Australians face surge in palliative care needs
The threat of a surge in deaths from COVID-19 brought the value of palliative care sharply into focus.
The palliative care sector was proactive, working with governments and health and aged care professionals to be ready to care for and support people who were dying, and those who love them.
Thankfully, COVID-19 deaths in Australia have been limited.
In reality, currently in Australia, around 160,000 people will die each year. This will reach 200,000 by 2030. The great majority of these deaths are what we describe as ‘expected’ or ‘predictable’ deaths, that includes many people who have had terminal conditions, or have been elderly and frail.
It’s been estimated that of those who die currently, around 80,000 people would benefit from, or need, palliative care. Holistic care that improves the quality of life of patients, helping them live as well as possible for as long as possible.
Here in Australia, the standard of palliative care is among the best in the world, providing prevention and relief of suffering through early identification, assessment and treatment of pain and other problems, including physical, psychosocial and spiritual needs.
And while those who gain access to palliative care are well managed, not everyone who needs palliative care gets access to that care when and where they need it.
Last year, all Australian health ministers signed off on the latest National Palliative Care Strategy, a document that doesn’t beat around the bush, boldly stating: “There is still much work to be done to ensure that people affected by life-limiting illnesses get the care they need to live well”.
As our population rapidly ages and grows, and more people live longer but with more complex chronic conditions, the need for palliative care is going to surge.
A test of public sentiment will quickly confirm that when living with a life-limiting illness, people want to have reduced pain and suffering, high quality of life and be able to choose the place of their care and potentially their death.
For that to happen governments need to invest in palliative care now.
As the Strategy states, “investment at national, state and territory levels will be required to ensure that the systems and people are available to provide quality palliative care where and when it is needed”.
The trouble we have is that there is no common approach across governments to ensure that investment is made.
That’s why Palliative Care Australia, with support from the Snow Foundation, commissioned KPMG to develop a report that paves the way to plug existing gaps and meet future need.
Access to quality care in the community, including in residential aged care settings and at home, can help reduce avoidable hospital admissions. We know that when good care is accessed, people with life-limiting conditions have fewer hospital admissions, have shorter lengths of stay when they do need to go to hospital, and also have fewer admissions to intensive care while there.
The KPMG report finds that with an additional annual investment of $365m on national palliative care reform, we can save up to $464m in other health system costs while making the system work best for those experiencing it.
The report makes a number of recommendations, including two that are easy for governments to implement.
Firstly, as health ministers have already made palliative care a priority, they now need to work together to develop a national health agreement for palliative care, with federal funding provided to assist states and territories to address agreed priority areas.
Secondly, there needs to be a change agent appointed, a national palliative care commissioner, who can work with agility across federal, state and territory governments to ensure the National Strategy is put into effect and key performance targets are met.
As we prepare for an ageing population and other unexpected stresses to our health care system, like COVID-19, we must look seriously at reforming our system to ensure it can meet people’s needs into the future.
Palliative care is about quality of life, living well with a palliative diagnosis and about dying well. We have to spend money to save money – and that’s backed by leading economists.
The report was released as part of National Palliative Care Week 2020 (24 – 30 May).
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