New Zealand Finance Minister, Grant Robertson. Image courtesy of New Zealand Tertiary Education Union.
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Analysis by Dr Bryce Edwards.

Political Roundup: Labour’s decaying policy on free universal dental care

Political scientist, Dr Bryce Edwards.

Grant Robertson has once again ruled out implementing a popular Labour Party policy: free universal dental care. He did so yesterday on RNZ’s Morning Report, citing the cost factor. The Acting Prime Minister suggested that spending on dental care wasn’t a priority for the Government and that the health budget had more important areas for funding.

Robertson’s continued stalling on free dental care essentially contravenes his own party’s policy. At the 2018 annual conference, Labour agreed to implement free universal dental care for all adults – extending that available to those under the age of 18 years. This decision was made when the party was only one year into government. The announcement was greeted with great enthusiasm.

Four years later, Labour’s dental policy seems to be decaying, almost rotten. Behind the scenes, officials have worked on the policy and come up with ways to implement it. But the politicians lack the will to prioritise the spending.

Although Robertson cites a $1bn price tag for universal dental care, there have been suggestions of ways that the policy could be incrementally introduced, beginning with either low-income adults or a younger population. For example, if the Government wanted to start by extending free dental to those up until their 27th birthday, the Ministry of Health has estimated it would cost just $148m, and they have come up with many other ways in which various other groups could be cheaply afforded free dental.

Increased dental funding would be popular

There is no doubt that the policy is extremely popular – with numerous surveys showing that the public wants free dental implemented. A 2020 Colmar Brunton survey showed that 64 per cent of the public backs free dental care. The most recent poll, carried out by Newshub’s Reid Research in May, asked “Do you think the Government should subsidise dental care to make it cheaper for adults to go to the dentist?” 84 per cent say yes.

At the time, the Minister of Health, Andrew Little responded by saying, “It’s an area we need to give attention to at some point” and that “there is a lot of room for improvement” in government funding of adult dental care.

Yet Labour’s shifts on this have been only tiny so far – increasing dental grants available through Work and Income. This is an improvement for those that can access them, but is no substitute for the proper reform promised by Labour.

Universal dental care back is on the agenda

The policy of free universal dental care is back on the agenda after the Association of Salaried Medical Specialists (Toi Mata Hauora)  – the union representing dentists – released a report this week recommending that the free and universal policy be implemented as soon as possible by the Government. The union complained that although Labour had committed to action back in 2018, there has been “radio silence since”.

The union’s report, “Tooth be told”, showed that unmet dental treatment had become so bad that out of 11 comparable countries, New Zealand now fared the worst. The report showed that unnecessary tooth decay is leading to a quarter of million New Zealanders having teeth pulled each year. This is because 40 per cent of New Zealanders can’t afford to go to the dentist. And it’s getting worse – there has been a 31 per cent increase in those needing hospital medical interventions as a result.

Some dentists have been speaking out about this recently. For example, last week Timaru dentist Fraser Dunbar went on TV3’s The Project to describe the heartbreaking job he has of taking out people’s teeth in hospital due to people not being able to afford to go to the dentist.

He says there has been a large increase in people in their 20s needing all their teeth removed. Dunbar said that “it’s not unheard of for him to take out 100 teeth in a morning at the local hospital” and that this includes “three or four patients getting full clearances”.

The release of the report was also supported by the Auckland City Mission (Te Tāpui Atawhai) because the issue relates so clearly to inequality and poverty. Because private dental treatment has become so prohibitively expensive, the problem feeds directly into overall inequality.

According to the report, 42 per cent of adults cannot afford dentist visits. And of course, for some ethnic minorities, it’s much worse – 53.7 per cent of Māori adults and 51.5 per cent of Pasifika don’t access dental care under the current system.

The dental problem is therefore its own “crisis”, and a key part of the overall inequality crisis that the Government is failing to combat. And this “crisis” categorisation was borne out earlier this year when the international website for dental news, Dental Tribune International, reported, “New Zealand’s oral health crisis rages on”. And it’s not just related to the Government’s lack of funding, but also to a declining dental workforce – New Zealand now has one of the smallest per capita dentist and dental specialist workforces in the OECD.

Cheaper to provide full universal dental care

The Salaried Medical Specialists union argues that the Government is misguided in taking a short-term approach of rejecting free, universal dental services on the basis of the price tag. The union says that the opposite is the case – that the price of neglecting this area of healthcare is actually producing greater costs for the taxpayer and society.

The union argues that any large expenditure on dental health will yield significant savings in the longer term. The head of the union, Sarah Dalton, says that by spending on dental care, “there’s a whole bunch of way more serious, way more expensive conditions, health conditions that would disappear”. Alternatively, chronic conditions like cardiovascular disease end up costing much more to deal with down the track.

In fact, the New Zealand Dental Association has carried out a cost-benefit analysis, using Treasury tools, and found that the Government would get back an extra $1.60 on every dollar spent on extended dental care.

The problem, however, for Grant Robertson and Labour is that such wins for the public would be further down the track than the next election, or even the one after that. So, the politicians have clearly done their own cost-benefit electoral analysis and decided not to invest, even if it would be a sensible way to reduce misery and inequality.

In this sense, the unheeded case for free, universal dental care is a clear case study illustrating the decay of the Labour Party as a force for progressive change. Unfortunately, the rottenness in both dental health and politics seems set to continue.

Further reading on universal free dental care

Background reading:
Bryce Edwards: Is it time for Labour to introduce public dental care?
Bryce Edwards: The missing election policy on free dental visits
Bryce Edwards: Pulling teeth – the fight for free dental care
Bryce Edwards: Time to campaign for free universal public dental care

New material today:
RNZ: Single-step move to universal dental care cost-prohibitive – Grant Robertson
Will Trafford (Te Ao – Māori News): Dental access stats worst for Māori; terrible generally
Jayden Holmes (Today FM): Dentist worried too many desperate kiwis pulling own teeth out
No Right Turn: Grant says “no” again

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+ 52 = 57

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