The structure of the dental system in Australia is largely private, with both providers and services concentrated in major cities. The funding structure in the dental system is different to the rest of the health system, in that individuals pay for the majority of their care. While government funding is significant, the subsidies available are far less than those provided in the general health system. The amount of funding available to the public system is dwarfed by consumer expenditure in the private system (see graph).
Supply and Demand
Issues surrounding the dental workforce mirror the general health workforce. The period of the 2000 decade was a time of estimated shortage of supply against effective demand. The response has been: a doubling of dentist graduates; strong recruitment of international dentist graduates; and increases in oral health practitioner graduates. As a result, supply capacity may have grown faster than projected through to the end of the 2000 decade. The latest published supply and demand projections indicate a small shortage of supply in 2020. However, supply and demand projections should be updated. The preparation of a national dental workforce plan by HWA across 2012 will bring forward such information.
The rapid expansion of the numbers of dental practitioners in training has accentuated concerns with the infrastructure available for students in university training. This includes both university facilities and staff and public sector service providers and clinical placement facilities. The constraints imposed on appropriate training environments will be further heightened by the introduction of the Voluntary Dental Intern Program, noting that infrastructure funding is being provided under the measure and that participants will be fully qualified dentists who can provide services without the need for significant supervision, unlike dental students.
Urban and Rural
In addition to the aggregate supply and demand balance, there is significant maldistribution between urban and rural areas and across urban areas as well as between private and public dentistry. In this way, workforce maldistribution affects the ability of people to access dental care, either in the public or the private systems. The factors leading to this maldistribution are multi faceted, including differences in income and career opportunities between the two sectors.