural student scholarship scheme ($30,000 each) for up to 10 candidates who agree (and are bonded) to work in rural and remote areas (a dental intern plan) for at least one year

· Aboriginal dental assistant scholarships and accommodation support

· Fund a mentorship project officer and promote mentor arrangements for new graduates

NB  All costings s.t.c.

$5m

$0.3m

$0.3m

$0.2m