Bryce Edwards: Political Roundup – Is it time for Labour to introduce public dental care?

Bryce Edwards: Political Roundup – Is it time for Labour to introduce public dental care?

Dental care is out of the financial reach of a large proportion of our population. At the moment about half of the public put off trips to the dentist due to the burden of paying in a private system.

With the Labour Government currently struggling to enact a programme of transformation, risking the loss of its traditional working class constituency, perhaps it’s time for it to introduce their promised free dental care for adults. Health Minister Andrew Little could fold dental services into the public health system, fixing the historic anomaly in which dentistry has been treated as separate from the rest of the health system.

Such a merger would cost Grant Robertson’s Budget a hefty amount, but making dental care universally available would be of immense benefit to poor and ordinary New Zealanders. This could be seen as something of a reward for the hard work in carrying the country through the Covid crisis, and as some sort of partial justice to balance the explosion of inequality that has resulted from Covid policies. It is estimated that about $1 trillion has been transferred to the wealthy in the last two years.

Such a transformative policy would be a true legacy for this Government, which must be looking especially attractive now, as the likelihood of Ardern’s administration being a two-term government increases. Covid aside, Labour and Jacinda Ardern have nothing much else for the history books.

In fact, making adult dental visits free is Labour Party policy – it was adopted by the party in 2018. Since then, the various ministers of health and the Prime Minister have dragged their feet, seemingly embarrassed by the lack of progress in implementing the policy. At the last election, Ardern said that it would be too expensive, saying “We need to prioritise” blaming the cost of the pandemic.

At the same time the Government fought to keep the estimated cost of better public dental care secret. There was an attempt to bury a Ministry of Health report which showed that full universal dental care would cost $648 million a year. The report also indicated that if the Government simply extended free dental care for children until the age of 28, the cost would be only $96 million.

Instead, Labour promised that, if it was re-elected, emergency dental grants for beneficiaries would be increased from $300 to $1000. Even this has not been implemented.

The health portfolio has shifted from David Clark to Chris Hipkins to Andrew Little, and each new health minister has to make excuses for not fixing a historic anomaly that is causing serious damage to New Zealanders’ health.

And the crisis is getting worse. There are continued reports of skyrocketing emergency admissions to hospital of people who can’t afford to see the dentist for minor problems that turn into major ones. Last year, more than 6000 people went to hospital emergency departments for problems that should have been fixed earlier by a dentist.

A New Zealand Medical Journal study released last week showed that nearly one per cent of emergency department patients turn up because they can’t access dental care, and that this is putting a strain on ED resources.

The notion of public dental health has also just received a push with the publication this week of a cover story in the April edition of North & South titled “The Shocking State of Dental Care, by Helen Glenny. You can read an 800-word preview of this online.

This must-read article explains that when New Zealand’s public health system was established, lobbyists for the private dental sector successfully pushed the Government to exclude dentistry from the system, so that they could carry on without competition. The compromise was to only fund public dental care for those under the age of 18.

The article argues that “Dental care in New Zealand is the gaping abyss in our health system.” It interviews dental health scholars who say free dental care for children has had a remarkable impact on lowering dental inequality. Prof Jonathan Broadbent at Otago University is quoted saying: “By the age of 26, a few short years after a publicly funded system finishes, [the inequalities] open up, and they open up really wide.”

Researchers say there are large returns to be made from government investment in public dental care. For example, according to Glenny’s North & South article, the New Zealand Dental Association calculates “the government could expect $1.60 returned on every dollar spent. This would come from savings to DHBs by reducing oral health issues that have to be treated in hospitals – as well as the tax revenue from increased productivity, given the impact of dental problems on employment.”

Meanwhile, a 2018 recent study shows “dental inequality” in New Zealand is worse than in comparable countries such as Australia, Canada and the United States.

So is it time to get rid of the user-pays system, and bring it under the public hospital system? It would certainly be popular. A recent Colmar Brunton survey showed that 64 per cent of the public backs free dental care.

The public are very happy to pay taxes for other parts of the welfare system to be universal – especially other elements of primary health care – and they would surely welcome transformation in this area when Andrew Little carries out his health reforms.


Further reading on dental health care

Background reading:
Bryce Edwards (Newsroom): Time to campaign for free universal public dental care
Bryce Edwards: Political Roundup: Pulling teeth – the fight for free dental care
Bryce Edwards: Political Roundup: The missing election policy on free dental visits
Zac Fleming (Newshub): The estimated cost of extending free dental care to adults revealed

New reading:
Helen Glenny (North & South): The Shocking State of Dental Care (preview)
Rachel Moore (Stuff): Dental difficulties driving people to Waikato Hospital’s emergency department, study shows


Other items of interest and importance today

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Rachel Smalley (Today FM): Learning from COVID : Why there must be a Royal Commission of Inquiry into our response
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Derek Cheng (Herald): Why vaccine mandates aren’t needed – and vaccine passes should be gone within weeks (paywalled)
Vaccine mandates and passes were extremely useful during the wave of Delta, but as Omicron passes its peak they can rolled back.

Jason Walls (Newstalk ZB): Cost of living to dethrone Covid as the most important issue to Kiwis
Back in October surveys showed that 32% of the public thought Covid was the most important issue facing New Zealand, and only 1% thought it was cost of living. Now both are on about 7%, and the “economy” is on 16%.

Chris Trotter (Daily Blog): Democracy’s a drag
The public’s view of democracy has been steadily tarnished over recent decades, and Chris Trotter reviews why this has occurred and where it might take us.

Emile Donovan (RNZ): Teaching Aotearoa’s history
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Simon Wilson (Herald): 7 big things I’d like to see in Grant Robertson’s budget(paywalled)
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Phil Pennington (RNZ): ‘No transparency’ on DHBs’ contractor spending
About half a billion dollars is spent on contractors in the public health system, but research shows that there are some “big holes and major discrepancies” in how this spending is reported.

Jane Patterson (RNZ): Where are the promised inquiries into the Parliament protest?
RNZ’s political editor reports on the different views on who should be reviewing the recent unprecedented protest outside Parliament and how it was handled by authorities.

Ben Strang (Stuff): Faces of a protest: Who were the 250 Kiwis arrested at the Parliament occupation?
A useful profile of the type of people that were at the Parliamentary Grounds protest, suggesting it “represented a broad cross-section of Kiwi society”, with a central focus being the people who had lost their jobs.

Cherie Howie (Herald): Parliament protesters speak about their experience
Interviews with protestors, and their observations of the protest that contrasted with how the media presented the event.

Virginia Fallon (Stuff): The Long Road Back: How can New Zealand mend the mandate pain?
A discussion of the rifts and polarisation in society caused by Covid and Government measures. The big question is how do we recreate social cohesion?

Glen Scanlon (Stuff): Racist and cultural insults offend us most
The chief executive of the Broadcasting Standards Authority reports on survey evidence showing a significant decrease in public tolerance for racial and cultural insults.

Chris Trotter (Interest): Holding National together
How can National deal with its very different factions of social liberals and conservatives?

Danyl McLauchlan (Spinoff): On Too Much Money, a book about what divides us
There’s been a shift back to concerns about class and inequality. Danyl McLauchlan reviews Max Rashbroke’s latest publication on wealth: “Too Much Money”.

Graham Adams (The Platform): Next stop for co-governance – science and universities
Should universities and Crown Research Institutes be run in partnership with iwi?