The primary health care system is failing older Australians in remote areas where services are deficient, Royal Flying Doctor Service chief executive Martin Laverty says.
Dr Laverty told the aged care royal commission in Broome on Tuesday people in remote areas used Medicare at one-fifth of the rate of metropolitan residents and had much higher rates of avoidable hospital admissions.
This reflected poor access to health professionals, he said.
"The longer you are able to maintain your health through access to adequate primary care, the longer you are likely to avoid the necessity of access to the formal aged care setting.
"We are letting older Australians down by a failure of the primary medical care system in remote Australia.
"The commission has an opportunity to articulate a reasonable standard. It then requires resourcing."
While the RFDS is focused on emergency healthcare, it has responded to requests by aged care service providers to help with dental care, with a trial underway in Victoria's Mallee district.
"There is an absence of awareness among the care staff to the importance of oral health," Dr Laverty said.
"Anecdotally we're being told there isn't the time within the workload of some care staff to be able to bush teeth, to support brushing teeth."
Providing health services in remote communities is not easy, with challenges including travelling vast distances and the northern wet season causing extreme flooding.
Two years ago, Noonkanbah was cut off for more than three months.
"It got so bad you couldn't even land a helicopter to evacuate somebody medically," Kimberley Aged and Community Services manager Ruth Crawford said.
"The aged care services couldn't run, so we were doing a lot of support on the phone to individual families when they had phones. Not everybody does."
Recruiting staff due to funding-related tenure uncertainty is also an issue and in some areas, staff turnover is high.
"Trying to recruit clinicians in particular or senior staff to be team leaders when you're telling them they're going to have a six month contract because we don't know what's happening with funding is really difficult.
"One of our nursing positions was vacant for 10 months last year and we advertised three times."
Navigating Aboriginal cultural complexities is also challenging.
When Ms Crawford previously worked as a continence nurse, she and a colleague drove 10 hours from Broome to Balgo but within minutes, men's business started.
"We were told by the women in the community that we had to go to our accommodation and stay there.
"Two weeks later, we went back to Balgo again to do the work we hadn't been able to do the first time around and we no sooner got there when an elder in the community died.
"It was the same again."
Australian Associated Press
