Prime Minister John Howard says the states should take responsibility for improving public dental care, despite a bi-partisan report calling for federal funding and an end to health blame shifting.
The inquiry into health funding has recommended handing responsibility for services to whichever government could perform it most cost-effectively, irrespective of their historical roles.
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The report said current funding arrangements led to waste, duplication and cost shifting between jurisdictions - estimated at between $1.1 billion and $4 billion a year.
The House of Representatives Standing Committee on Health and Ageing, comprising six Liberal and four Labor MPs, said health reform must not be delayed.
The committee's preferred two funding models are the Commonwealth taking full financial responsibility for the health system, or the Commonwealth and states pooling their funds and forming a health commission to dole out money to regions based on their individual needs.
Report chair, Queensland Liberal MP Alexander Somlyay, said blame shifting between state and federal governments was a feature of Australia's health system but did not benefit patients.
"Addressing the blame game will involve a national approach to developing and funding health care," he told parliament.
The unanimous report also found the federal government should supplement state and territory funding for dental services so reasonable standards were maintained, particularly for disadvantaged groups.
Receiving dental care when it was needed could significantly affect a person's quality of life and future health costs, it said.
"The committee is particularly concerned about the waiting times for public dental health services, and considers these to be under funded," the report says.
"Many Australians who cannot afford private dental services are not receiving the services necessary to maintain oral health."
Mr Howard said the government would examine the report, but the delivery of dental services had historically been the states' responsibility.
"Those who sit opposite talk about ending the blame game," he said.
"You can't end the blame game until both sides of the federal compact discharge the responsibility that is historically theirs.
"The states are responsible for the dental care of their communities and it's about time they carried out their responsibilities."
Mr Howard said the government had already taken a number of very significant measures to end the blame game, including contributing $1.9 billion in mental health funding irrespective of whether the states came through with their promised boost.
The report said removing barriers to reform should be a priority of the next health care funding arrangement between state and federal governments, due when the present agreement expires June 30, 2008.
The Blame Game: Report on the inquiry into health funding also backed Health Minister Tony Abbott's push to link funding with accountability.
Mr Abbott has already foreshadowed a number of significant changes in the next round of health agreements, including the states publicly releasing statistics on individual hospital performance including waiting lists, the number of operations performed and medical mishaps.
He has also suggested allowing private management of public hospitals but has ruled out transferring public hospital responsibility to the federal government, a plan Labor says it will consider if elected.
Among its 29 recommendations, the inquiry also found the government should co-ordinate recruitment of overseas health professionals, and develop a strategy so Australia produces enough of its own graduates by 2021.
