ADAVB Inc. Blog

Branch comments on National Registration Standards

2009-11-25T12:10:00.004+11:00

ADAVB has lodged its submission on the draft national registration standards with the Dental Board of Australia . The Branch generally welcomed most of the proposed arrangements but felt restricted in commenting on some areas because of the lack of accompanying guidelines.

The submission was prepared with the assistance of a number of members who provided comments. Thanks to those members who took the time to offer their considered views.

On the CPD standard, ADAVB suggested that after the first three-year cycle, the infection control requirement of two hours be reduced to two hours in future cycles.

Responding to the scope of practice standard, ADAVB queried how dental therapists, oral health therapists and dental hygienists can “exercise autonomous decision making” while not being independent practitioners in terms of training. Depending on the information to be provided in the guidelines, ADAVB is concerned at the lack of defined duties in this standard and asked the Board to review it in order to avoid uncertainty.

Pay for performance arrangements under consideration

2009-11-24T09:46:00.003+11:00

Another paper published by the Commonwealth Parliamentary Library may have implications for dentists, along with other health practitioners. The paper address the question 'Should we expand the use of pay-for performance in health care?'

According to the Executive Summary "this paper examines the evidence on the impact of P4P schemes in health care. While the evidence is limited and yields mixed results, some experts argue that this should not spell the end for P4P. Instead. they suggest that policy-makers proceed with caution and use the existing evidence to highlight the challenges commonly associated with the use of P4P in health care. Some of the most important challenges are designing a system with:

substantial rewards and targets that are reasonably difficult to achieve;
minimal unintended consequences and incentives to 'game' the system; and
incentives to both the best and worst performers to improve the quality of health care."

Presumably the Parliamentary Library has not produced this paper merely as an academic exercise, and someone in Canberra thinks this is a policy initiative that should be pursued.

Denticare - an overview by the Parliamentary Library

2009-11-23T11:20:00.004+11:00

The Commonwealth Parliamentary Library has prepared an overview of the proposed Denticare scheme.

The 12-page background note outlines the features of Denticare Australia and looks at the responses to the proposal including costs and equity. ADA’s concerns are highlighted along with feedback from various other parties.

Health Ministers announce progress on e-Health

2009-11-13T14:45:00.003+11:00

The Australian Health Ministers' Conference issued a Communique today affirming their commitment to the introduction in 2010 of national healthcare identifier numbers and agreed to release for further consultation draft legislation for establishing the healthcare identifiers.

Ministers considered feedback from the first phase of public consultations held in July-August 2009. Following these consultations and feedback, further work has been done on the identifiers to clarify and strengthen patient privacy. Ministers have now agreed:

the legislative framework will limit the use of healthcare identifiers to health information management and communication purposes as part of delivering a healthcare service;
healthcare identifiers will be underpinned by effective national privacy arrangements, protecting health information wherever it is associated with healthcare identifiers, regardless of whether the information is held by a public or private organisation;
the Healthcare Identifiers Service (HI Service) will have an appropriate governance framework with transparent and accountable processes;
penalties will apply to the misuse of healthcare identifiers; and
to review the implementation of the healthcare identifiers after a period of two years.

According to the Communique, Healthcare Identifiers are unique numbers that will be given to all healthcare providers, healthcare organisations and healthcare consumers. These unique numbers will provide a new level of confidence when communicating patient information between the myriad of private and government healthcare providers and systems. The identifiers are considered an important building block for the eventual introduction of a patient controlled Individual Electronic Health Record.

Members are referred to the CEO's Comments in the September and November editions of the ADAVB Newsletter for further information about e-Health developments affecting dentistry.

The legislation to establish the Healthcare Identifiers will be introduced to the Federal Parliament in the Autumn 2010 sittings.

Consultation re Registration Standards

2009-10-27T20:40:00.003+11:00

The Dental Board of Australia (DBA) published its first Consultation Paper today regarding 'registration standards and other matters'.

These draft standards are proposed to take effect from 1 July 2010, and the DBA is seeking submissions by 24 November 2009. The ADAVB intends making a submission in response and is issuing an Alert! inviting member feedback in the usual manner i.e. bullet point suggestions sent to garry.pearson@adavb.org

The consultation paper covers the following mandatory standards which will apply to all boards and various proposals for standards specific to dentistry.

Mandatory standards

Criminal history
English language skills
Professional Indemnity Insurance
Continuing Professional Development
Recency of practice

Dentistry standards

Scope of practice standard
Dental specialties
Endorsement for conscious sedation

Commentary about these draft standards will appear in the Branch Newsletter and on our website over the coming weeks.

For more information about the progress of the national registration and accreditation scheme go to http://www.ahpra.gov.au/

Sunrise exposes sugar content in soft drinks

2009-10-21T09:04:00.005+11:00

Yesterday's Sunrise program on Channel 7 featured a segment which demonstrated that mini cans of Coca Cola, introduced 'to assist consumers with portion control', still contain 4 teaspoons of sugar, while a 2 litre bottle contains around 40 teaspoons.

The segment promoted drinking water or mineral water in preference to highly sugared drinks.

Members are encouraged to draw their patients' attention to this story as it may help them to make better decisions about their diet and so help to reduce their dental decay. The story is likely to remain online for the next few days before being archived.

DHSV 2009 Annual Report

2009-10-20T12:16:00.006+11:00

Dental Health Services Victoria’s 2008-09 Annual Report has been tabled in Parliament. It shows a decline in adult patients treated but an increase in the number of children treated because of dental health services being provided through local health centres, resulting in greater targeting of high-risk families.

The report also reveals:

a decline in domiciliary patients treated over the last three years

an increase in patients treated in the teaching clinic (this is a reflection of increasing student numbers and greater utilisation of student clinic chairs)

nearly 20% increase in the general waiting list over the course of the year, with almost 326,000 patients treated

about 15% increase in specialist waiting lists (about 6200 patients), but a decline of some two months to just over eight months in waiting time

the ratio of emergency:general care of 46:54 has improved from the last two years.

Blitz to lower Ballarat's waiting lists

2009-10-09T15:57:00.002+11:00

Six dentists from the Ballarat Health Services' dental clinic tomorrow will screen 150 people in an effort to reduce the city’s public dental waiting lists.

They will determine whether the patients can be issued with vouchers to go to private dentists for treatment or, if the work is considerable, for appointments to be made at the clinic.

The work – 1000 extra treatments - is being funded under a State Budget allocation of $350,000 for this financial year and the same amount for next financial year.

Government officials are confident that this “blitz” will reduce the waiting lists.

Department of Health officers will brief ADAVB’s Ballarat members about the project, along with information about the fluoridation of the city’s drinking water, at a meeting next Thursday evening.

Teeth whitening in pharmacies

2009-10-08T13:56:00.002+11:00

Following the recent prosecution of a beauty therapist by the Dental Practice Board of Victoria for carrying out teeth whitening, the Pharmacy Board of Victoria has determined that it may approve teeth whitening conducted within a pharmacy if – and only if – the person carrying out the business or activity is registered as a dental care provider.

If a pharmacist personally carries out teeth whitening or employs someone to do it within or separate from the pharmacy, both the pharmacist and the person actually performing the activity would be liable to prosecution unless they are registered as dental health care providers.
The Pharmacy Board’s advice does not apply to the sale or supply of products that are marketed for teeth whitening.

ADAVB comments on climate change Green Paper

2009-10-02T08:39:00.002+10:00

The ADAVB has called on the State Government to create a positive vision for sustainable health services and reward good practice rather than inaction by adjusting the tax and utility pricing regimes.
Commenting on the Victorian Climate Change Green Paper, the Branch makes a number recommendations including that the Government should make budgetary and logistical provision for the installation of ISO 11 143 compliant amalgam separators in all public dental clinics by 2012. The Branch also urges for the encouragement of other States to follow EPA Victoria and Victorian water authorities to provide rebates for dental practices which install ISO 11 143 compliant amalgam separators.

Magistrate rules against tooth whitening

2009-10-01T09:28:00.004+10:00

A Melbourne beauty therapist has been found guilty of practising dentistry while not being a registered dental care provider.
Sitting at Heidelberg Magistrates’ Court, the magistrate, Ms Crowe, recorded a conviction and fined the beauty therapist $2000.
The Dental Practice Board of Victoria took the action after receiving a complaint from a customer who had undergone tooth whitening. The customer suffered severe mottling of her teeth, marbled teeth, ulcerations to her gums and chemical burns.
Ms Crowe ruled that tooth whitening constitutes an “invasive and irreversible procedure” and that people registered as dental care providers may only carry out tooth whitening.
ADAVB Vice President Dr Anne Stewart welcomed the decision, saying that it would send a clear warning to the public about the dangers of having teeth whitened by non-dentists.

ADAVB submission re National Safety and Quality Framework

2009-09-12T06:48:00.007+10:00

The ADAVB has lodged its latest submission in response to the National Safety and Quality Framework proposed by the Australian Commission on Safety and Quality in Health Care (ACSQHC).

Their website about this initiative states that the Framework "is designed to guide action to improve the safety and quality of the care provided in all health care settings over the next decade." (emphasis added)

"The proposed framework would:

Be used as the basis of strategic and operational safety and quality plans;
Provide a mechanism for refocusing current quality improvement activities, reviewing investments for safety and quality and designing goals for health service improvement; and
Promote discussion with consumers, clinicians, managers, researchers and policy makers about how they might best contribute to safety and quality improvement."

In general the ADAVB considers the Framework to be quite reasonable, with sound concepts and ideas. A few points in the ACSQHC Discussion Paper have raised concerns, and these are informed by the view that office-based practice cannot be asked to meet the same standards as acute facilities or community health centres, with their access to extra administrative personnel to address red tape requirements.

Some points we have argued against, while we believe that other issues raised by the Framework lend strong support to our arguments against certain reforms being advocated in other places e.g. the National Health and Hospitals Reform Commission and the National Health Workforce Taskforce.

Ethical Promotion of Therapeutic Goods

2009-09-09T11:20:00.003+10:00

The Therapeutic Goods Administration will meet with all therapeutic industry associations next week to discuss their restrictive codes of conduct and consider ways to ensure that self-regulation retains public and Government confidence.

The meeting has been called following recent media reports claiming that incentives are being offered to promote the sales of certain medical devices and pharmaceuticals.

Whilst the Therapeutic Goods Act regulates advertisements for therapeutic goods, the professional relationship between companies and healthcare practitioners is governed by industry and professional codes of conduct.

National Preventative Health Strategy Launched

2009-09-01T12:12:00.010+10:00

Federal Health Minister Nicola Roxon launched the National Preventative Health Strategy after a visit to the Peter MacCallum Cancer Centre in Melbourne today.

The Taskforce responsible for the Strategy has made several findings, set a number of what it describes as 'ambitious' targets, and made 35 recommendations and 139 sub-recommendations.

The Government will consider the Taskforce's recommendations alongside those of the National Health and Hospitals Reform Commission. Some of the recommendations, such as the establishment of a National Preventative Health Agency, are already in train.

The Strategy identifies seven strategic directions to ensure a comprehensive approach:
1. Shared responsibility - developing strategic partnerships - at all levels of government, industry, business, unions and the non-government sector, research institutions and communities;
2. Act early and throughout life - working with individuals, families and communities;
3. Engage communities - act and engage with people where they live, work and play; at home, in schools, workplaces and the community. Inform, enable and support people to make healthy choices;
4. Influence markets and develop coherent policies - for example through taxation, responsive legislation, and through coherent and connected policies;
5. Reduce inequality through targeting disadvantage - especially low socio-economic status (SES) groups;
6. Indigenous Australians - contribute to Closing the Gap; and
7. Refocus primary healthcare towards prevention

The action proposal likely to be of greatest interest to the dental community is for a review of economic policies and taxation systems, and development of methods of using taxation, grants, pricing incentives and subsidies to:

promote the production of healthier food products, including reformulation of existing products;
increase the consumption of healthier food and beverage products;
decrease production, promotion and consumption of unhealthy food and beverage products; and
promote healthy weight.

A soft drink tax could generate wide support amongst those seeking to reduce dental decay rates.

Dental Board of Australia membership announced

2009-08-31T10:55:00.005+10:00

The Australian Health Workforce Ministerial Council has announced the membership and Chair of the new national Dental Board of Australia (DBA).

Dr John Lockwood a dentist from NSW (previously President of the NSW Dental Board), will chair the 12 member body.

The Ministers decided that the practitioner members of the DBA would comprise five dentists, one dental therapist, one dental hygienist and one dental prosthetist. This is an improvement over an earlier proposal that would have only seen three dentist members.

The DBA members are as follows:
Ms Susan Aldenhoven - appointed as a practitioner member (dental hygienist) from South Australia
Mrs Jennifer Bishop - appointed as a practitioner member (dental therapist) from Queensland
Dr Carmelo Bonnano - appointed as a practitioner member (dentist) from the ACT
Dr Gerard Condon - appointed as a practitioner member (dentist) from Victoria
Mr Stephen Herrick - appointed as a community member
Mr Paul House - appointed as a practitioner member (dental prosthetist) from Tasmania
Dr Mark Leedham - appointed as a practitioner member (dentist) from the Northern Territory
Dr John Lockwood - appointed as Chair and a practitioner member (dentist) from New South Wales
Mr Peter Martin - appointed as a community member
Mr Michael Miceli -appointed as a community member
Dr John Owen - appointed as a practitioner member (dentist) from Western Australia
Mrs Myra Pincott - appointed as a community member

Induction programs and arrangements for the first meetings of the new national boards are now being finalised so that they can commence in September, and start preparing for the new national registration and accreditation scheme to be operative from 1 July 2010.

Minister Roxon's Speech re e-Health

2009-08-20T14:03:00.004+10:00

Federal Health Minister, Nicola Roxon delivered the opening speech at the Health-e-Nation Conference yesterday, and in that presentation she gave some clues to the linking of Government funding of certain services with the adoption of e-Health systems.

Dental practices will not be immune from these developments, so members interested in understanding the Government's policy directions may wish to read the transcript of the Minister's address.

Training resources for nursing home oral health plan

2009-08-18T11:33:00.002+10:00

One of the first steps to improving the oral care of people in aged care facilities has been taken with the release of a number of training aids for nursing home staff.

These resources are part of the implementation of the Nursing Home Oral and Dental Health Plan announced by the Federal Government last May.

The documents include a facilitator portfolio, staff and professional portfolios, and several posters.

Most children visit dentists regularly - report

2009-08-12T11:41:00.006+10:00

A new dental report from the Australian Institute of Health and Welfare

shows that most children had visited a dentist during the previous 12 months.

The report, Trends in access to dental care among Australian children, covered the period from 1994 to 2005, and showed that at least 4 in 5 children had visited a dentist in the last 12 months with children aged 5–11 years slightly more likely to visit than those aged 12–17.

Between 1996 and 2005, visiting for a check-up, rather than a problem, increased across both age groups, peaking in 2005 at 78% for 5–11 year- olds and 81% for 12–17 year-olds.

A higher percentage of children in families with a health care card and without private dental insurance visited for a problem.

When visiting a dentist, about 8% of 5–11 year-olds had a tooth extracted. Among 12-17 year-olds, prevalence fluctuated between a high of 15% in 1994 to a low of 9% in 2005.

Children who visited for a problem were more than twice as likely to have an extraction as those who usually visited for a check-up.

About 30% of children aged 5-11 years and 25% of children aged 12–17 years had a filling.

Cost was reported by a low percentage of families as a barrier in accessing dental care for children, with the percentage falling over the 1994–2005 period. The report, released today, costs $24.

CRC for Oral Health Science funding renewed

2009-08-07T17:49:00.006+10:00

The ADAVB is delighted to congratulate the Cooperative Research Centre for Oral Health Science on today's announcement that a new round of funding has been provided to permit the centre to continue its world class research.

The announcement of the $31.6M funding was made by Federal Minister for Innovation, Industry, Science and Research, The Hon Kim Carr.

The new CRC, again based at the University of Melbourne, will further the work of the existing CRC for Oral Health Science on the discovery and development of new preventive products and treatments for oral diseases such as caries (dental decay) and periodontitis (gum disease) which currently cost Australians some $6 billion a year. Anti-decay technology developed within the current CRC is already being used in food and drink and oral care products around the world.

Senate Committee reports on national registration Bill

2009-08-06T20:13:00.004+10:00

The Senate Community Affairs Legislation Committee report on the National Registration and Accreditation Scheme (NRAS) was tabled in Parliament today.

The ADA Inc., ADAVB and various other ADA Branches made submissions to this Inquiry, and the federal President and CEO appeared before the committee to present evidence on the proposed legislation.

The 77 page report highlights a range of continuing concerns held by health professions about the legislation, and these are summarised for the benefit of the Parliament. In addition, the committee has made the following recommendations:

that the Australian Health Workforce Ministerial Council fully consider and evaluate the potential usefulness and feasibility of the proposed amendments to clauses 10(3) and 10(4)* of the Health Practitioner Regulation National Law (Bill B), especially those proposed by the Australian Medical Association (AMA).
that the Australian Health Workforce Ministerial Council introduce a requirement into the proposed national registration and accreditation scheme (NRAS) that the reasons for issuing a direction in relation to an accreditation standard be made public.
that the Australian Health Workforce Ministerial Council ensure that the national registration and accreditation scheme (NRAS) contains sufficient flexibility for the composition of National Boards to properly reflect the characteristics and needs of the individual professions.

* These clauses relate to the power of the Ministerial Council to issue a policy direction to a Board in respect of an accreditation standard. Numerous submissions raised concern that this power could change standards in ways that are incompatible with protecting and improving public health and safety. The ADA recommended that clause 10(4) be deleted so as to remove entirely the power of the Ministerial Council to give a direction in relation to an accreditation standard.

The Bill is subject to further amendment as a result of consultative processes administered by the National Registration and Accreditation Implementation Project, and the revised version is due to be presented, initially to the Queensland Parliament, before the end of 2009.

ADAVB submissions regarding the NRAS proposals can be found here.

Dental Health Week's online health check

2009-08-03T11:07:00.004+10:00

Dental Health Week, now underway, is focusing on the general health of people aged over 55.

As part of this oral health campaign, the public are being advised that dentists - by looking inside mouths - can provide a snapshot of their overall health.

To further help people, the ADA has developed an easy self-check test which can assist in the detection of conditions such as diabetes, cardiovascular disease, oral cancers and even Alzheimer’s and Hodgkin’s disease.

For more information on oral health management for those 55 plus, and to take the ADA’s online self-check test go to http://www.dentalhealthweek.com.au/

NHHRC recommends Denticare

2009-07-27T11:00:00.006+10:00

The National Health and Hospitals Reform Commission (NHHRC) report, entitled A Healthier Future for All Australians, recommends a public dental system at a cost of $3.6 billion a year and a national one-year dental intern scheme.

The NHHRC made the following recommendations on oral health matters:

"that all Australians should have universal access to preventive and restorative dental care, and dentures, regardless of people’s ability to pay. This should occur through the establishment of the ‘Denticare Australia’ scheme. Under the ‘Denticare Australia’ scheme, people will be able to select between private or public dental health plans. ‘Denticare Australia’ would meet the costs in both cases. The additional costs of Denticare could be funded by an increase in the Medicare Levy of 0.75 per cent of taxable income.
the introduction of a one-year internship scheme prior to full registration, so that clinical preparation of oral health practitioners (dentists, dental therapists and dental hygienists) operates under a similar model to medical practitioners. We recognise that this will require an investment in training and capital infrastructure.
the national expansion of the pre-school and school dental programs.
that additional funding be made available for improved oral health promotion, with interventions to be decided based upon relative cost-effectiveness assessment."

The ADA Inc. has issued a media release which welcomes inclusion of dental issues in the report but expresses concern at the approach taken.

Study on the oral health of children who visit dentists

2009-07-27T10:37:00.003+10:00

Less than 12% of Australian children regularly experienced toothache or the need to avoid eating certain foods because of problems with their teeth or mouth, according to a new study.
The report, Oral health impacts among children by dental visiting treatment needs, released by the Australian Institute of Health and Welfare, provides information on the oral health impacts experienced by children during the period 2004–06.
It investigates differences in parent-reported toothache, eating difficulties and poor oral health perception between children with different dental visiting patterns and treatment needs. The main findings are:

More than 90% of parents considered their child’s oral health to be good, very good or excellent
Oral health impacts varied by children’s age, sex and state of residence.
Children with more oral health impacts were more likely to visit the dentist regularly.
Reduced dental visiting was associated with poorer oral health.
Greater treatment need was strongly associated with more oral health impacts.

ADAVB raises concerns over national registration legislation

2009-07-20T10:44:00.009+10:00

Although supporting national registration and accreditation of health professionals, ADAVB has serious concerns about some aspects of the drafting of the enabling legislation, particularly errors and oversights.

Our submission on the draft Bill which will create the National Registration and Accreditation Scheme (NRAS) highlights the following concerns, amongst others:

The lack of procedural fairness when a complaint is referred to a disciplinary body before any investigation has been undertaken;
States and Territories being able to opt out of a national law complaint process which will lead to inconsistencies and be perceived to be unfair;
Proposals to allow practitioners who have not met local qualification requirements to practice in ‘areas of need';
Using the new system for workforce reforms such as ‘workplace substitution’;
Potentially giving health funds more control over the shape of health services, in particular clinical decisions;
The potential for the Public Interest Assessor to turn the regulation of professional conduct into an adversarial consumer complaint system;
Having only three dentists on the Dental Board of Australia, while regulating five types of practitioners and 11 specialties, may jeopardise the Board effectiveness and credibility, and
Mandatory reporting arrangements are too wide.

As part of the process of exposing the draft legislation to stakeholders, consultative meetings have been held nationally and submissions invited. As well as the Branch submission, the ADA Inc. and Branches also made written representations. As they are lodged, submissions are published on the NRAS website. Governments want the legislation passed by each State and Territory by the end of the year, with the new scheme starting on 1 July next year.

New Tobacco Laws to Protect Children

2009-06-29T17:35:00.006+10:00

The ADAVB welcomes new Victorian tobacco laws that will help prevent young people from taking up smoking, protect children from exposure to second-hand smoke in motor vehicles, and support more adults to quit smoking.

Introducing the Tobacco Amendment (Protection of Children) Bill 2009 to Parliament last week, Health Minister Daniel Andrews said smoking remained the leading avoidable cause of many cancers, respiratory, cardiovascular and other diseases.

The key reforms include:

Banning the display of tobacco products in retail outlets (other than specialist tobacconists and on-airport duty free shops);
Banning smoking in cars carrying a person under 18 years of age;
Banning the sale of cigarettes from temporary booths at events such as The Big Day Out or the Melbourne Grand Prix;
Providing the Health Minister with the power to ban youth-orientated tobacco products and packaging, such as fruit-flavoured cigarettes; and
Stronger penalties and enforcement provisions.

Aside from the point-of-sale tobacco display ban, which will be introduced on 1 January 2011, the remaining reforms will commence on 1 January 2010.

The ADAVB made a submission to the Government in 2008 in support of these measures.