Governments must invest more in palliative care

Most Australians don’t regularly think about the end of their lives. In many ways this is to be expected. Life already has too many stresses and pressures without adding one’s own death to the list.

Unfortunately, the result is a lack of knowledge about what end-of-life healthcare options are available and how to access them. And the consequences of this on us, our loved ones, and society can be significant.

National palliative care week provides an important opportunity to raise awareness about palliative care, in particular the top quality physical and spiritual care offered by Catholic providers all over Australia

Palliative care is not just about pain relief in the last few weeks of life. When it’s delivered well, it’s about supporting people who are dying to actually ‘live’. And if it is made accessible earlier rather than later to those in need, although a sometimes confronting personal reckoning about our mortality, it can provide comfort and reassurance for years.

Catholic providers – many who have chosen to specialise in leading, quality palliative care – support patients and their loved ones through every step of their treatment.

A significant part of this is pastoral care, whether in the form of accompaniment, conversations, or prayer and spiritual guidance for patients and their friends and family.

It was 134 years ago that the Sisters of Charity delivered Australia’s first hospice to care for the dying as part of St Vincent’s Hospital Sydney.

Now about 100,000 Australians access palliative care each year – and this number is set to significantly increase as the baby boomer generation ages.

The problem, however, is that government funding is not keeping pace with need, and innovative new models for delivering this care optimally aren’t well supported by Government and policy.

The NSW government, for example, has cut palliative care funding by $250 million, despite waitlists blowing out to multiple weeks.

The cuts were as large as 40 per cent in western Sydney and the Hunter region and more than 30 per cent in several other areas including the Central Coast.

Both doctors and providers in other states including Victoria and Queensland have also warned of chronic funding shortfalls which are limiting access to quality care. It doesn’t take a stretch of the imagination to conclude that these barriers are experienced more often by those in regional and rural areas of Australia, who having worked just as hard their whole lives, cannot rely on a health system that meets their needs in the final years.

Furthermore, we know that one key demographic feeling the squeeze of Australia’s cost of living increase are those in the outer metropolitan suburbs, mortgaged and with dependents of their own, who are often also considering care for their own parents.

The accessibility and affordability of end-of-life care options for this “sandwich generation” has ramifications for their stability, and our economy.

We know that many people with a terminal illness want to die at home, in the familiarity and comfort of their own surroundings and with their loved ones by their side.

This makes access to properly funded, flexible palliative care services even more important, so people have genuine choice on where they spend their final precious weeks and days, rather than being forced into hospital. Currently, this is an option granted to the few, rather than the many.

We also know that a large majority of Australians support government investment in palliative care.

Without quality and accessible palliative care, there is a real risk that some patients decide to explore the option of ending their own lives when they may not otherwise have done so.

This is exacerbated by the complete mismatch between the accessibility of VAD and palliative care. Patients can obtain VAD approval in the space of a few days while entering palliative care requires navigating a regulatory minefield.

It shouldn’t be vastly easier to die than it is to live a little longer with the comfort and dignity that a universal health system promises.

Since Victoria became the first state to legalise Voluntary Assisted Dying Legislation in 2019, the number of VAD deaths has increased every year, reaching 306 in 2022-2023.

Catholic providers object to the very concept of deliberately ending a life as it undermines our ministry of healing and is inconsistent with our ethic of care.

But the idea that patients feel encouraged to pursue this option due to a lack of alternatives is even more problematic.

Voluntary Assisted Dying legislation now exists in all six states. It is therefore more important than ever that palliative care services are easily accessible and properly funded.

Aside from the need to provide patient choice and effective care, there is also a compelling economic argument.

Work by KPMG has shown that investing more in palliative care actually saves taxpayers money in the long run by reducing hospitalisation time and costs.

This palliative care week is a good opportunity to remind governments that there is no good reason to continue underfunding such a critical aspect of healthcare.