Graduation address given by Emeritus Professor Clive Wright

Emeritus Professor Clive Wright, former Chief Dental Officer of New South Wales, gave the occasional address at the Faculty of Dentistry graduation ceremony held in the Great Hall at 2.00pm on 16 March 2012.

The photo of Mr Anstice is copyright, Memento Photography.

Emeritus Professor Clive Wright

Graduation address

Madam Chancellor, Professor Peck, Distinguished Guests, Graduates, Ladies and Gentlemen!

Today is a celebration of the culmination of many years of dedicated and difficult work by those who are graduating this afternoon, their families and supportive partners.

Before addressing the many benefits of being a graduate from the University of Sydney, and the exciting future you are facing in your professional careers, I wish first to acknowledge the traditional custodians of the land on which we meet today - the Gadigal people and other clans of the Eora nation - and pay my respects to Elders both past and present. May I also acknowledge and pay my respects to all people of Aboriginal and Torres Strait Islander descent who are with us today to share in the celebration of this graduation ceremony. A special congratulations to those of Aboriginal descent who are graduating today.

Madam Chancellor, thank you for the opportunity of speaking to our most recent graduating dental professionals at this milestone in their careers and personal journeys through life. Congratulations also to the parents, families, partners, friends, university and hospital staff who have also supported today’s graduates during their challenging courses.

I wish in this address to focus on three interlocking themes which you as young professional graduates will need to reflect on as your future opportunities unfold.

The first theme considers what meaning underpins the notion of “rights and privileges” of being a University graduate in present day society. The second, what we, as dental professionals have to develop and understand with respect to working within a “health team” within the changing health reform fabric of Australian society; and the third theme, of how changing social and economic needs of Australians require all health professionals - especially dental professionals’ - to find new ways of ensuring fairness in access to health and dental health services, and fairness in outcomes in health and oral health.

Rights and privileges which accompany the Award of the degrees you have received today vary in nature and extent within the changing Australian community. They bestow on the Bachelor of Dentistry graduates, among other privileges, the courtesy title of “doctor,” and accord all oral health professional graduates; the public status, recognition and acknowledgement of a high level of knowledge, competence and skill in their profession.

These rights and privileges set you aside from others in employment opportunity and in social status within the Australian community. The University of Sydney degrees are recognised nationally by Australian regulatory authorities for you to practise your professions without further examination - acknowledgement of the quality of your education programs and of your competence and skills in meeting the demanding standards of the regulatory authorities. The rights and privileges bestowed by your University degrees carry with them however, social and professional responsibilities and obligations – the other side of the rights and privileges coin. Some of these obligations and responsibilities are explicitly laid out in Codes of professional practice – for example, as laid down by the Dental Board of Australia, the Australian Dental Association and the Australian Dental and Oral Health Therapists Association. These outline your responsibilities to your patients, your communities and yourselves. These Codes of Practice may be recognised legally as Standards by which a Court, a Board or Commission may judge your action, behaviour or competence against.

In addition to Codes of Practice are the moral and ethical responsibilities and obligations, of University professional graduates. For example, to effective collaboration between health professionals (that is to teamwork and working as a member of a team) and to health advocacy (that is, the recognition of health disparities in different groups of Australian society) and the responsibility and obligation to reduce inequalities and inequities wherever possible.

You also have a clear responsibility and obligation to life-time learning, maintaining and expanding your competencies and skills in line with the dental and oral health care you personally provide. This too is now framed within the changing health regulatory framework as a mandatory obligation.

The community expects University graduates to provide informed, unbiased and evidence-based leadership in your respective professions. This is implicit in your responsibilities and obligations to the Australian community as a University professional graduate.

Teamwork however is more than simply recognising the existence and assistance of other dental and health professionals in the provision of an oral health services. Teamwork is embodied in the ideal of primary health care. And, the oral health team is no longer simply a dentist working with a dental assistant in a store front practice on the high street!

The oral health team recognises the strengths of the professional relationships between the different oral health disciplines – therapy, hygiene, prosthetics, and health promotion - and all allied health professionals, in the delivery of appropriate total health care to an individual, within the broader context of the complexity of the Australian health care system. Within the context of the complex and evolving Australian health care system - oral health professionals will increasingly be called upon to work within a Primary Health Care context and not in isolation from other health and allied professionals.

The future will increasingly see oral health professionals working within corporate, group practice or multidisciplinary health agencies. And this will be the real challenge for you within the next two decades of this Century.

We are already seeing clear trends in this change with practice accreditation regulations, the roles of Medical Locals and community health centres, and innovations in vocational experience for dentists through the Commonwealth Voluntary Dental Intern Program - which will commence in January 2013.

How will you as a dentist, oral health therapist, and dental specialist work within this primary health care team? What is Primary Health Care and what will be the expectations and skills required of you to work within this context?

Primary Health Care was defined by the World Health Organization in 1978 as: “essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination”.

As young dental health professionals, you are highly skilled and competent in understanding the biological, psychological and technical requirements of treatment for people who sit in your dental chair, you are ready to meet the diverse technical challenges before you - your restorative, preventive, prosthetic and educational neurones are poised to meet the needs, demands and wants of your patient - but is this all that will be expected of you as a University graduate in the brave new world of primary health care?

There have been two recent major reviews of how dentistry could or should fit into the evolving Australian Health Care system which suggest that technical expertise and treatment alone will not be sufficient in the future. The first is the NSW Ministerial Taskforce on Dental Health commissioned to develop a state Dental Health Action Plan, and the second, is the Report of the National Advisory Council on Dental Health released in February of this year.

There are very clear indications - both at a national and state level - that dentistry and oral health therapy will need to look toward new models of dental care delivery within the transforming Australian health care system.

The National Advisory Council on Dental Health Report, for example, set a series of aspirational goals for dental services in Australia. The key intent is to have “An integrated national oral health system, as part of the broader health system that provides equitable access for people in Australia to prevention, promotion and clinically appropriate, timely and affordable oral health care. The goal embodies the principle of universal access (equitable access to services across the population).” These are radical aspirations for the dental profession and shift thinking from high technological solutions for resolving a population’s dental problems - to a Social Determinants of Health and preventive approach to solving oral health problems.

Examples of how the oral health system may better integrate into the broader primary health care initiatives were cited within the National Report as the Marion GP Plus Health Care Centre in South Australia, the Western Sydney Medicare Local Model and the development of dental services under the Medicare framework.

If these series of aspirational goals unfold - then the creative and adaptive skills that you have learnt during your University education will need to be called upon to allow you to transition into the mainstream health system.

In this broader health system context, your specific oral health competencies will be applied to the most challenging groups of Australian society, to improving oral health access and outcomes for Aboriginal and Torres Strait Island communities, to those in aged care residential facilities, those in rural and remote geographical settings and to meeting the dental needs of the medically compromised and those with disabilities!

Adaptability requires learning new skills both technical and interpersonal, and in moving out of ones’ comfort zone.

Governments and the community will be looking to you to provide leadership in determining better ways for those in greatest need to access your services in meeting their aspirations.

Your University professional education has provided you with skills also in - critical thinking, leadership and the capacity to adapt to a changing and challenging social and economic environment. These are the important skills necessary to meet the challenges of the future.

Madam Chancellor, thank you for the privilege of being able to address our most recent graduates in dentistry and oral health. I have attempted to cover briefly the challenges which I believe express the growing expectations of governments and the community with regards to the dental professions. There are an abundance of opportunities for the graduates of today in research, teaching, clinical practice and in public health - a great future in an ever expanding national and international primary health care environment!

Again I extend my congratulations to you in successfully completing the first part of your voyage.

I am sure that with the experiences you have gained through the University of Sydney, the continuing association you will have through the University of Sydney Alumni Association and your linkages to your professional associations - you have all the ingredients on board for a safe and prosperous voyage through your professional lives.

Thank you.