Policies With Teeth: Where the Parties Stand on Dental Care

Election 2023

The political will to plug the dental gap in healthcare seems higher than ever – but will it be enough to get dental policies over the line?

Afraid to socialise, reduced quality of life. 

Cheaper to fly to the UK to get work done.

Pulling their own teeth out with pliers.

“I need my small mouth bones for eating.”

These are just some of the comments on a petition for free dental care that show how dental care access in New Zealand can be just like pulling teeth.

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Representatives from Labour and the Greens were on hand yesterday to receive a 16,500 signature petition calling for free dental care for all New Zealanders.

Minister of Health Ayesha Verrall and Greens health spokesperson Ricardo Menéndez March received the Dental for All petition at the University of Auckland.

Dental health advocate Max Harris from the Dental for All coalition said there had been an explosion of public support for the policy.

“We’re really encouraged that the Greens and Labour have taken up free dental, and we think there’s clearly a strong public appetite,” he said. “We think there’s a window of opportunity now that perhaps hasn’t been open for decades. Passing over this petition is about encouraging the public to see this opportunity and encouraging politicians to keep it on the agenda.”

Meanwhile, Verrall said Labour’s policy of free dental care up to 30, instituted over the next three years, was the first step in the aspirational direction of one day delivering universal dental care.

The petition follows a poll conducted by the Association of Salaried Medical Specialists, which found more than seven out of ten adults supported bringing dental into the public healthcare system.

Association research also found New Zealand had recorded the highest unmet need for adult dental care among 11 comparable countries in 2020.

In that same year, 37 percent of adults skipped dental care or check-ups because of the cost – more than in the United States.

Adults with unmet need for dental care owing to cost (2019/20). Image: Association of Salaried Medical Specialists

Menéndez March said the Greens policy, paid for by a wealth tax, would create the New Zealand Dental Service – a public entity focused on oral health.

“While we acknowledge that initially we would have to partner up with the private sector, it’s really important that we start building the capacity within the public healthcare system to ensure that in the longer term we can roll out dental services as part of the public healthcare system,” he said.

Verrall said the Labour Party had similar aspirations. But her party’s policy stops short at 30, and will take a few years to come in. Does the reach of the party’s dental policy fit the severity of the problem?

“It is an area we could put a lot more attention on, but we’ve presented a balanced set of health priorities and I bristle a bit at the word incrementalism when we’ve implemented the word’s leading tobacco control policies as a government, the world’s leading Covid response, substantial reform to improve equity in the health system,” she said. 

“We just can’t do everything at once.”

New Zealand Dental Association chief executive Mo Amso said free universal dental care would be untenable in the current economic and workforce landscape without some big changes.

He said the current funding models disincentivise dentists from providing free care for under 18s.

The cost of a tooth extraction is around $250 to $300 fair market value; a funded contract only receives $150.

“We’ve said for many years and it’s fallen on deaf ears,” Amso said.

Amso said he was therefore cautious about promises of free dental care for all.

“We’ve welcomed political appetite for better funding. However, we have questioned the pricing that’s put to the policy and how ambitious it is, especially if the existing model is failing.”

Questioned on whether his party’s policy was putting the cart before the horse, Menéndez March said the introduction of the New Zealand Dental Service would help with these challenges.

“We made our policy costings quite generous to allow for that initial partnering with the private sector, but we are really clear that the way to actually not go in circles around that conversation is to establish a public health dental service.”

Nevertheless, Amso described Te Pāti Māori’s dental policy – which provides free care for households earning less than $60,000 a year – as more pragmatic.

Though it’s obviously cheaper to focus a policy on the people of the greatest need, Harris said there were clear benefits to a universal policy

There’s a reduced stigma for people accessing the service, a reduced need for bureaucracy, and ultimately a higher likelihood of sustained political will behind the policy as the middle classes benefit as well.

“After 80 years of dental care being excluded from our public healthcare system, we are excited to see a window opening up to plug this gap in public healthcare, and we want to see the next government grasping this opportunity,” Harris said.

But while just Labour and the Greens showed up to get their teeth into the petition, are they the only parties with a dental care policy?

Newsroom surveyed the party’s policy documents for dental-specific policy.

Policies:

Labour

  • Free dental care for everybody under 30.
  • Labour will expand dental care in two stages, reaching 18-23-year-olds from July 2025 and 18-29-year-olds from July 2026.
  • Dental workers have already been added to the immigration green list.
  • Increase funding to increase the number of dentists trained in New Zealand by 50 percent, or 30 more dentists a year.

Greens

  • Free dental care for all.
  • Create the New Zealand Dental Service.
  • Lift the cap on training placements to meet increased demand for dentists.
  • Reduce barriers to access via mobile dental vans and funding for community dental clinics, including marae.

Te Pāti Māori

  • Free dental care for households earning less than $60,000.
  • Invest $1 billion per year in Health Workforce Development.

The Opportunities Party

  • Fully funded dental care for under 30s through the Teal Card scheme. It gives the examples of annual check-ups, x-rays and fillings as dental services provided for under the scheme.

National

  • $120m in additional spending on the Child Dental Package over four years.

Act

  • Cut red tape making it easier for medical professionals to move to New Zealand.

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