Mike Morgan: There’s virtually no interaction teaching-wise now between the Medical and Dental Schools. I think that’s a big change in the last few decades. One or two of us have given lectures to medical students, but it’s on an ad hoc basis.

Henry Atkinson: There used to be the odd lecture from oral surgeons to medical students.

Pat Storey: And Tony regularly gave medical students a lecture on calcium metabolism.

Hector Orams: Steve Seward,[103] a dental graduate, used to demonstrate in anatomy and Gerald Dickinson[104] was another example of a dentist who lectured to medical students.

Gerry Dalitz: There’s a saying that dentists know more about medicine than doctors know about dentistry. It’s a true statement actually. I think dentistry is part of medicine, but mixing the two is extraordinarily difficult. The demarcation has worked pretty well over the years. If you want to go further you can get dual degrees in medicine and dentistry.

Ann Westmore: One way, as an outsider, that it doesn’t work so well is the difficulty of getting financial assistance for dental care as compared to medical care.

Peter Reade: When the National Health Scheme came into being in 1948, by agreement there were differing arrangements made for medical and dental groups. In the UK, a benefit went to the dentists out of their National Health Service, while in Australia it went the other way, because there were very few dentists.

Gerry Dalitz: There were a lot of professional jealousies.

Ann Westmore: Is the matter of dental benefits something the School ever engages in discussion with government about?

Henry Atkinson: Not the School directly. It’s more an Australian Dental Association activity.

Peter Reade: The professional organisations, such as the ADA and specialist groups, have got involved. There have been pressures, especially related to oral surgery needs. When I came to Victoria, there were some dentists recognised by medical item numbers if they performed particular procedures, and then when oral and maxillofacial surgery came along that disappeared. There was a scheme where general dentists could do some surgical procedures and were recognised for it.

Owen Crombie: Registered specialists could get recognition from the Department of Health for item numbers relating to oral surgery that were not actually dental things. The patient could get a Commonwealth benefit for removal of a tumour, cyst or scar but not for a wisdom tooth. So if the oral surgeon wanted to take out a wisdom tooth there was no financial relief for the patient. But there was, for example, a schedule fee for removal of a cyst discovered around the root of a tooth.

But that then turned into a monumental can of worms because such procedures were frequently done under general anaesthetic, and the anaesthetic fee for those particular procedures only covered the non-dental part of the procedure and not any dental part of the procedure that may have arisen.

And when more recent Medicare arrangements came in, the issue of public and private patients became an issue. A public patient in any hospital, other than the Dental Hospital, could have the anaesthetic for the tumour, cyst or scar covered by public health, but not the wisdom tooth. So the anaesthetists, by and large, were not too keen about being paid for only half their anaesthetic work. It was easier if oral surgeons could get operating rights at the Dental Hospital. They were then covered because it’s a public hospital.

Other than that dentists just explained to people that it would cost this much.

Garry Pearson: There are two different sets of public funding issues, whether it’s in a private dental practice or in a hospital. The Commonwealth and all these issues Owen’s raising come up in a hospital setting, but they don’t necessarily apply in a practice.

So it’s the State that exclusively funds any public patients being treated in private practice using one of the voucher schemes, which was what was left over after the present Commonwealth government withdrew from the Commonwealth dental health program in the 1990s.

We’ve still got $25-27 million of the $129 million in the current year budget that’s being spent on voucher schemes for private treatment of public patients. Is that right, John?

John Rogers: That’s a touch high, but it’s about right.

Garry Pearson: So it might be over $30 million now.

Witness to the History of Australian Medicine