Motions

Palliative Care

The Hon. F. PANGALLO (16:00): I move:

That this council—

1. Recognises Palliative Care Week was held from 20 to 26 May;

2. Recognises that access to appropriate pain and symptom management, and being surrounded by family and loved ones, are most important to people who are dying;

3. Acknowledges that the Productivity Commission’s draft report into human services, released in June 2017, argued that more community-based palliative care services are needed to enable more people who wish to die at home to do so, and that end-of-life care in residential aged care needs to be better resourced and delivered by skilled staff;

4. Notes that there are just 213 palliative medical specialists across Australia, equating to one specialist for every 704 deaths each year;

5. Notes that Palliative Care Australia estimates that while 70 per cent of Australians wish to die at home, only around 14 per cent do so;

6. Recognises Palliative Care Australia’s call for a national palliative care commissioner who would examine existing palliative care services and programs nationally to assess their efficiency and effectiveness in supporting terminally ill individuals and their families to live as well as possible, right to the end of life; and

7. Urges the federal government to make palliative care a health priority and appointing a national palliative care commissioner.

The motion I move today recognises Palliative Care Week, which was held last week, and the importance of raising awareness about properly resourced palliative care in our community. As the saying goes, 'nothing is certain except for death and taxes', but while taxes will always remain painful death does not need to be. Pain and symptom management, along with being surrounded by family, are most important to people who are dying. All Australians deserve to die with dignity and to be surrounded by the people they love. Sadly, the wishes of thousands of terminally ill Australians to die without pain is going unmet. Why? Because palliative care services fall severely short in Australia, and particularly in South Australia.

Families are being forced to helplessly watch someone they love die without receiving adequate care, pain relief, nursing support or information about end-of-life care options. Palliative care helps terminally ill people see out their lives as fully and comfortably as possible. It can be provided at home, in hospitals or at aged-care facilities. This specialised care includes pain and symptom management, support for families to talk about sensitive issues and psychological and spiritual support for the patient and their loved ones. Palliative care in South Australia is in the worst condition it has been since 1980 when it was first implemented in the South Australian health system.

Presently, the number of people wishing to die at home with the support of community-based palliative care services far exceeds the availability of that care, particularly for those with illnesses other than cancer. For many, access to community-based palliative care is determined by where a person lives rather than where they prefer to die. A postcode should not determine the level and quality of palliative care a dying person receives. Palliative Care Australia, the peak body, estimates that while 70 per cent of Australians wish to die at home only 14 per cent do so. That is a shocking indictment in anyone's language. Sadly, South Australia lags behind the other states with three out of four South Australians not getting access to palliative care. This is totally unacceptable.

The Productivity Commission released a draft report in June 2017 which examined reforms to human services and specifically palliative care services. It stated:

Each year, tens of thousands of people approaching the end of life are cared for and die in a place that does not reflect their choice or fully meet their needs. Most people who die do so in two of the least preferred places—hospitals and residential aged care.

The commission also said that patients' end-of-life journey will likely be punctuated with unavoidable or unwanted admissions to hospitals and the confusion, loss of dignity and loss of control that comes with it. South Australians deserve much better than this. The Productivity Commission's draft report argued that reforms in this area should be a high priority for the government of South Australia and SA-Best could not agree more.

More community-based palliative care services are urgently needed to enable more people who wish to die in their own homes to do so. The Productivity Commission also argued that end-of-life care in residential aged care needs to be better resourced and delivered by skilled staff. There are just 213 palliative care specialists across all of Australia—213 palliative medicine specialists—that is just one specialist for every 704 deaths in Australia. That should shock everybody in this place. That is simply not good enough for a country like ours.

Inadequate funding of palliative care services only furthers the pain and stress that terminally ill patients and their families are forced to endure. Many family members feel they have to go it alone in the last few weeks and months to ensure their loved one has help to use the bathroom or wash, something that causes an enormous amount of strain at an already stressful time. It is also traumatic for families to see their loved one dying before their very eyes, without access to adequate care and support.

South Australia and other states desperately need to regenerate the investment in palliative care so that people can be supported to live, die and grieve appropriately. This government must make palliative care a top priority.

In my motion I call for this place to urge the federal government to make palliative care a national health priority and appoint a national palliative care commissioner who would address the current fragmentation of palliative care services in Australia. Further, the commissioner would be chartered to examine existing palliative care services and programs nationally to assess their efficiency and effectiveness in supporting terminally ill individuals and their families to live as well as possible right to end of life.

I end by encouraging all members of the Legislative Council, and members of the other place, to have an end-of-life conversation with their loved ones. We do not like talking about death and dying because we do not want to think about our loved ones dying or suffering. That fear explains our reluctance to talk about the issue as we should, but we actually do need to talk about it, so to that end we can help our loved ones at the end of life and vice versa.

To quote Dame Cicely Saunders, the founder of the modern hospice movement, 'How people die remains in the memory of those who live on.' We are all part of the story. We must do better. Death is inevitable, but dying unsupported should not be.

Debate adjourned on motion of Hon. I.K. Hunter.