Review of Australian Government Health Workforce Programs

Appendix v: History of Commonwealth investment in the dental and allied health workforce

Page last updated: 24 May 2013

Historically, Commonwealth funding for the dental and allied health workforce has focused on expanding the eligibility of benefits (predominantly through access to Medicare) for certain health procedures and services. There has also been an emphasis on education and training support for these disciplines through various scholarship schemes. The majority of the scholarship schemes and the education and training support programs have had a combined health discipline approach rather than specifically targeting individual allied health and/or dental disciplines. As such, dental and oral health disciplines are supported through many of the schemes and programs listed in the allied health table below. Many of the scholarship schemes and education and support also have a rural and remote and/or Aboriginal and Torres Strait Islander focus (further information on education and training support is at Chapter 3).

In addition to expanding the scope of benefits and support for education and training programs, the Commonwealth has provided direct funding to jurisdictions to assist with service delivery, particularly in regards to dental services. This investment has coincided with the allocation of Commonwealth funding for infrastructure and capital works projects to assist with service delivery, as well as funding to support clinical placements. This funding has not only been in the form of direct funding to jurisdictions but also in broader DoHA infrastructure funding rounds and programs such as the University Departments of Rural Health (UDRH) program (refer to Chapter 4).

More recently the Commonwealth has allocated funding for specific dental workforce initiatives with an aim of enhancing and distributing the dental workforce, particularly in the public sector and rural/remote locations. These programs are in the early stages of implementation or are due to commence in 2013-2014.

Below is a table outlining various Commonwealth initiatives that have influenced the supply and distribution of the allied health and dental workforce. The various funding rounds that assist with service delivery and the health workforce are not included in the table below (for further details on DoHA funding rounds refer to Chapter 9).

Dental/oral health
Time period
Policy drivers
Policy and program activity
1970s
1973 -1980sBuilding dental service capacity for Australian children Australian School Dental Program
Under the supervision of dentists, dental therapists provided dental treatment for all Australian school children up to the age of 15 years.
1980s
From1981Benefits for dental services The Commonwealth provided benefits for orthodontic services for young patients with cleft lip or cleft palate conditions since 1981.
From 1984Medicare benefits for dental services Since the introduction of Medicare in 1984 the Commonwealth has provided benefits for various surgical procedures (performed by dental surgeons) to treat diseases of the oral cavity and jaw.
2000s
2004 – 2007Medicare benefits for patients with chronic conditions. Strengthening Medicare package
Allied Health and Dental Care Initiative (AHDCI)
Medicare benefits for particular dental services to treat patients with chronic conditions were introduced. A referral from a General Practitioner and an Enhanced Primary Care plan was required to claim rebates.
2007 -2012 - 2007-08 Budget
Dental benefits for people with a chronic condition and complex care needs.
The Medicare Chronic Disease Dental Scheme (CDDS)
The CDDS provided up to $4,250 in Medicare benefits over two years to patients with a chronic disease and complex care needs. The CDDS covered a comprehensive range of preventative and treatment items. Residents of aged care facilities (that were managed by a general practitioner) were eligible for benefits.
2007Enhance dental clinical training in rural areasDental Training Expanding Rural Placements (DTERP) is now a component of the RHMT program.
DTERP provides longer-term rural clinical placements for dental students studying at six universities throughout Australia. Capital funding to establish training sites has been provided to participating universities.
2008Preventative dental care for teenagers aged between 12 and 17 years.
Medicare Teen Dental Plan
Eligible families have access to vouchers (up to $150 each year) to assist with dental check-ups for teenagers aged between 12 and 17 years.
A new standalone Dental Benefits Schedule that includes means-tested, age restricted Medicare benefits for the preventative dental check for teenagers was also developed as part of this initiative
2010COAG 2006
Ensuring safe practice standards for the public.
National Registration and Accreditation Scheme
Dentists, dental hygienists, dental therapists, dental prosthetists and oral health therapists are all included under the scheme
20122011-12 BudgetNational Advisory Council on Dental Health
Time-limited group to provide strategic, independent advice to the Government on dental health issues. A report was provided to the Minister for Health and Ageing in 2012.
20122012-13 Budget
Reducing the public dental waiting list
National Partnership Agreement on Treating More Public Dental Patients
Funding to be provided to jurisdictions to treat patients on public dental waiting lists
20122012-13 Budget Funding for the National Oral Health Promotion activities
20122012-13 BudgetSupport for private dentists’ pro bono work
20132011-12 BudgetVoluntary Dental Graduate Year Program (VDGYP)
The VDGYP provide up to 50 dental graduates each year, with a structured program for enhanced practice experience and professional development opportunities, whilst increasing the dental workforce capacity in the public dental system and other areas of need. The first cohort of graduates commenced their placements in January 2013.
20142012-13 Budget
Building the dental workforce capacity
Expansion of the VDGYP from 50 to up to 100 placements each year. Additional placements are due to commence in 2015.
20142012-13 Budget
Building the oral health workforce capacity
Oral Health Therapist Graduate Year Program (OHTGYP)
Similar to the VDGYP, the OHTGYP provides participating oral health therapist graduates with a structured program for enhanced practice experience and professional development opportunities, whilst increasing the oral health therapist workforce capacity. The first cohort of placements commence from early 2014.
20142012 Dental Health Reform CommitmentGrow Up Smiling
Grow Up Smiling will replace and expand the former Medicare Teen Dental Plan. Under Grow Up Smiling eligible children aged between 2-17 years will have access to dental benefits of up to $1,000 over two calendar years for basic prevention and treatment services. Grow Up Smiling will commence on 1 January 2014.
20142012 Dental Health Reform Commitment National Partnership Agreement on Adult Public Dental Services
Additional funding to be provided to the states and territories from 1 July 2014 to expand dental services for adults in the public system.
20142012 Dental Health Reform CommitmentThe Flexible Grants Program
Under the Flexible Grants Program a total of $225 million will be provided from 2014 for dental infrastructure (both capital and workforce) in outer metropolitan, rural and regional areas to assist in reducing access barriers for people living in these areas. The grants may also be used for targeted programs to address other gaps in service delivery.
Allied Health
Time PeriodPolicy DriversPolicy and Program Activity
1970s
1975MBS accessOptometrist access to the MBS, limited to a range of restricted items.
1990s
19971997-98 BudgetServices for Australian Rural and Remote Allied Health (SARRAH) established through consolidation of various rural programs.
1999MBS access and chronic disease management. Enhanced Primary Care package

Included new items for medical practitioner involvement in multidisciplinary case conferencing and care planning for people with chronic and complex needs.

2000s
2000Third Community Pharmacy AgreementThe Rural Pharmacy Workforce Programs and the Aboriginal and Torres Strait Islander Pharmacy Workforce Program were introduced under the Third Community Pharmacy Agreement, commencing 1 July 2000. The programs comprises a range of elements which aim to maintain and improve access to quality private sector community pharmacy services in rural communities, and strengthen and support the rural pharmacy workforce in Australia.
2001Promotion of team care arrangements.The Better Outcomes in Mental Health Care program was introduced.
2001Rural health disparities.More Allied Health Service program established to help rural communities gain better access to allied health services.
2002Building Indigenous health workforce capacity.The Puggy Hunter Memorial Scholarship Scheme inaugurated.
2003Building Indigenous health workforce capacity.Australian Rotary Health Indigenous Health Scholarship Program commenced.
2004Medicare benefits for patients whose chronic conditions.Strengthening Medicare package - Allied Health and Dental Care Initiative (AHDCI)

This package included items for allied health services provided to patients with chronic disease management plans. It also included particular dental services (see dental table above).

2005MBS accessIntroduction of the Chronic Disease Management (CDM) items, which replaced the Enhanced Primary Care (EPC) multidisciplinary care planning Medicare items for patients with a chronic or terminal medical condition.
2006MBS accessBetter Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule initiative.

Medicare items for GP mental health care plans, consultations on a new patient by a psychiatrist, and rebates for treatment by a range of mental health professionals;

2007MBS accessAllied health items for group services to patients with type 2 diabetes when they are managed by their GP under a GP Management Plan
2008Creation of the Office of Rural Health in response to the findings of the Audit of Health Workforce in Rural and Regional Australia.Rural Primary Health Services (RPHS) program commenced, incorporating the More Allied Health Services program.
2008MBS accessThe Helping Children with Autism initiative

Introduced new allied health items for a psychologist, occupational therapist or speech pathologist to assist with diagnosis and provide treatment services.

2008Building Indigenous health workforce capacity.The incorporation of Indigenous Allied Health Australia Inc. was preceded by a 12 month project to establish the Indigenous Allied Health Network, which was funded by the from July 2008.
2009The Rural and Remote Health Programs Reform Strategy and the 2009-10 Budget process consolidatingThe Rural Health Multidisciplinary Training (RHMT) program was established.
2010Consolidation initiative 2010-11 Budget.Nursing and Allied Health Scholarship and Support Scheme (NAHSSS) commenced.
20102010-11 Budget Nursing and Allied Health Rural Locum Scheme (NAHRLS) created.
2010COAG 2006

Ensuring safe practice standards for the public.

National Registration and Accreditation Scheme commences for a limited number of allied health disciplines.
2011MBS accessThe Better Start for Children with Disability initiative introduced:
  • amendments to existing allied health items for a psychologist, occupational therapist or speech pathologist to assist with diagnosis and provide treatment services for children with an eligible disability;
  • new items for audiologists, orthoptists, optometrists and physiotherapists to assist with diagnosis and provide treatment services for children with an eligible disability.

Amendments to the Helping Children with Autism program which introduced:

  • new items for audiologists, orthoptists, optometrists and physiotherapists to assist with diagnosis and provide treatment services for children with autism or other pervasive developmental disorders.
2012Ensuring safe practice standards for the public. Four further professions joined the National Registration and Accreditation Scheme on 1 July 2012: Aboriginal and Torres Strait Islander health practitioners, Chinese medicine, medical radiation practitioners and occupational therapists.

Source:Parliament of Australia website http://www.aph.gov.au
Department of Health and Ageing website www.health.gov.au