VOHA has just completed its Submission to the Victorian Budget. Its proposals focussed on:

• a short-term recovery program for adult care by
  • funding a catch-up program in community clinics of $42million to treat an extra 92,000 Victorians in 2022/23 as a first step in future investments

• facilitating changes in the medium term to enable greater focus on prevention,
  • enabling different value-added and preventive models of care to be included in the DWAU formula for care provided by community health clinics

You can read VOHA’s Budget Submission HERE.

Good oral health is important for general health and wellbeing and the impact of oral disease places a considerable burden on individuals, families and the community.

Our position paper outlines the two major initiatives that VOHA believes are required to improve access to oral health care for both older Australians and for disadvantaged adults more generally in Australia. These are:

• Establishing a Seniors Dental Benefits Scheme as a matter of urgency to make oral health/dental care more accessible to all older Australians, as recommended by the recent Royal Commission into Aged Care Quality and Safety.
• Providing a sustainable long-term funding model with the state/territory public dental services for disadvantaged and vulnerable adults.

VOHA’s position paper can be accessed below.

Consumer experiences of the long waiting lists

A couple of (many) stories provided by Community Information and Support Victoria of the impact of long waiting lists for oral health care in Victoria.

‘I have had a 72 year old who endured much before finally being placed on the waiting list for Periodontics at the Dental Hospital. Being accepted at all was a great feat and took over six months. Been on the waiting list now for 2 years and 2 months…believes she will have lost her remaining teeth by the time she is eventually seen. No one will tell her when. Cost of local Periodontist appointment – $500 approx for 1st appointment. Subsequent appointments are around $300 – $400. Not feasible on an Age pension.’

(One wonders if he/she would have been in this situation if regular timely care was available at the local community clinic).

And on the impact of waiting for years ….

Economic evaluation of the aged care oral health program -Senior Smiles

An economic evaluation of an oral health hygienist program in aged care facilities showed a significant cost-benefit $3 – $5 for every dollar spent.

The Senior Smiles model of care provided residents with preventive oral hygiene care, referral pathways for complex dental treatment needs and established a formal management programme for ongoing oral health care within the RACFs. A qualified dental hygienist undertook a 24-week oral hygiene intervention in five residential aged care facilities In Central Coast, NSW, to test the model of care. An evaluation concluded that the Senior Smiles model of care was both successful and transportable. [1]

Further, a cost-benefit analysis of Senior Smiles and another UK oral health Improvement program showed both would create overall savings to their health systems.

• Over a three-year period the Senior Smiles project would generate a cost saving for the healthcare system of $3.14 for every $1 spent.
• Over a five-year period, the Mouth Care Matters project (UK) would generate £2.66 in cost savings, within the healthcare system, for every £1 spent.

These evaluations were instrumental to enable a national rollout for Mouth Care Matters in the UK, and a public endorsement of Senior Smiles.[2]

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[1] Wallace JP, Mohammadi J, Wallace LG, Taylor JA. Senior Smiles: preliminary results for a new model of oral health care utilizing the dental hygienist in residential aged care facilities. Int. 2016;14(4):284-288. 

[2] Jessica Mann et al, Cost-Benefit Analysis of Two Oral Health Improvement Programmes, Community Dent Health, 2021 Feb 25;38(1):26-32

2021 Snapshot

In 2021 VOHA successfully:

• Gathered and analysed new Victorian waiting list data for January – June 2020 and June – December 2020
• Developed a one minute video for World Oral Health Day to shine a light on oral health in residential aged care
• Met with Victorian Health Minister the Hon. Martin Foley to discuss the impact on COVID-19 on oral health services 
• Ran a successful Dental Health Week webinar event co-hosted by the University of Melbourne Dental School
• Distributed a media release on the Federal Budget
• Promoted new ideas via our Innovation video statements
• Meet with Dental Health Services Victoria (DHSV) CEO Sus McKee
• Launched a position paper for the 2022 federal election
• Held eight VOHA meetings
• Published four VOHA newsletters 
• Met with key Victorian MPs including
  • Josh Bull MLA
  • Pauline Richards MLA
  • Louise Staley MLA
  • Tim Read MLA
• Met with key Federal MPs and Senators including:
  • Senator Jordan Steele-John
  • Rebekha Sharkie MP
  • Peta Murphy MP
  • Maria Vamvakinou MP
  • Joanne Ryan MP
  • Julian Hill MP
  • Ged Kearney MP
  • Andrew Giles MP
  • Kate Thwaites MP
  • Anthony Byrne MP
  • Helen Haines MP
  • Brendan O’Connor MP
  • Emma McBride MP
  • Clare O’Neil MP

2022 Snapshot – advocacy activities

VOHA activities in early 2022 include:

• Meeting with Federal MPs
• Continuing to run regular VOHA meetings with the next meeting scheduled for 1 February 2022
• Running another World Oral Health Day event with Victorian MPs (late March 2022)
• Quarterely VOHA Newsletters 
• Meeting with Minister the Hon. Martin Foley MP
• Meeting with DHSV CEO Sue McKee 

Federal Advocacy

VOHA has now met with 14 Federal MPs (and/or their advisors) in the last three months, in advance of the 2022 Federal election.

We have been advocating for two key policy positions:

Establish a Seniors Dental Benefits Scheme

• As a matter of urgency, make oral health/dental care more accessible to all older Australians on Health Care Cards, as recommended by the recent Royal Commission into Aged Care Quality and Safety. Estimated cost $2.84 billion over the first three years.

Provide a sustainable and higher-level long-term funding model for adult care

• Replace annually agreed National Partnership Agreement with an ongoing model of funding (as per hospital agreements) to state/territory public dental services. Increase Commonwealth contribution to meet the planned Gillard Government spending levels, i.e. increase from current $108m to $416m pa, and increased annually by CPI, reviewed every three years.

 You can access our full Position Paper here.

We have provided MPs with key oral health data relevant to their electorate as well as background data – we have provided an example of this information for electorates in New South Wales and Victoria.

Overall the response has been positive, with all MPs understanding the significance of the issues. It is clear that oral health is unlikely to be a frontline issue in the election campaign itself  (except for the Greens), but MPs have indicated there is a reasonable chance that should they win government action could be taken within the government’s term.

MPs we have met (or * if advisors instead) include:

• Senator Jordon Steele-John, WA, Greens, Health Spokesperson    
• Rebekha Sharkie MP, Mayo, SA, Central Alliance,  
• Peta Murphy MP, Dunkley, Victoria, ALP
• Maria Vamvakinou MP, Calwell, Victoria, ALP
• Joanne Ryan MP, Lalor, Victoria, ALP
• Julian Hill MP, Bruce Victoria, ALP
• Ged Kearney MP, Cooper, Victoria, ALP, Shadow Asst Minister for Health and Ageing
• Andrew Giles MP, Scullin, Victoria, ALP, Shadow Minister for Cities, Multicultural, etc
• Kate Thwaites MP, Jagajaga, Victoria, ALP
• Anthony Byrne MP, Holt, Victoria, ALP
• *Helen Haines MP ,Indi, Victoria, Independent
• *Brendan O’Connor MP, Gorton Victoria, ALP, Shadow Minister Defence
• *Emma McBride MP, Dobell, NSW, Shadow Minister Mental Health ALP
• *Clare O’Neil MP, Hotham, Victoria, Shadow Minister Senior Australians & Aged Care

Victorian Advocacy

In the last three months, VOHA has had both its six-monthly meeting with the Minister for Health, the Hon. Martin Foley, and its quarterly meeting with DHSV CEO, Sue McKee. Further, VOHA has just completed its Victorian Budget Submission for the 2022-23 financial period. Our budget proposal focusses on:

• a short-term recovery program for adult care by
  • funding a catch-up program in community clinics of $42 million to treat an extra 92,000 Victorians in 2022/23 as the first step in future investments
• facilitating changes in the medium term to enable greater focus on prevention,
  • enabling different value-added and preventive models of care to be included in the DWAU formula for care provided by community health clinics

You can read our Budget Submission HERE.

The Victorian Council of Social Services (VCOSS) has generously agreed to include VOHA’s recommendations in the VCOSS Budget Submission.

Primary health care services for people with an intellectual disability

Western Victoria Primary Health Network (WVPHN) is launching an important project called ‘Supporting People with an Intellectual Disability to Access Health’ (SPIDAH) project. The SPIDAH project is based in Western Victoria and will end on 30 June 2024.

The SPIDAH project represents Western Victoria PHNs pilot of the Primary Care Enhancement Program (PCEP) to learn, develop and trial activities to improve access to primary health care services for people with an intellectual disability. We are in collaboration with the Council for Intellectual Disability (CID) and the Department of Health for this project. An external evaluation will take place at the end of the 3 years, and those activities that are evidence-based and proven to be successful are intended to be rolled-out nation-wide.

We are requesting our community in western Victoria to share their experiences, thoughts and ideas through these surveys, which ask:

• What is good and working well.
• What is difficult, challenging or not working well.
• What can be done to make primary health care more accessible for people with an intellectual disability.

The surveys are available at www.westvicphn.com.au/spidah

(ACE Oral Health Prevention)

Unlike medical and other primary healthcare services, which are  funded under Australia’s public health insurance system, Medicare, 58% of the expenditure for dental services are largely borne by individuals. Dental care remains in principle, an individual responsibility and excluded from universal healthcare coverage.

From an Australian context, there is limited research to inform public policy directions for translating and implementing interventions to improve population oral health. Despite technological advances, dentistry remains treatment-dominated and highly specialised healthcare, and has not successfully tackled the global burden of oral disease.

The Assessing Cost-Effectiveness on Oral Health Prevention Interventions (ACE Oral Health Prevention) is a PhD funded research project by the National Health and Medical Research Council (NHMRC). Using a priority-setting approach, the first of its kind in Australia (perhaps internationally), leverages on the expertise of key stakeholders from an established Project Steering Group (PSG).

The PSG is an integral component of ‘due process’ since it sets the research agenda according to the ACE framework. Members includes representatives from the professional associations, academics and consumers perspectives (e.g. includes Tony McBride, Chair of VOHA). The PSG provides strategic direction, technical advice and leadership throughout the life of the project.

The PSG met twice in 2020, and have agreed on the following prevention interventions for full economic evaluation modelling:

• Oral health promotion (OHP), which includes anticipatory guidance, risk assessment, dental screening and referral, provided by primary care providers with/without fluoride varnish.
• Implementation of a sugar-sweetened beverages (SSBs) tax.
• Targeted pre/school-based dental screening with/without fluoride varnish.
• Targeted school-based fissure sealants.
• Minimally Invasive Dentistry (MID) (early detection and risk assessment, regular monitoring and preventive interventions).
• Tobacco cessation services (individualised).

For more information, please contact the PhD Candidate, Tan Nguyen from Deakin Health Economics at tan.nguyen@deakin.edu.au.

Recently, VOHA asked some of Victoria’s public dental care providers how they would reduce dental waiting lists if they had more resources – find out what they had to say HERE. The Dental Health Week event was followed by the discussion from our expert panel chaired by Professor Nancy Baxter, Head, Melbourne School of Population and Global Health.
The expert panel included:

Mr Tony McBride – Chair Victorian Oral Health Alliance
A/Prof Matthew Hopcraft -CEO Australian Dental Association Victorian Branch
Mr Tan Nguyen -Deakin Health Economics, Institute for Health Transformation, School of Health & Soc. Dev., Faculty of Health, Deakin University
Dr Ramini Shankumar – Director of Dental Services, Monash Health
Dr John Rogers – Past Principal Oral Health Policy Advisor in the Victorian Department of Health
Sandra Anderson – Member of the Community Advisory Committee of Dental Health Services Victoria

This webinar was co-hosted by the Victorian Oral Health Alliance and the University of Melbourne Dental School. Our panel explored innovative approaches to managing Victoria’s unmet oral health needs.

Given that the State Government has recently allocated a sum to public dental care for innovative approaches to reducing dental waiting lists, VOHA has been active in promoting some early thinking about possible approaches.

We sought short video statements from interested services and others about which innovations could work at either a State or local service level. These 3-minute videos was shared in the Dental Health Week event.

VOHA hopes this will stimulate further ideas and also be useful to the Department of Health and DHSV as they develop the aims and processes for utilising the yet unannounced new innovation funding.

Watch our video below