Palliative care and aged care deserve more attention during election campaign

At the halfway mark of the Federal Election campaign, Palliative Care Australia is calling for detail on how the next steps in aged care reform will ensure a dignified death for the 400 Australians who die each day of predictable causes. 

“We have heard very little from those standing for election about improving access to palliative care,” says Dr Peter Allcroft, Chair, Palliative Care Australia (PCA). 

“When the subject does come up, the Health Minister and Aged Care Minister have pointed to the new End of Life Pathway. This is a welcome reform, but access to the Pathway will be highly restricted at a time when we should be making palliative care more available to all those who need it.”  

The new Support at Home End of Life Pathway is due to come into place on 1 July this year. The Pathway will mean more people over 65 with terminal illness can receive end of life care at home, where 90% of people want to be cared for.  

“This has the potential to reduce unwanted, avoidable, and costly hospitalisations, due to the provision of better palliative care at home,” Dr Allcroft says. 

“But that will only be the case if aged care workers are upskilled in end-of-life care and only if other parts of the health system support them in this critical work.” 

The Support at Home End of Life Pathway provides a one-off $25,000 for in-home aged care services. Eligibility is limited to those with a life expectancy of 3 months or less and who are bed-bound most of the time. 

“This limits the number of patients and families who will benefit. Rather than setting strict criteria about life expectancy, which can be very hard to predict, we’d rather see the program be available on the basis of need.” 

There are also concerns across the sector about what happens to people who ‘live too long’ and are still alive after 16 weeks on the Pathway. 

“For example, if someone lives beyond the approved timeframe, at the moment, those patients will lose that higher level of care and go back to a lower-level package – for administrative reasons, not because that’s in their best interests,” Dr Allcroft says 

“PCA is calling on an incoming government to establish an exemptions process for the End-of-Life Pathway, so that people who are close to death don’t miss out on vital at-home support at the very time when they need it the most.” 

Another major challenge that PCA has raised with the Government and Opposition is the capacity of primary care to deliver palliative care. Local GPs and nurses are a critical part of the palliative care system, but Medicare does not fund this work properly. 

 Without reform to how primary care practices are remunerated; the primary care system will struggle to meet the growing need for palliative care. 

“With an ageing population, the need for palliative care will only increase further for the foreseeable future,” Dr Allcroft says. 

“Those who seek to form the next government need to outline their plans to make sure palliative care is available to everyone who needs it. 

“With growth in the 85-plus population on track to triple in the next 7 years, we have no time to waste. 

“PCA has presented our advice and priority actions to those standing for election, as well as a petition with over 40,000 signatures supporting our plan for ‘better access to palliative care’. 

“We hope that in the weeks leading up to Election Day we will see tangible commitments to palliative care from candidates and parties.”