Party time to mark milestone

Media item: article

Date published: 23 September 2012

This page records the media item. The original article is the property of its publisher and is not reproduced here.

The archive preserves the headline and the date. What follows is general information about the organisation the building is named after — and it is the most directly relevant piece of history on this site, because it is about how ordinary people paid for health care before there was a public system.

Who the Oddfellows were

The Manchester Unity Building was commissioned by the Manchester Unity Independent Order of Oddfellows, and completed in 1932 to a design by architect Marcus Barlow. See Have a Deco at a Classic and Manchester Unity Building.

Manchester Unity was a friendly society.

Friendly societies were mutual organisations: members paid regular small subscriptions, and in return drew benefits when they could not work. They emerged in Britain in the eighteenth and nineteenth centuries and spread throughout the colonies, and in Australia they became one of the principal ways working people insured themselves against illness.

What membership typically provided:

• Sick pay while unable to work — the core benefit, in an era with no welfare safety net
• Access to a doctor. Societies contracted with a ‘lodge doctor' who attended members for an annual capitation fee.
• Medicines, sometimes through the society's own dispensary — the pharmacy side of that history, and how differently the two professions are regulated now, is in Is dental really different to pharmacy?
• Funeral benefits, which mattered greatly — a pauper's burial was a real fear
• Support for widows and orphans
• A social organisation, with lodges, ritual, regalia and meetings

They were not charities. Members were contributors with entitlements, and the distinction was fiercely held. The whole point was that a working man was not asking for help; he had paid in.

Why a friendly society built a tower

By the 1920s Manchester Unity was a large institution with substantial reserves, and the building was its Victorian headquarters — an assertion of permanence and solidity by an organisation whose entire product was the promise that it would still be there when a member fell ill. The building's argument in stone and metal is described in Manchester Unity Building, Open House — part 2 and Manchester Unity Building, Open House — part 5.

It was built during the Great Depression, at a moment when almost nothing else in Melbourne was going up. That timing was not incidental: it demonstrated the society's stability precisely when stability was in doubt, and it employed people who needed the work. The opening is recorded at The new shopping centre opens today.

What happened to them

The friendly society model was substantially displaced across the twentieth century by government health schemes and by commercial health insurance.

In Australia the decisive changes were the introduction of national health insurance arrangements from the 1970s — Medibank, and then Medicare from 1984 — which made universal medical and hospital cover a public entitlement rather than a subscription.

Many friendly societies survive, some as health funds, some as financial or pharmacy businesses. Several familiar Australian health insurers trace their origins to friendly societies or to similar mutual roots.

The part that matters to a dental practice

Here is the connection, and it is not a stretch.

Medicare covers medical care. It does not, for adults, cover dental care.

When the universal system was built, the mouth was left outside it — and it has remained outside ever since. The full sequence of schemes and programmes is set out in Manchester Unity Building. The consequences are visible in the data every year:

• Cost is the most commonly reported reason Australians delay or avoid dental care. See also Explosive uplift in Australians tapping into their super for dental treatment and One man's mission to deliver smiles on where practitioners are and are not.
• Over a third of adults have untreated decay.
• People delay, and delay makes treatment more invasive and more expensive — a filling becomes a crown becomes a root canal becomes an extraction and then a replacement. The progression is described in The stages of dental decay and How does tooth decay develop?

So for dentistry, the friendly-society question was never fully resolved. What replaced it is a mix of private health insurance extras cover — with annual limits, waiting periods and gaps; see Bupa Platinum Dental Provider — and a public dental system with eligibility criteria and waiting lists.

What exists now, in Victoria:

• Public dental care through community dental agencies and the Royal Dental Hospital of Melbourne, generally for concession card holders and children. General care is by waiting list; emergency care is triaged by clinical urgency. Say clearly if you are in pain — see Emergency Dentistry and What is considered a dental emergency?
• The Child Dental Benefits Schedule for eligible children — significantly under-claimed, and requiring no application. See Child Dental Benefit Schedule and how the scheme operates.
• Private extras cover, which is the direct descendant of the friendly-society subscription: pay in regularly, draw benefits when needed, subject to limits.

And if cost is the barrier, say so. Sequencing treatment over time, treating what is urgent first, and choosing the more conservative option are all legitimate clinical decisions — see the Price Guide and Understanding Your Treatment. The National Debt Helpline is 1800 007 007, free and independent.

A note on how to read the name

‘Oddfellows' is not a joke and ‘Manchester Unity' is not a company. The former is the historic name of a fraternal order; the latter identifies the branch of that order the society belonged to. The building carries the name of a mutual insurance institution, which is worth knowing when you walk past it — see Our City: Manchester Unity Building on how the place is protected now.

The other Manchester Unity Building pages in this archive

• Have a Deco at a Classic — the building's origins, Marcus Barlow, and the faience cladding
• Inside the Manchester Unity Building — the arcade, the escalator and the restoration
• Let there be light for Manchester Unity's brighter future — the illumination
• Melbourne, Australia: Manchester Unity Building, Art Deco oasis in the heart of Melbourne, Manchester Unity Building — John Gollings
• Open House: Melbourne Open House, Part 6, Part 7
• The complete index is Our Media

Common questions

How big was the society that paid for this building?

Big enough to need twelve storeys, and the register puts a number on it. Heritage Victoria records that the building was designed by the architect Marcus R Barlow to meet the corporate needs of the Manchester Unity Group, a friendly society with 28,000 members in 1932. That figure is a membership rather than a customer list — twenty-eight thousand people paying subscriptions into one Victorian society, in the third year of the Depression.

One detail the record does not settle. Its statement of significance says the building was built in 1932 by Walter Cooper Pty Ltd, while the history of the place on the same record names the builder as W. E. Cooper Pty. Ltd. Same document, two sets of initials, and nothing on the record resolves it — worth knowing before quoting either version as settled. Source: the Victorian Heritage Database entry for place 728 (Victorian Heritage Register H0411).

The lodge doctor had an agreed fee. Could anything like that be done for dental fees today?

It has been formally proposed, and the proposal names its own model. A submission to the parliamentary inquiry on private health insurance and out-of-pocket costs argued that a recommended (i.e. non-mandatory) Dental Fee Schedule should be developed by the government — in line with those published by the Australian Medical Association and the Australian Psychological Society, and that the usual objection should not stop it: any argument that a similar recommended non-mandatory dental fee schedule can amount to ‘price fixing' in the private dental sector should thus be challenged.

It also says who would have to start it, and why not the profession: given that the Australian Dental Association (ADA) serves the interests of dental practitioners, the government will need to initiate the development of a fair and affordable Dental Fee Schedule. That is one submitter's argument rather than policy, and no such schedule exists. What it tells a patient is simply that there is no published benchmark to measure a quote against — which is why a written itemised quote does the work a schedule would.

If I am unhappy with dental work I have paid for, can I get the money back?

Often not, and the same submission treats that as the gap rather than the rule. It states that refunds to patients and private health insurers via HICAPS for dental items are likely to be non-existent, or negligible, noting alongside it a 33.8% increase in complaints about dentists (Dental Board, 2016). Where a patient is left to pay for corrective work, the submission argues, that not only conflicts with patient-centred health care, but may be at odds with Australian Consumer Law.

Read all of that as one submitter's argument, not a finding — whether consumer law applies to a particular set of facts is a legal question, not a dental one. What follows practically is unglamorous: the protections that actually work are the ones used beforehand. An itemised written plan, a clear account of what the alternatives were, and a second opinion before irreversible work all cost less than a dispute afterwards. See Understanding Your Treatment and Second Opinions and Corrective Dentistry.

Practical details

Smile Solutions, Level 1, 220 Collins Street, Manchester Unity Building, Melbourne VIC 3000. Phone 13 13 96, or theteam@smilesolutions.com.au. Monday–Friday 8.00am–6.00pm, Saturday 8.30am–1.30pm, Sunday by appointment. See also Our Location and Contact Us.

Every practitioner's registration can be verified free on the AHPRA public register at ahpra.gov.au.

This page records a published article and its date. The historical material above is general background rather than a summary of the item, and dates and details of health-scheme history should be confirmed with authoritative sources. Statements attributed to the registration are drawn from the Victorian Heritage Database entry for place 728 (VHR H0411); material attributed to a parliamentary submission is one submitter's argument rather than a finding, and nothing here is legal advice. Government scheme eligibility changes; confirm current details with Services Australia and the Victorian Department of Health. This is not a diagnosis or a treatment plan. Third-party published content is not reproduced.

Smile Solutions trades under ABN 28 193 514 103.