Senate debates

Wednesday, 9 May 2012

Matters of Public Interest

National Palliative Care Week

1:30 pm

Photo of Helen PolleyHelen Polley (Tasmania, Australian Labor Party) Share this | | Hansard source

I rise to speak on the forthcoming National Palliative Care Week, commencing on 20 May and going through to 26 May. It is important that this event is recognised to improve the profile of the necessity of palliative care. It was recognised in the 1980s that, for people to receive appropriate end-of-life care, palliative care needed to be recognised as a specialty in its own right. This has been a slow process. Even today, many who work in this area still see palliative care as the poor cousin of many medical speciality areas. This recognition has taken time, but with the ongoing efforts of many people and the change in the demographics of our population, it is becoming inevitable.

In November 2010 the Senate supported a motion recognising palliative care as an essential component of a contemporary healthcare system. In Northern Tasmania, during Palliative Care Week, the support group the Friends of Northern Hospice and Palliative Care Foundation are warmly inviting people to attend a non-denomina­tional candle-lighting service of remem­brance and thanksgiving on Sunday, 21 May. The support group was previously known as the Friends of Philip Oakden House. To the people in Northern Tasmania, it is a very well known group. Unfortunately, the previous hospice in Launceston, Philip Oakden House, was closed in 2007, despite the commitment of funds from the community. This had a disquieting effect upon the community. It reinforces the perception that palliative care is the medical poor cousin.

The other significant event in Northern Tasmania during National Palliative Care Week will be a public palliative care forum. This is being jointly hosted by the Friends of the Northern Hospice and Palliative Care Foundation, by federal MP Geoff Lyons and by me. I have been and remain a strong advocate for comprehensive palliative care services. Palliative care aims to affirm life and treat dying as a normal process; to neither hasten nor postpone death; to provide relief from pain and other distressing symptoms; to integrate the physical, psychological, social, emotional and spiritual aspects of care, with coordinated assessment and management of each person's needs; to offer a support system to help people live as actively as possible until death; and to offer a support system to help the family cope during the person's illness and in their own bereavement.

The forum will be chaired by the former President of the Legislative Council of Tasmania, the Hon. Don Wing, who is well known throughout Northern Tasmania. We have invited two key speakers. One is Dr Katherine Clark, Area Director of Palliative Care for Hunter New England Health and Director of Palliative Care at Calvary Mater Newcastle. Katherine is a physician with extensive experience in palliative care, having worked across a number of locations including Royal Prince Alfred Hospital and the Sacred Heart centre, St Vincent's Hospital, Sydney. In 2010 she relocated to Newcastle, where she holds the appointments of Medical Director of the Palliative Care Service of Calvary Mater Newcastle, the Area Director of Palliative Care for Hunter New England Health and a conjoint appointment at the University of Newcastle. Alongside her clinical appoint­ments Katherine continues to be involved in medical teaching, education and research. In particular her research focuses on improving the evidence base from which symptoms are managed. I was fortunate enough last year to visit the centre in Newcastle and I was so impressed with her team there and, I think more importantly, the groundwork that that centre has put in over many years to embrace the community and bring them in to educate them about the essential needs of palliative care. I think a very important point is that they have embraced the medical professions and been able to bring them along with them. It was very impressive. We are very fortunate to have her come down to Launceston.

The other speaker will be Sue Hanson, National Manager of Palliative Care Services, Little Company of Mary Health Care. Sue has worked in various capacities over the past 20 years in palliative care in the community, consultative and inpatient settings. She held an academic appointment as a professor of clinical nursing from 2000 to 2007. Sue has also held a health service executive position in clinical governance in New South Wales. She is a past president of Palliative Care New South Wales, past co-chair of the New South Wales Palliative Care Advisory Group and a past member of the executive and council of PCA. In these roles she has contributed to palliative care strategic planning at national, state and local levels and held the position of National Standards and Quality Director at Palliative Care Australia between 2007 and 2010. Sue led the development of the National Standards Assessment Program while at Palliative Care Australia.

The forum in Launceston is expected to attract somewhere in the order of 200 members of our community. Hopefully, the outcome will be the promotion and development of palliative care services across Northern Tasmania—an appropriate facility and services not just to assist aged-care facilities provide palliative care but also, very importantly, to support people to remain in their own home for as long as possible. Unfortunately, when we are talking about palliative care, we are not just talking about people who have reached their later years in life. As we know, there are too many young Australians who also rely on these services, and their families particularly need that support.

The importance of palliative care was recognised in the recent policy announce­ment by the Prime Minister, the Minister for Mental Health and Ageing and Minister for Social Inclusion, Mark Butler MP. The aged-care reform package 'Living Longer. Living Better', has continued the recognition of palliative care that was presented in the Productivity Commission's report Caring for Older Australians. Let me quote from the document Living Longer. Living Better, to illustrate this recognition:

Better palliative care and support in aged care

($21.7 million)

End-of-life care, or palliative care, is an issue of great importance to Australians as they age. The Government is acutely aware of the pressure and anxiety that comes with end-of-life considerations and the overwhelming desire for an individual’s wishes to be respected. We are committed to ensuring older people and their families have the support and assistance to allow end of life planning to be about personal control and choice.

Aged care providers need to be appropriately skilled to look after people needing palliative care. The Government will provide direct access to specialist palliative care and advance care planning expertise through palliative care innovative advisory services.

This proposal aligns with the National Palliative Care Strategy, which aims to raise awareness of and information about palliative care and its benefits, and help build a skilled workforce across the health system to deliver quality palliative care.

Promoting better practice and partnerships

($58.5 million)

The Government is introducing initiatives to encourage aged care providers to work with public and private health care providers and medical insurers to deliver short term, more intensive health care services. This will involve grants to develop models of service which will remove barriers including regulatory road blocks, and aged care funding adjustments. This will result in improved access to complex health care, including palliative and psycho-geriatric care.

The Government will support implementation of innovative ways of delivering aged care services, and support translation of research into everyday practice and actual care delivery. Innovations will be shared and promoted. Projects that promote innovation, improved care and better business practice in priority areas of care will be targeted. These include care for people with dementia, mental illness, and culturally and linguistically diverse backgrounds or other special needs, and palliative care.

Page 17 of 17 These are not just words from the Prime Minister, Julia Gillard, and Minister Mark Butler; these words have the full endorsement of Palliative Care Australia. The forum that is being held in Launceston on 24 May aims to help the community to understand the direction of the government and enhance their encouragement and support.

But we need to do more. We, as family members, need to have the discussions with our loved ones about what their wishes are as they go through the ageing process. It is not always easy to address these issues. I have personally had that experience, as my mother went into high-dependency care, which was a confronting issue that lots of families go through every day. Knowing that she was going through the final chapter of her life, we had discussions with her—we knew what her wishes were, we knew that the struggles and the pain that she had endured for so many years had led her to a place where she was at peace with her spiritual beliefs and she knew what was in her best interests and what she believed was in the interests of her family as well. We had those discussions, so when it became apparent the time had come—there were a number of episodes before we finally lost mum—there was a decision made not to take her to an acute-care hospital, that the treatment would be given to her in the aged-care facility. That was her decision because just trying to transport her to another facility caused her immense pain and discomfort. No matter how hard it is as family members, you have to have those discussions because when the moment comes when you are going through the transition of the end-of-life process you have to know in your own mind and your own heart that you are doing what your loved one wants. So I would encourage those within the chamber, those listening today and, more importantly, those within our community to have those discussions. This is part of the life process we go through.

I am sure that government members and others in the chamber would support much better palliative care, but we have to engage with the community. We also have to engage with the health professionals, and that was the thing that stood out when I went to Newcastle and met the team there: how they had engaged their GPs and specialists to provide that palliative care and wherever possible to give that palliative care in the home of the individual so that they had their loved ones and their normal surroundings and that they were able to take that final journey in their own surrounds supported by their loved ones. We have to remember that during this process family members all need support because they are the ones watching their loved one slip away. We have to promote discussion on this important issue. We have to have this discussion around our kitchen tables, and many in the community and amongst health professionals still need further education to ensure that we provide good support, because we owe it to people as part of our health system. I encourage my own state government to look at this important area of funding and commit more money in their upcoming budget to provide the sort of palliative care that all Australians should be able to rely on.