Community health services to remote Australian communities are frequently overlooked by health policy and planning authorities, despite the particular health and social problems confronting these communities. Nurses are the main providers of health care in isolated regions where they must perform an extended primary health care role. It is assumed that a nurse in the community can fulfil multiple and continuous roles in clinical care, and public health. In the absence of administrative expertise the isolated community health service functions more often by reflex action than design. Essential factors in the development of health services to remote communities include evaluation of current practices and staff utilisation. Greater accountability for funding would enforce regular reviews. Deliberate health services planning must be flexible to community changes and consider appropriate alternatives to the prevailing curative focus.