Picture of RFDS workers and clients outside circular head Aboriginal corps

Filling service gaps in remote communities

Date published

08 Jan 2018
RFDS staff and boy patient on scooter

A NEW mobile outreach program is helping improve access to dental services in remote Tasmanian communities.

Starting with Circular Head in the north west, the Royal Flying Doctor Service (RFDS) Tasmania is providing free screening, preventive and restorative dental services for adults with Health Card Cards plus all children.

The Launceston-based outreach service will rotate through a number of remote Tasmanian communities as part of an $11 million, two-year Australian Government-funded program which started rolling out across the country in May this year.

RFDS Tasmania CEO John Kirwan says the organisation is working with Oral Health Services Tasmania, private dentists and the Circular Head community to make sure the new service is filling service gaps, rather than duplicating what was already on the ground.

Until the new service commenced, free dental services in the area were limited to a children’s clinic at Smithton, visits to some schools, and emergency care for adults with Health Care Cards. 
“We’ve been able to provide improved access to dental services because we have an outreach model and we are funded to see a broader range of people,” John says.

The RFDS Tasmania model sees a Launceston-based dental therapist and dental assistant travel to Circular Head on a Monday morning and back on a Thursday night. 
Their focus to date has been largely on screening and prevention, because “if we can get that right for the children, it means we won’t have to do the restorative work when they’re in their early 20s or 30s”.

Local dentist Dr Jay Kotay was contracted to offer restorative dental treatment in Smithton until the appointment of an RFDS dentist, who starts in December. A dental surgeon will be contracted as needed.

The preferred model – which RFDS Tasmania is aspiring to – is two teams taking a stepped care approach. A therapist and assistant focusing on screening and prevention, and a dentist and assistant following up with restorative work.

The current team takes its van to schools not serviced by Oral Health Services Tasmania and sets up a mobile clinic within school grounds. Dental treatment is also provided from rooms made available by Dr Kotay and the Circular Head Aboriginal Corporation (CHAC), both of whom John says have been “absolutely brilliant to work with”.

CHAC CEO Dianne Baldock is similarly complimentary about the RFDS service.

“I’ve been discussing the needs of our community with John for several years and I never lost hope that something would come of it,” Dianne says. “I feel very grateful that we have this opportunity for services to be provided in a culturally appropriate setting which is also open to the broader community. I can see the community becoming more empowered and more aware of the importance of oral health. It’s great to see the people we refer to the service being able to have done what needs to be done – without having to go out of the community. Because even though a service might be free, there can be a financial burden associated with getting to and from an appointment in another town.”

Dr Jay Kotay splits his time between private practice in Smithton and Burnie and is also contracted to the RFDS Tasmania.
He says the new service has been very well-received in an area where job losses in recent years have contributed to demand for free health services.
“I think it is benefiting a lot of people, because some of them don’t even have cars to travel to Burnie. Travelling to Burnie is quite a big deal and a big drain on their income,” Jay says.

John says once the team has done all the screening and restorative work it can in Circular Head, it will move to the next highest area of need. He expects the team to spend around three to six months in each area.

“We’re looking at the west coast, the east coast, and the north east,” John says. “We will go back to areas, but if we’ve done the screening and restorative work, then it becomes more of a care and maintenance approach. It might be that every two years we go back and do the whole thing again.”

This isn’t RFDS Tasmania’s first foray into oral health – it has been supporting the provision of dental services on Flinders Island since 1964. More recently it has self-funded projects with a school and with the Aboriginal community in southern Tasmania.

In late 2016 the organisation self-funded a dental outreach trial at Swansea on the East Coast which acted as a pre-cursor to the current Australian Government-funded program.

“To some extent that worked some of the bugs out of the system. We learnt some interesting lessons there, particularly about making sure we did really good community engagement about what we’re doing, why, and how we will do it,” John says. “That’s led to really quite strong community support in the Circular Head area, including locals offering help in a range of ways – it’s all those great little things that a country town gives you.”

The current Australian Government funding – which has been supplemented by donations to cover establishment costs such as purchase of equipment and vehicles – ends in March 2019, but the RFDS nationally is hopeful of securing ongoing funding.

2018 will mark 90 years of the RDFS providing health services to rural and remote communities.

“The dental program shows how a strong partnership can work in providing services to communities that would otherwise miss out or have to travel,” John says.
For more information, contact Nicole Henty at Nicole.Henty@rfdstas.org.au or on 6779 1480.

In early 2017, five organisations started delivering free services to people living with chronic conditions under a new rural primary health program. The program – funded by the Australian Government – has involved Primary Health Tasmania commissioning the services in 21 of the state’s 29 local government areas. It responds to the Government’s brief for primary health networks to improve the health care of people who have the highest needs. The services work closely with local GPs and other health professionals to provide coordinated care to people with chronic conditions and support them to stay healthy and out of hospital.

For more information go to www.primaryhealthtas.com.au/programs-services/rural-health, or contact Susan Powell at spowell@primaryhealthtas.com.au or on 6213 8200

This story was first published in Primary Health Tasmania’s Primary Health Matters magazine, online at www.primaryhealthtas.com.au