“I am just doing my job,” says Les­ley whose lat­est acco­lade is the 2024 CRANAplus Auro­ra Award – for the Remote and Iso­lat­ed Health Pro­fes­sion­al of the Year, which was pre­sent­ed to her at the organisation’s con­fer­ence in Mel­bourne in Octo­ber. As her nom­i­na­tion states: Lesley’s qui­et ded­i­ca­tion to and advo­ca­cy for the health of remote com­mu­ni­ties reflects CRANAplus val­ues, par­tic­u­lar­ly integri­ty, social jus­tice, and inclu­sive­ness in sup­port­ing the deliv­ery of qual­i­ty, safe health care in remote and iso­lat­ed settings.

Ear­li­er this year, Les­ley was award­ed the Medal of the Order of Aus­tralia in the King’s Birth­day 2024 Hon­ours list for ser­vice to Indige­nous health and to rur­al and remote nurs­ing. And in 2023, she was cho­sen as a final­ist in the NT Senior Aus­tralian of the Year Awards for her work in tran­si­tion­ing health ser­vices to Abo­rig­i­nal Com­mu­ni­ty Con­trolled Organ­i­sa­tions in the Territory.

Les­ley is quick to embrace the entire nurs­ing com­mu­ni­ty in acknowl­edg­ing her recog­ni­tion: ​“You do what needs to be done, iden­ti­fy­ing needs and work­ing as hard as you can to get things done. You see what can be improved and try to get that. You want to make a difference.”

She then moves on to talk about her favourite top­ic – pri­ma­ry health care. ​“If we are going to improve health in Aus­tralia, in fact world­wide, we real­ly need to look more care­ful­ly at pre­ven­ta­tive health, be proac­tive in terms of health.

“I think pri­ma­ry health and remote health is becom­ing sexy and more attrac­tive than ever. 

As a mem­ber of a pan­el at the con­fer­ence dis­cussing the Nation­al Rur­al and Remote Nurs­ing Gen­er­al­ist Frame­work, Les­ley recog­nised its val­ue in pro­vid­ing guid­ance for nurs­es in remote areas, process­es for organ­i­sa­tions striv­ing to be bet­ter, and recog­ni­tion of the extent of the work done by remote area health pro­fes­sion­als. This frame­work describes the unique con­text of prac­tice and core capa­bil­i­ties for rur­al and remote Reg­is­tered Nurs­es in Australia.

“While I see inter­est in remote health care mov­ing in the right direc­tion, it’s still hard to get nurs­es into these roles par­tic­u­lar­ly with the right skills and expe­ri­ence. It’s impor­tant that they are well pre­pared and receive a lot of sup­port. To go out there unpre­pared can scar peo­ple for life.

“I can see more and more peo­ple want­i­ng to become remote area nurs­es. I think that’s great. 

“The old adage of see­ing peo­ple who go into the out­back being Mis­sion­ar­ies, Mer­ce­nar­ies and Mis­fits, is fad­ing. In terms of the health field, we are see­ing more peo­ple want­i­ng to be remote area nurs­es for the right rea­sons, with a gen­uine inter­est in Abo­rig­i­nal and pri­ma­ry health care.

“There are more and more oppor­tu­ni­ties for nurs­es to fol­low that path and, of course, CRANAplus is an impor­tant part of that, includ­ing offer­ing more and more cours­es that pro­vide eas­i­er access to pro­fes­sion­al devel­op­ment and rur­al and remote context.”

Les­ley is also thrilled to see more Abo­rig­i­nal peo­ple becom­ing health prac­ti­tion­ers, and more being done to make this pos­si­ble. ​“When I see local peo­ple with the knowl­edge of health prac­ti­tion­ers speak­ing to local peo­ple, often in lan­guage, talk­ing to each oth­er about health, tak­ing own­er­ship… that’s my dream.”

Les­ley, who has now been at Malal’a for nine years, lists a few oppor­tu­ni­ties over the years that opened her eyes and expand­ed her mind on the depth and val­ue of pri­ma­ry health; instances and oppor­tu­ni­ties that made her think over the years.

Work­ing in Queens­land for 30 years, Lesley’s nurs­ing career start­ed on the wards of Cairns and Mount Isa Hos­pi­tals, soon man­ag­ing the emer­gency depart­ment. ​“I saw such dis­par­i­ty in the bur­den of dis­ease for Abo­rig­i­nal peo­ple,” she says. ​“I was prob­a­bly a bit naïve.”

Com­ing back years lat­er as Direc­tor of Nurs­ing, Les­ley then had respon­si­bil­i­ty for all the com­mu­ni­ties in the far west region. ​”I’d pre­vi­ous­ly gone out to Doomadgee which had a lit­tle clin­ic that was basi­cal­ly falling down, it was so poor. There was no real health ser­vice and patients had to be flown out all the time.

“If a child had a tem­per­a­ture, they had to fly them out, the health ser­vice was so lim­it­ed. As Direc­tor of Nurs­ing, I start­ed talk­ing about a new health cen­tre, and I focussed on the fact that it would be so much more cost effec­tive. There would be no need to fly out so many patients. Even­tu­al­ly we got that sev­en-bed health centre.”

A huge eye-open­er which was ​‘a tough gig’, was her appoint­ment to the Board of Direc­tors for a diver­sion­ary cen­tre in Mount Isa, deal­ing with peo­ple who would oth­er­wise end up in prison. ​“There, I saw how pro­vid­ing a feed, a bed and care, and they’d walk away a much bet­ter per­son. Some­times, I’d man­age to fast-track them to the emer­gency depart­ment to see a doctor. 

“It became obvi­ous that if you care for peo­ple, pro­vide basic care, you can change lives.” 

Mov­ing to the North­ern Ter­ri­to­ry to work and even­tu­al­ly for Sun­rise Health Ser­vice in Kather­ine, Les­ley was mov­ing essen­tial­ly from a back­ground in hos­pi­tal envi­ron­ments to com­mu­ni­ty. ​“The CEO at the time made me think dif­fer­ent­ly. I say thank you every day in my life that he helped to change my direc­tion,” says Les­ley. ​“He gave me that opportunity.

“I had been in hos­pi­tals most of the time, focussed on how many beds, how many spare beds, beds in emer­gency, and there was nev­er enough money.

“I had come in from a fair­ly green per­spec­tive. I thought before this that I knew what pri­ma­ry health care was. But I realised I knew noth­ing about pri­ma­ry health care and I had to be hum­ble and ask a lot of questions.

“Sun­rise was all about ser­vice pro­vi­sion – in the home and in the com­mu­ni­ty. It was about pre­ven­tion rather than reac­tion. Work­ing with the com­mu­ni­ty and talk­ing about what their pri­or­i­ties are. Think­ing of what is best for the com­mu­ni­ty. And I realised that it was impor­tant to apply this in the hos­pi­tal set­ting too.

“In pri­ma­ry health care you can con­trol bud­gets bet­ter than in a hos­pi­tal,” Les­ley acknowl­edges. ​“You can have patient recalls. We work on pre­vent­ing peo­ple from get­ting sick, not help­ing peo­ple get well.

“While hos­pi­tals are so essen­tial, I can see that pri­ma­ry health care also has an impor­tant role to play and real­ly is essen­tial in mak­ing a difference.”