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House of Assembly - Fifty-Fifth Parliament, First Session (55-1)
2023-06-28 Daily Xml
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Regional Hospices

Mr BELL (Mount Gambier) (11:12): I move:

That this house—

(a) recognises the need for varied end-of-life care in regional areas; and

(b) calls on the state government to investigate the potential for a dedicated palliative care facility based in the City of Mount Gambier and servicing the wider Limestone Coast region.

What is a good death? According to the Grattan Institute in their research paper Dying Well:

A good death meets the individual physical, psychological, social and spiritual needs of the dying person. Most people prefer to die comfortably at home or in a home-like environment with minimal pain and suffering. They hope to be surrounded by friends and family and the care services they need.

A good death means choice. Approximately 70 per cent of South Australians wish to die at home, yet only 15 per cent manage to do so, with a majority being in hospitals or residential care homes. Rising rates of cancer, chronic illnesses and other conditions such as dementia coupled with our ageing population have led to a rise in demand for palliative care services. Palliative care in Australian hospitals has increased by 28 per cent over the last four years. The impact of ageing and increased numbers of single-person households will continue to place a greater demand on health services.

Country patients have to do it tough. Those who suffer with cancer and chronic illnesses will have already had to spend countless hours travelling and days away from home to undertake treatment in Adelaide or Warrnambool. They do not have the luxury of returning to their home and family after treatment each day.

Currently, the Limestone Coast is serviced by a hardworking team of specialist palliative care nurses who cover an extensive area from Mount Gambier to Bordertown. They provide these services between 9am and 5pm Monday to Friday. Our local hospital has one dedicated but not exclusive palliative care room, which is situated in an environment that struggles to provide person-centred care that meets the holistic, cultural and spiritual needs of the patient and their loved ones. There is no resident palliative care specialist.

Recently, through the efforts of the chair, Maureen Klintberg, and a dedicated group of volunteers, we have seen the introduction of the Mount Gambier In Home Hospice Service. This service provides vital non-medical support and assistance to help ease the burden on carers and families, allowing patients to stay home and out of hospital for longer. Too often in regional areas we lack access to the same services our metropolitan counterparts enjoy.

Whilst we applaud the government's recent addition of an additional part-time specialist care nurse to the Limestone Coast, there is still much more to be done and many gaps that need to be filled. An example of this is 53-year-old Mount Gambier resident Glenys Smith and her sister Annette Smith. Glenys was diagnosed with breast cancer in 2015 and received a terminal diagnosis in December last year. She suffers from severe lymphoedema in her right arm, which has led to Glenys requiring round-the-clock care, as she requires assistance for general everyday tasks. Glenys was a carer for her mother, who now resides in an aged-care facility.

As Glenys now lives independently, her sister Annette has moved out of her own home she shares with her partner to help care for Glenys. Annette, who suffers herself from rheumatoid arthritis, has spent countless hours advocating on behalf of her sister and navigating the regional health services to find assistance for Glenys so that she can maintain her own employment. When Annette first called Carers SA, she was told it would be two weeks before anybody would be able to return her call.

She has been receiving assistance from the palliative care nurses and the volunteer In Home Hospice Service. Homecare Plus was visiting three days a week for a total of two weeks; however, the funding for this package was only available for a two-week period, as this was for end-of-life care. Annette then had to apply through Carers SA; however, limited funding meant this was now reduced to 3½ days for the next two-week period, leading to the constant stress and worry of what the next week would bring and who would care for Glenys.

Whilst we rightly speak about the patient's needs, we also must not forget about the carer's needs. The emotional and physical burden for those caring for loved ones can be great. Just two weeks ago, Annette reached the point of exhaustion and needed help. The only option available was to have Glenys admitted to the local acute hospital in Mount Gambier. Glenys has now undergone an ACAT assessment, and it has been assessed that her needs do qualify for respite care. ACAT stands for Aged Care Assessment Team; Glenys is 53.

The only option available is an aged-care facility. This then depends on availability, with patients often being sent to Millicent or Naracoorte, up to 100 kilometres away. Glenys has now found accommodation for respite in Mount Gambier; however, there is a wait for this to occur, and in the meantime she is still in the Mount Gambier hospital.

Another Mount Gambier resident, Fay Lamond, was unable to be placed locally. I became aware of Fay's story through the advocacy of her granddaughter Gail. In early 2020, Fay became unwell. At this time, she lived at the Woodlands retirement estate with her husband, Col, for whom she cared after he suffered a stroke in 2018. In March, it was discovered that Fay had bowel cancer and required surgery. This required Col to go into an aged-care facility. No beds were available locally, so he was transported to Sheoak Lodge in Millicent, which is 50 kilometres away.

After Fay's surgery, she needed to be transferred from the hospital to a respite facility. Again, there were no beds available in Mount Gambier. She, too, was transferred to Millicent but ended up in a different facility from her husband of 64 years, that is, Boneham Lodge. During this time, COVID arrived and Fay's family had to travel over 50 kilometres for a half-hour visit. At a time when Fay's family wanted to be by her side, Fay spent most of her days alone, with overworked aged-care workers and nurses trying their best in unprecedented circumstances.

Her last three weeks were spent in Mount Gambier hospital, the family restricted to 15-minute visits by no more than two family members at a time for two hours a day and her great-grandchildren unable to visit at all due to COVID restrictions. There was no designated palliative care room, and the family found themselves congregating in corridors in the clinical hospital environment with no place to go for a moment's reprieve other than the hospital cafe. Since the passing of her grandmother, Gail has become a passionate advocate for palliative care and fundraised for a cuddle bed, which is now being used in our local hospital. Too often, country residents are taken for granted and made to feel like we should be happy for what we have.

I am calling on the state government to investigate the potential for a dedicated palliative care facility to be based in Mount Gambier, the state's second largest city, and to service the nearly 70,000 residents in the Limestone Coast—a facility that provides a homelike environment for those who have a chronic life-limiting illness, a facility that provides respite for both patient and carer, a facility that can be a home to our specialist palliative care unit, a facility that can be home to our invaluable in-home hospice service, a facility that can give our student nurses and doctors the ability to specialise in palliative care, a facility that gives people a choice in their end-of-life journey. Let's give those who have been given an end-of-life prognosis the dignity of choice and give them a good death.

Ms PRATT (Frome) (11:21): I am very proud to rise to speak to this motion as the lead speaker for the opposition. I am proud of the chamber for the number of people who are going to speak to this motion today, and I thank the member for Mount Gambier for bringing this motion to the house for debate and discussion.

When I think about my grandparents and great-grandparents, who were born and who died on the land, and what options and services were available to them as they approached their final years with serious ailments and diseases, it certainly gives me a sharp focus on the motion before us reflecting on end-of-life care in the regions, and I look forward to the speeches that will follow.

There is certainly an increasing call across regional South Australia for more attention and investment into ageing well at home, preparing for end-of-life for people of all ages sadly, downsizing of homes for those who are older and sourcing essential services for domiciliary care, which is more often than not paired with a disability or at least immobility. While this motion asks us to consider services in Mount Gambier and more broadly the Limestone Coast, I cannot help but reflect on what my electorate of Frome also needs in the way of health services for cancer treatment, aged-care services and retirement housing.

When it comes to the rest of state, there are certainly many valid examples of communities that are deserving our attention, our investment and our resourcing in palliative care and in providing hospice services. Again, as the shadow minister for regional health services, I reflect on the needs of the entire state, factoring in distance, population mass and an ageing demographic. Towns that come to mind immediately, alongside Mount Gambier of course, would be Port Lincoln in the electorate of Flinders in terms of probably demographic but certainly distance and population mass, and Victor Harbor as a growing destination for retirees.

I reference Mount Barker as a regional community, Mr Speaker, which through your advocacy is calling for not just the expansion but in fact the implementation or the rollout of a hospice. In reflecting on hospice services, I pick up on the member for Mount Gambier's reference to Maureen Klintberg, who is widely known certainly on this side of the house as a very fierce advocate for hospice services in the South-East and who has done extremely well to extract funding from the current and former governments. May she continue to advocate for that.

Living and teaching in Mount Gambier as they did for over 10 years, there is definitely a soft spot for the Limestone Coast, member for McKillop. In listening to the comments of the member for Mount Gambier, there are six degrees of separation often in our comments. I played softball with Gail Lamond, and it is heartbreaking to hear those personal stories. Again, her advocacy, tied to her family and her grandma, drives us to deliver a cuddle bed for the Limestone Coast and is just one example of a variety of services that we should be calling for.

In reflecting on what the current services are, I want to recognise the current government's commitment to and announcement of funding 10 additional palliative care nurses across regional South Australia. It is not clear to me through the recruitment whether all those nurses are yet in place but, to reference the local health networks where they are going to be established, 3½ FTEs in the Barossa Hills Fleurieu; two FTEs in Eyre and Far North; one FTE allocated to Flinders and Upper North; to the member for Mount Gambier's point, only half an FTE in addition to the Limestone Coast; two FTEs of the Riverland Mallee Coorong; and one to the Yorke and Northern, which encompasses my electorate of Frome.

We welcome that investment as well as the federal government's announcement of $7.5 million towards palliative care services in South Australia, but it will not surprise the house that I will go further and say there is always more to be done. Navigation pilots are an essential part of planning and mapping support services for end of life, and I know that the government has its eye on that as it reviews palliative care services through the Health Performance Council.

Again through my portfolio and travels around the state, whether it is cancer treatment, the Cancer Council Lodge itself provides a cancer support coordinator, as does the McGrath Foundation. I will touch on the MND Association shortly, but there is a need and a call for more investment in those navigators who assist our loved ones as their illnesses are diagnosed to support them through what must be a terrifying time.

It is quite timely that today I have shared with the member for Davenport the role of co-convening our inaugural Parliamentary Friends of MND group, and we welcomed a number of patients, their carers, the board and we heard from Karen Percival, the CEO. I want to make the most of my time reading into Hansard some of the comments Karen shared with us today about MND—that is, it is about:

…supporting patients and carers from initial diagnosis to end of life, and for those who grieve beyond.

She said:

We do this at home. Research shows that over 95 per cent of time spent by dying and grieving people is at home. Less than 5% of time is spent in front of a doctor or nurse.

I think the conversation we are having today is one of those compassionate options that we need to provide to people who should be allowed to make the decision to die at home.

Karen Percival said that we need to address the provision of palliative care from diagnosis to end of life. We note the recent joint federal-state initiative in this area to provide navigators, which I touched on just briefly. Over the last two years, MNDSA, with the help of palliative care grants, completed a palliative care pathways project for those patients and also introduced a loss, grief and bereavement support service led by volunteers.

MNDSA has the opportunity to play a central part in health and wellbeing. They see the new palliative care initiative around navigators to link the terminally ill with palliative care services, which they can do, but they also see expanding this work with the wider personal networks that patients and their carers already have. I want to thank Karen again for her words. We heard examples from sufferers and from carers, and I note that some of our guests popped into the chamber in recognition of the motion that was put forward.

I have been saving my final comments to touch on yet another heartwarming and heartbreaking example of a human story of a South Australian who, once diagnosed with a terminal illness, is confronted with the decisions before them. I want to recognise and pay my respects to a lovely young lady called Lily Thai, whom I did not get to meet. At the risk of no-one else in this house recognising her life, I want to do that.

At the age of 17, she was diagnosed with a life-limiting illness, a disease called Ehlers-Danlos syndrome, and later on she was diagnosed with autoimmune autonomic ganglionopathy. She passed away last Wednesday at the age of 23. She was very brave. She made a brave decision to access the newly legislated voluntary assisted dying laws. May she never be forgotten. She deserves no less.

Ms CLANCY (Elder) (11:32): I also would really like to thank the member for Mount Gambier for bringing this incredibly important motion to the chamber. I know I have spoken in this place before about previously having worked for Minister Mark Butler. He is now the federal Minister for Health, but back when I worked for him he was the minister for ageing. The time I spent with him, meeting with different people working in palliative care across our country, was incredibly moving and challenging, and it really brought home the importance of people being able to die with dignity, die with choice and also being able to have really good services near them.

The Malinauskas Labor government is committed to delivering end-of-life care options across South Australia so that people can access the care they need and make choices for their care, no matter where they live. The government committed $5.1 million to recruit 10 new palliative care nurses in regional South Australia. That is part of our commitment to deliver 76 more nurses in areas of priority need. When we formed government, we took very strong advice that these new positions need to be based in regional South Australia: 9.3 FTE of these positions have been filled, with recruitment for the final part-time position now being finalised.

We are also partnering with the federal Albanese Labor government to launch a new palliative care pilot program in South Australia. Palliative care navigators will be employed to connect terminally ill patients with local palliative care services in both Adelaide and in South Australian regional centres, in a three-year $7.5 million pilot program. As well as palliative care navigators helping individual patients and their families, the pilot will invest in a user-friendly phone line, a dedicated website offering information around the clock, improved volunteer coordination and access to bereavement supports.

People with a terminal illness in regional South Australia will be able to contact palliative care navigators directly by phone. As a statewide service, palliative care navigators will have the capability to assess people's needs, either remotely or in person, and the expertise to link people to the supports they require, particularly in their local community.

We also partner with the federal government to jointly invest in improving the provision of palliative care for people in aged care. A total of 15 state-funded residential aged-care facilities are taking part in the regional hospice in the residential aged-care pilot across six regional local health networks, including Bordertown, Naracoorte and Millicent. That is delivering training and embedding palliative care practices as business as usual across these facilities.

Supporting people with choice in end-of-life care is an important component of access in regional South Australia. We continue to promote the use of advance care directives to raise community understanding of advance care planning, foster self-determination and establish innovative peer volunteer roles. Support is being provided to local councils through codesigned project workshops, resources, online training and volunteer roles. This work was developed with the Inner Southern Councils Advance Care Directive Collaboration and is now being rolled out in the Southern Fleurieu, Murray Mallee and Adelaide Hills regions.

Another end-of-life choice for South Australians is now voluntary assisted dying, with the commencement of those laws on 31 January this year. Of the 30 regional doctors who have registered to undertake the mandatory training, 16 have completed it and are eligible to deliver voluntary assisted dying in South Australia. Doctors from metropolitan Adelaide are also able to support regional patients, with supported travel and telehealth consultations where appropriate.

We have also established a statewide Care Navigator Service and dedicated regional liaison nurse for voluntary assisted dying for both the community and health professionals to seek support and advice on access to voluntary assisted dying in regional South Australia.

The Malinauskas Labor government has tasked the Health Performance Council of South Australia with undertaking an inquiry into the provision of palliative care services in the state. We have asked the Health Performance Council to provide recommendations for the most effective and efficient improvements that could be made to palliative care services in South Australia, and I expect this to also include recommendations for palliative care services in regional South Australia.

The Limestone Coast Local Health Network provides level 2 palliative care services to the Upper Limestone Coast and level 4 services to the Lower Limestone Coast. Level 4 services are available seven days a week in Mount Gambier. In the Upper Limestone Coast, care coordination is available five days a week through the specialist team in Mount Gambier or the community nursing team in Naracoorte.

The Limestone Coast Local Health Network palliative care team includes registered nurses, clinical nurses and a nurse practitioner as well as an occupational therapist, physiotherapist and social worker, with referrals to other services as required. There has been 0.5 FTE palliative care nurse funding provided to the health network under election commitments, which has been utilised to create a registered nurse level 3 palliative care role. This role has been recruited and is providing direct clinical care and assisting the local health network to provide an increased level of service in the upper Limestone Coast.

There are end-of-life-care packages available from the specialist palliative care team which can include after-hours care in the terminal stage on a case-by-case basis. These packages support community-based end-of-life care for individuals and their caregivers and families and are designed to provide end-of-life care to people with palliative care needs that require additional support outside of that already available from existing services.

Palliative care services are provided in the community, at acute hospitals and in aged care facilities within the Limestone Coast Local Health Network with trained staff and appropriate amenities for patients and families to ensure appropriate palliative and end-of-life care in the person's place of choice. The network has been undertaking extensive and inclusive service planning activities to guide the growth of clinical services across the region.

As part of these service planning activities, access to hospice care, whether at home, in hospital, in the community or in a dedicated facility will be considered as part of these activities, because access to a range of end-of-life choices is something we can all agree on.

I know that through my experience with loved ones in palliative care in Adelaide, it is obviously a really challenging time for everyone involved. I was really, really grateful to the staff at the Repat in 2009 for providing incredibly loving, compassionate and understanding support while my nanna was dying. They were just absolutely beautiful, and I am really, really appreciative of it.

I was actually just at the motor neurone disease event, which was put together by the member for Davenport and the member for Frome, and had the opportunity to speak with a doctor from the new palliative care facility at Flinders hospital, which is just over the border from my electorate and obviously something a lot of people in my community, when they do need to access palliative care services, go to.

I was really touched when he said that the nurses there just make people feel like they have been enveloped in this big hug as soon as they walk in there. The staff are just so incredible, and he said that the services for the patients are second to none.

My friend's mum, who I was also close with—and she was part of my book club—passed away at the Laurel Hospice in January. My friend said that for their family it was a really beautiful environment for them to spend their last few days with her. The opportunity to easily wheel her outside—which was not available at the previous facilities at the Repat, it was a bit challenging to get outside to the garden—meant they were able to take her out to watch the sunset and get that fresh air, and try to feel, for a moment, like they were not in a clinical environment. It was very special to them.

They had also heard of the tiny horse that is in that palliative care facility some days who, apparently, is dressed in little pink boots so she—or he, I am not sure—does not slip over; they also have a little pink poo bag for any accidents. The doctor I was speaking with today said he actually had a GP call him and say, 'I'm really worried about my patient; I called to see how they were doing and they were talking about how there was a tiny horse who had pink feet.' The GP was concerned that the patient was hallucinating, but the doctor from Laurel was able to say, 'No, we really do have a tiny horse who wears pink boots there.'

Those incredible services are available here in the city: we should also be able to have incredible services available at the most challenging time for members of our community in our regional areas. Thank you again to the member for Mount Gambier for this motion.

Mr TELFER (Flinders) (11:42): I thank the member for Mount Gambier for bringing this important motion to this place. It is a challenging subject, because I am sure each and every one of us have been touched by someone who has had to go through end-of-life care, palliative care, whether it was a friend or a family member.

In particular, paragraph (a) of the motion recognises the need for varied end-of-life care in regional areas. Coming from a regional electorate a similar sort of distance away as the member for Mount Gambier's electorate, and with far-flung areas of my electorate, it is a long way away from that high level care that we get within the metropolitan area. It is also an area, when you are at that stage of life, that is an incredibly challenging time not just for the individual but for their family, their carers, the people who have been supporting them—often through long and drawn out illnesses.

The support for the terminally ill and those within palliative care within regional areas does vary. Obviously it is more challenging to deliver those services there, but it is so incredibly important for those people; the further you are away from your safe place, your home, your area of comfort, the more challenging it is.

I look especially at some of the challenges faced within my electorate in, as I said, some of the more far-flung communities, some of the Indigenous communities that have that connection to country, that connection to home. If you are forced to be further away from that at the most vulnerable time of your life, at the end of your life, it is incredibly sad to see a situation like that.

I recognise the government's commitment to additional palliative care nurses across regional South Australia. A lot of things happen in this place that are bipartisan and there is agreement on all sides, and I think no-one could argue against this. We have seen additional allocations and another two palliative care FTE nurses in my area (they are in the Far North), bringing the total palliative care nurses to 3.3 FTEs. The rise is fantastic, but the need is even greater unfortunately.

The distance even between Port Lincoln and Ceduna, where there are some 400-plus kilometres up to the further-flung areas from Port Lincoln to my neighbouring electorate of Giles, to Whyalla, is 2½ hours away. The expanse of our electorates cannot be underestimated. Really, to recognise that there are people with need for end-of-life care throughout that whole area is something that is really important. Increasingly, people are choosing to have hospice care for their end of life. There is a real focus now on the care, the comfort and the quality of life of a person with a serious illness who is approaching end of life.

Obviously, we all know that at some time these serious illnesses can get to a point where they are not possible to cure or the person might decide that they are not going to continue to undergo certain treatments. It is at this point that that hospice care is really important. The patient beginning hospice care is under the understanding that, because their illness is not responding to the medical attempts to cure or slow it down, this is the next step. As I said, it is something that is very confronting and something that I am sure each and every one of us has been touched by, but in regional areas it has that extra layer of complication.

There is a growing body of evidence in the literature that demonstrates that that home-based palliative care, hospice care, to treat and help manage patients' symptoms, improve their quality of life and try to prevent avoidable hospitalisations, is really important. To have a team of care around patients, around people going through this with specialised palliative care—specialists, nurses, general practitioners—is so really important.

A lot of the time in regional areas, within my electorate and others comparably, medical professionals are doing the best with the skills they have and the knowledge they have, but this palliative care work is specialised in nature and specialised in what it actually delivers for patients. That is why it is incredibly important that we do what we can as decision-makers to make sure that those sorts of supports are in place for people within the regional parts of our state and recognise that the quality of life it does deliver at end of life is something we should be really striving for.

There should not be an assumption that, because someone lives further away from Adelaide or the major health centres, the level of care they get is somewhat lessened. We understand in regional areas that you are not going to get all the wide range of services that you do in higher population areas, but there is a standard, a level that we should expect as a state—that every one of us, wherever we live within our state, should and does deserve.

With these sorts of motions, the individual stories, the individual experiences, always hit home to you. My family have had experience of this, and it has been front of mind for me at the moment. Only last week, someone who was well known to me lost their life after a long battle with breast cancer. I note in this place Deb Glover, who spent the majority of her life battling breast cancer—and she did battle. I note her parents, Robin and Valda Glover. As I said, only one week ago she passed away. Her funeral is on Friday. I will be in this place, so unfortunately I will miss the funeral.

In the funeral notice, the family noted the incredible work of the Port Lincoln palliative care team. They recognised that, although it is a challenging and most difficult time of a life for family and for carers, to have quality of life at end of life is incredibly important. As decision-makers, we should have an expectation that those of us within regional areas have that same capacity to access this sort of care. I commemorate Deb Glover here today, a brave, courageous woman now finally at peace, leaving us a beautiful legacy.

Mr HUGHES (Giles) (11:49): I also rise to support this important motion, especially as a regional member. I think all regional members deeply appreciate some of the challenges when it comes to delivering services to regional communities, especially the smaller communities. It can be a challenge in terms of finding the appropriate staff and facilities, but I think we should all expect, as best as possible, to have a quality end.

As people have said, many of us have been exposed to the passing of family members or close friends. Certainly I have had that experience in Whyalla with the death of my younger brother from cancer. As the member for Mount Gambier said, usually when there is a diagnosis of that nature some time is going to be spent in Adelaide, often for surgical intervention. That does require specialist teams. Even big communities are never going to replicate the capacity you would find in the big cities, but there is much else that can be done.

There was a $70 million investment on the part of the Rudd-Gillard government and the Rann government that led to a big improvement in facilities in Whyalla. It is not just the improvement in the facilities; it is what happens in those facilities. To have a cancer treatment centre where, in many cases, people can have their chemotherapy and not have to go to Adelaide is certainly a plus.

The new facility in Whyalla was where my brother spent the last six weeks of his life. It was a very high-quality facility in terms of both the personal care that was provided and the built environment. He was in a room that had its own kitchen, its own ensuite and its own deck overlooking a beautiful garden. We could all turn up, mates could turn up, and we had barbecues on the deck. It made what was a very difficult situation somewhat easier.

My sister was over from New South Wales, where she works in the private health system. She saw this facility in a public hospital and said it was better than anything that she had come across where she has worked in the private sector in New South Wales. Good quality facilities with caring staff can make an enormous difference at the end of life. The flexibility of the staff is also important.

My brother was a smoker from the age of 16, a very heavy smoker. There was no point in his giving up at that stage of his life. If the hospital had been very tight on the rules, he would not have been able to smoke on the hospital grounds. He was in a wheelchair in the last few weeks of his life, and they had no issue with us pushing him out onto the hospital grounds so he could take care of his very strong addiction. That combination of things made easier something that was incredibly difficult.

It would be good to see the quality of what was provided back then in 2015 replicated in our major regional communities, whether it is in Mount Gambier—and I have heard what the member said about Port Lincoln and the service is great there. I do not know what the quality of the facilities is, but if we can replicate that in those hospital settings that is great. Ideally, we should have the resources to enable people to die at home. For most people, that is what they want to do.

Often, for a whole range of physical and other constraints, that can become difficult. It becomes difficult because—and this is especially in regional communities—the services to support a person dying at home are often not in place. It is good that there are some initiatives being taken with extra palliative care nurses, and the inquiry that is going on at the moment is great. I will be interested to see where that leads. We need more support in regional communities when it comes to services like this.

It was interesting to reflect upon when my brother passed away. Especially for those of us from the regions, we often talk about the metro-centric culture and the concentration of resources in the big cities. To a big degree, that is understandable, but my dad died in Sydney in one of the largest public hospitals—that was in 2008, so it was not all that long ago—and the quality of the palliative care there at Concord Hospital was absolutely appalling. My brother had far better at a regional hospital in South Australia than my dad had in that major public hospital in Sydney towards the end of his life.

This is a very important motion. I wish the member for Mount Gambier all the success in the world in prosecuting his case. Likewise, to other members who represent regional communities, we need to see our services enhanced and especially, because it is easier, in our bigger regional communities, with the appropriate outreach and other services and supports that are needed for people in smaller and more remote communities.

Mr McBRIDE (MacKillop) (11:57): It gives me great pleasure to speak on this topic. I must thank and congratulate the member for Mount Gambier on his advocacy not only for Mount Gambier; he has clearly highlighted the Limestone Coast with his motion. I would also like to thank the member for Frome, the shadow regional health minister for the opposition, and the member for Flinders and also on the other side the members for Elder and Giles for their contributions on this important motion. Hopefully, we see some sort of traction.

I must also acknowledge the Labor government with its 10 additional nurses, which was mentioned by the member for Elder. They are regionally based, and point five of them have ended up on the Limestone Coast. This motion touches a heart chord in the fact that my wife is a nurse. She worked for community health for 20-odd years from Millicent. She also travelled the regions of the Limestone Coast up towards Bordertown and Naracoorte. She headed a Limestone Coast community nursing role, and one of their strong roles was palliative care. If I may, I can touch on how valuable this service is to the region, and not only for the patients and families who fall into this sort of situation.

There is no doubt that any sort of news that any human being receives that their death is near, that they have something terminal, whether it be months or years, is never good news. Ultimately, there is an end in sight, and that end is obviously a wish that we would all like to be in the most comforting, supportive and caring place possible, knowing that not all ends are as dignified and easy as others.

Obviously, there will always need to be that hospice or hospital-type role when things become complicated, difficult and perhaps beyond what this palliative care service could offer, but I think it is really important that this service is offered as much as it possibly can be. Some of the data I have here is that we know that 30 people died in 2019 in the Naracoorte hospital. Fifteen of those would have liked to have participated in palliative care at home but did not get that option because there was no service provided.

Then there are also the options—when we talk about palliative care and when we talk about nursing, what does that actually mean? It means that a nurse will generally come around five days a week, sometimes even on weekends if it is needed, on some sort of contract basis. The nurse goes there to talk on, and meet with, the patient who is in this palliative care for all the things that they need today and will need tomorrow.

What does that look like? It means pain relief and it means that the medication is working—and if it is not, the nurse has an obligation to then speak to the GP to make sure that GP is aware of the patient's needs and requirements. It might be about the needs of the house, so there might be some handles, movement aids in showers, or ramps in the house. When a patient might be moving towards a wheelchair or mobility device, the house is then fitted so that that aid can actually work in that house. They are all small little bits and pieces, but the palliative care system puts in these sort of additives to the home to keep people at home for as long as possible.

Another thing that comes on top of this is the fact that we are taking and keeping people in their home and not in the hospital system, which we know is already under strain and stress. There is all that positiveness in that financially, with obviously a better outcome and cost, where people can live at home as long as possible with the visitation of a palliative care nurse who makes only that visit and then goes on and visits other patients. I would imagine it would have to save the medical system a greater amount of money than if people were in the hospital care system.

The other thing I will just touch on and go through is that, with the patient being allowed to stay at home, what is the benefit to the family surrounding that patient—the families that see the loss or the losing of their loved one over a period, but know that they are having good care in their home in the family environment and not in the hospital environment.

This is what this palliative care system is all about. This is why I believe it does need to be funded well, I think it needs to be represented well, and it certainly needs to give those options to all those who want to participate—whether you are a city resident or you are a regional resident. As this motion talks to, it is about the regions, and particularly the Limestone Coast, but regional South Australia as a whole.

So, without speaking further, I would like to congratulate the member for Mount Gambier on this motion and I hope that the state government can do all that it possibly can to make sure that this service is well funded, well resourced and can be utilised by as many regional South Australians as possible. I support the motion.

Mr BELL (Mount Gambier) (12:02): I first of all would like to thank the members for Frome, Elder, Flinders and Giles, and of course my electoral neighbour, the member for MacKillop, for their comments, which I really appreciate. It is a really important motion and I am looking forward to working with both sides of parliament to progress the motion. I assume it is going to pass without dissent, which means it is supported by this parliament as an important motion that has bipartisan support. With that, I commend the motion to the house.

Motion carried.

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