South Australia ‘must do dying better’
The Palliative Care Council has called for more funding to support dying South Australians, with 90 per cent of people missing out on specialist end of life services.
PCC chief executive Tracey Watters said the state “must do dying better” or standards of care will regress to how they were 40 years ago.
“In SA we have got extreme, competent, hospital-based palliative care services for those people who have got extremely high clinical and complex needs,” Watters told InDaily.
“But the person who is simply dying without major tumour or pain issues – that are just doing the ordinary dying – they are not able to access services at all and I think services here in SA are extremely fragmented.”
Watters said 90 per cent of the funding that is available for end of life care was serving only about 10 per cent of the population.
“The current promoted palliative specialist model of care promotes a pyramid and the specialist tip of it is where that funding is going at the moment.
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“We need to turn that model on its head.”
Palliative care funding should also support GPs, nurses practitioners, practice nurses, district nurses and residential aged care facilities.
Watters said to qualify for care, people needed to get into a “highly medicalised acute state of unwellness”.
“But health-promoting palliative care says we shouldn’t allow people to get into that situation, so when does the oncologist stop treating?
“If we are going to embalm people into chemotherapy ‘to the death’, then palliative care has no space to work in because the paradox of palliative care lays in the realisation of the fact that ‘I am not immortal’.”
She said if people were rejected for the acute palliative care services, “then it is a fairly dry end argument after that”.
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At the moment, dying people who aren’t suffering an acute illness, but who are seeking palliative care, must rely on the “interest” of their GP or aged care facility in providing such care.
“If it’s not on their radar and if it’s not on their scheme of things to do, you are not going to get access.”
The council is preparing to lobby the State Government for greater funding for general practioners and aged care services to deal with end of life care.
It is conducting surveys to gather information about what GPs, residential aged care providers and the community want from palliative care.
“The important part it is not about people doing it wrong: the funding structure for health care in South Australia is that the funding triggers are only flicked when people get into acute crisis.
“A person in a residential aged care facility said to me, ‘Tracey that’s all very well but we don’t get funding to keep the patient well, we get funding when the patient gets unwell and we can apply for an ACFI subsidy to provide it’.”
Watters wants block funding for aged care and GPs to provide a standard of care for everyone.
“End of life care should be a part of any health professional’s repertoire of skills, maybe not to a specialist level, but to acknowledge the principles of what it is like to face death and bereavement.
“Palliative care can not change the outcome of dying, but we can change the experience and it is an absolute right for every person to have access to that.”
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