Improving the oral health of Aboriginal people and people from vulnerable communities has been a powerful force driving Claire Phelan since she was a child, as Tracey Porter reports
Claire Phelan’s path towards a big career as a pioneering public oral health clinician, policy maker and manager was first set at the tender age of just 12. It was then that a poster she created of multicultural youngsters titled ‘Healthy Teeth make Happy Children’ won her a dental health week competition.
“My prize was a transistor radio in the shape of a Coca-Cola vending machine, I kid you not,” Phelan recalls. “I never forgot it and it definitely influenced my decision to study dental therapy.”
In the intervening 40 years, Phelan has gone on to win awards and accolades for her tireless and highly effective work improving the oral health of people who had previously little to no access to dental healthcare.
Currently into her fourth year as director of the South Eastern Sydney Local Health District (SESLHD) Oral Health Service, Phelan considers her greatest professional achievement to be strengthening ties with local Aboriginal communities. She has transformed the service into a forward-looking, client-focused operation with a clear strategic direction and a culture of innovation and excellence.
Notable improvements under her watch include a new two-chair dental clinic at the La Perouse Aboriginal Community Health Centre and the commissioning of a mobile dental clinic in 2016 that has greatly enhanced access to dental care for priority populations such as residents of aged care facilities.
Since 2016 Phelan has been busy executing the SESLHD Integrated Oral Health Promotion Plan, a strategic framework she developed to set service goals and planned actions to integrate health promotion through all areas of the oral health service and to work in partnership with communities in need. The imminent redevelopment of the Mission Australia dental clinic and further transition towards utilising central sterilisation departments, instead of benchtop sterilisation at dental clinics, are next on her agenda.
Born in 1956, the second eldest of nine children in Swansea, NSW, Phelan credits her compassion to her parents and tight-knit family.
While enjoying a humble upbringing with no landline telephone or access to a TV screen, Phelan says entertainment in the early days came in the form of two pianos in the house with each member of the broader Phelan tribe learning to play proficiently. “My parents worked as a well-oiled team to support us and provide us with whatever opportunities they could. They were deeply in love and still are to this day. They taught me to be compassionate and passed on a love of music, which has given me much pleasure in life. I have been able to pass these things on to my own (two adult) children so it is a gift that keeps on giving.”
Phelan trained as a dental therapist in Newcastle in the late 1970s. But after two years working on the North Coast of NSW, a 1980 move to Sydney, where she has lived ever since, prompted a three-year break from all things dental.
“I was looking for some new experiences and held a variety of jobs, including barmaid, brew house operator in an inner-city brewery and international telephonist with the then Telecom—pre-computer.”
It was in 1983 that her remarkable dental career got back on track. Phelan was then living in the city’s inner west and had a number of Aboriginal friends.
“Through them I observed first-hand the devastating effects of dispossession and racism and I developed a passionate desire to help reduce Aboriginal disadvantage.”
“I try in all aspects of my life and my work to show respect for and welcome Aboriginal people to our service by making our dental clinics culturally welcoming and by ensuring all our staff members undertake training in cultural appropriateness.”—Claire Phelan
Following her brief hiatus from dental therapy, she was employed by the Aboriginal Medical Service in Redfern (AMS) as senior dental therapist. Phelan says she gained much more from that experience than she could ever give back.
“Through my Aboriginal friends and colleagues, I learnt the true meaning of compassion and inclusion. I was privileged to work in remote locations on a number of mobile dental vans that Redfern AMS operated. Before I started working at the AMS I had never even been across the Blue Mountains so working in places like Walgett, Brewarrina and Wilcannia really broadened my understanding of inequity and deepened my commitment to working with vulnerable populations.”
Phelan says that when she accepted the position of dental therapist at the AMS she did so on the understanding she would vacate the position for an Aboriginal dental therapist, in keeping with the principles of self-determination.
“By 1996 one of the former AMS dental assistants was in her final year of dental therapy and, no matter how much I loved the work I was doing, I was starting to feel that I might have more to contribute than working as a full-time clinician.”
She left to take up the position of community dental health programs officer for the then Central Sydney Area Health Service.
The role saw her manage the Save our Kids Smiles Program and various research and oral health promotion projects from 1996 to 2004. In 2004 Phelan joined the Centre for Oral Health Strategy NSW as senior policy analyst where she was responsible for developing, implementing and evaluating the NSW Early Childhood Oral Health Program.
This was also the year Phelan gained a Master of Health Management from the University of New England.
In 2010 Phelan had the great privilege of being chosen by the Global Child Dental Health Taskforce to represent Australia and New Zealand at the 4th Senior Dental Leader’s Course in Boston, USA. This provided her with a firm foundation on the theory and practice of strategic leadership and change management.
In 2011 Phelan moved into health promotion to broaden both her experience of health systems and people management. A year later she accepted a position with SESLHD Oral Health Service as operations manager. Her first task was to assist in transitioning the service from a combined South Eastern Sydney Illawarra Area Health Service to two separate entities. Following a restructure in 2014, a new director role was established with a managerial and strategic focus and Phelan was the successful applicant.
The SES Oral Health Service has long been passionate about improving equity in access to oral health for people experiencing homelessness or with drug and alcohol or mental health issues.
Phelan says people who experience homelessness and other marginalised groups can have great difficulty scheduling and keeping appointments due to their uncertain lifestyles and complex needs, which is why the Mission Australia co-located dental clinic was established in 2003.
In 2013 Phelan formed a review committee to strengthen the model and the partnership. She says the service provided for marginalised people is unique because, aside from being co-located within a residential facility for homeless people in Surry Hills, it also employs an experienced welfare officer as part of the dental team.
“Establishing trust and providing continuity of service is extremely important when setting up an Aboriginal dental clinic. The way to do this is to employ Aboriginal people who can liaise with community members.”—Claire Phelan
The officer’s role is to support clients by facilitating access to dental services and linking them in with other social and welfare services that they may need as well as providing outreach services in collaboration with other specialist homelessness services, and facilitating referral pathways for general anaesthesia and denture care.
In 2016 Phelan completed the NSW Clinical Excellence Commission’s Executive Leadership Program.
Reflecting on her career to date, Phelan reserves a special affinity for Aboriginal people. “I try in all aspects of my life and my work to show respect for and welcome Aboriginal people to our service by making our dental clinics culturally welcoming and by ensuring all our staff members undertake training in cultural appropriateness. We provide employment opportunities for Aboriginal people—both permanent positions and traineeships and I believe this enhances the respect our staff have for Aboriginal people.”
Phelan says having worked closely with the indigenous community over a long period has given her a good understanding about their ways of working.
When asked in what ways Aboriginal community health centres differ from traditional clinics Phelan says “the word ‘community’ says it all really. To Aboriginal people, family and community means everything. Their concept of family is different from most non-Aboriginal concepts, in that it extends across generations and to cousins, second cousins, close family friends and so on.”
For this reason, she believes it is vitally important to attract more staff of Aboriginal heritage into a variety of roles. “Establishing trust and providing continuity of service is extremely important when setting up an Aboriginal dental clinic. The way to do this is to employ Aboriginal people who can liaise with community members.”
When Phelan started working at SESLHD, the oral health service had no Aboriginal staff members but under her guidance the service now has three permanent Aboriginal employees and two annual traineeships.
There are no signs Phelan is ready to call time on her lengthy career that has achieved so much for so many. In 2018 the Mission Australia dental clinic will be expanded from one dental chair to two, allowing Phelan to roster an oral health therapist and increase service provision to youth at risk.
“Co-location of dental clinics within a centre that delivers a range of community and employment support services has been key to reducing barriers to access for this vulnerable group.”
Just last year her work in this area saw Phelan awarded the Collaborative Leader of the Year Award in the state government’s NSW Health Awards.
Phelan says that, while it was great to be recognised for the work she does, the accolade was also directed towards her team “because I would not be able to achieve anything without their dedication and commitment to implementing the new models of service provision.
“There are always setbacks when developing new ways of doing business but receiving the award has been a positive affirmation of the directions we are taking and it has strengthened my resolve to continue to try and find innovative solutions to complex problems.”