Senate debates

Tuesday, 10 September 2019


Palliative Care Tasmania

8:03 pm

Photo of Catryna BilykCatryna Bilyk (Tasmania, Australian Labor Party) Share this | | Hansard source

Before I start my speech tonight, can I also, as a past Rotarian, add my condolences and thank Senator Askew for that lovely speech about Lew Pretorius.

Two years ago I campaigned successfully to save Palliative Care Tasmania from closure. After that campaign had concluded, I had hoped not to have to plead once again for their continued survival. Yet that is precisely what I'm doing in tonight's adjournment debate, because neither the state nor the federal government will provide funding certainty to this wonderful organisation. In 2012 the organisation received funding under the Better Access to Palliative Care Program. That funding was due to end in June 2016, but Palliative Care Tasmania managed to extend their life by using some unspent funds and by cutting back on offices, staff and other expenses until they were running on the smell of an oily rag.

I started campaigning to save Palliative Care Tasmania a few months before their funding agreement ended. I organised a petition, which received over 1,000 signatures. I wrote to the Minister for Health and I delivered several speeches in this place. It took another year of campaigning for Palliative Care Tasmania to receive the funding that eventually saved them—another $1.5 million over three years. This funding was an eleventh-hour reprieve. The new three-year funding agreement is due to expire in June next year, so Palliative Care Tasmania has once again had to go cap in hand to both the state and federal governments to seek further funding.

I really don't care whether they're funded by the state or the federal government, or even both, but somebody needs to step up to the plate. It is inconceivable that neither government can come up with a sum of money that is a drop in the ocean for them and that, to this day, has been delivering enormous benefits for the Tasmanian community. At the moment the state and federal governments are simply passing the buck to each other. When Palliative Care Tasmania go to the federal government, they are told, 'Talk to the Tasmanian government.' When they go to the Tasmanian government, they are told, 'Talk to the feds.'

I've long been on the record as saying that palliative care across Australia does not receive the funding it needs—not just the peak bodies but the other services as well. This is evident when 70 per cent of Australians express a preference to die in their own home, yet the overwhelming majority of Australians die in hospital or residential aged care. It is evident when very few Australians are making advanced care directives or having conversations with their loved ones about their end-of-life-care wishes. It's evident when the Hodgman government have failed to deliver on the dedicated palliative care beds they promised two years ago to residents of the north-west coast of Tasmania.

I have highlighted in a previous speech to this place the importance of Palliative Care Tasmania to the aged-care sector. But I will repeat the quote I gave in that speech from Darren Mathewson, the then CEO of Aged and Community Services Tasmania:

The aged care industry needs ongoing support in this area of core business to ensure our workforce is adequately skilled and supported and we are building capability across the industry.

It's a little-understood fact that palliative care is not just end-of-life care; it is care for people with life-limiting illnesses. And it is so much more than just health care; it's not just beds and nurses and equipment. Palliative care is a form of care that provides for physical, emotional, social and spiritual needs. The medical issues, such as management of pain and other symptoms, are important, but there are so many other aspects of care for people with life-limiting illnesses. It can include issues like where a patient wants to spend their final days, and under what circumstances they would want to refuse medical intervention to not prolong life. It can incorporate services such as grief counselling, and assistance to observe certain cultural or religious practices. It can link to services and support for family members. That's why the work of the peak body is so important. It promotes awareness in the community of the need for people to make plans in advance of having a life-limiting illness. It encourages care providers to consider all aspects of palliative care, and it promotes best practice in palliative care.

We need the Tasmanian and Australian governments to appreciate how broad palliative care is and to see beyond just the medical aspects of it. It makes no sense whatsoever for Palliative Care Tasmania's funding to run out. It's outrageous that Palliative Care Tasmania has not once but twice faced an uncertain future. Dealing with this uncertainty is such a shameful waste of time and resources. Without certainty, it's impossible for them to undertake any long-term planning and it's also extremely stressful for the staff. If those staff go looking for other work and secure it, their skills are lost to Palliative Care Tasmania, even if the organisation's funding gets extended. The peak bodies for palliative care in other states and the ACT are funded. Why should Tasmania be any different?

Palliative Care Tasmania is of enormous value to the sector and the wider community. This is an organisation which is punching well above its weight. For example, one of their core programs is community education on palliative care, death, dying, grief and bereavement. This community education program was started as a component of the Better Access to Palliative Care Program and they were given a target to deliver this education to 1,000 Tasmanians. Instead of reaching 1,000 Tasmanians, they reached 15,000 by the time their funding had almost run out. To date, they have delivered the community education to around 25,000 people—in other words, around one in 20 Tasmanians have been reached by this program. This education has formed the basis of palliative care professional development for a number of workers in the sector, including workers in aged care.

Palliative Care Tasmania also completed a project where they consulted with service organisations and the Tasmanian community to develop a set of principles for palliative care practice. These principles, known as the Tasmanian Palliative Care Community Charter, are now embedded into the practice of many organisations. We know that some groups have unique cultural perspectives on palliative care, and the consultation included a number of cultural and social groups, including members of the Tasmanian Aboriginal community.

Palliative Care Tasmania also provides a wealth of information and resources on topics such as advanced care planning and dealing with grief and loss. They organised the Tasmanian Palliative Care Awards, which celebrate excellence in palliative care, and in November this year they are hosting the 2019 Tasmanian Palliative Care Conference in Hobart. This conference will feature a variety of local, national and international speakers. It will bring together the leaders in palliative care from across the state for a discussion on the future of the sector and how they can work together to ensure the best possible services for Tasmanians with life-limiting illness. In the last year alone Palliative Care Tasmania has had 80 strategic meetings with politicians, stakeholders and advisory groups, amongst others. They wrote a comprehensive submission for the aged care royal commission and they successfully lobbied the Tasmanian government for an after-hours palliative care phone support service in the south of the state.

It would be almost impossible for me to cover the full breadth and depth of the work this organisation does. They are truly amazing, particularly considering they receive core funding of only $500,000 a year. It's a pity that the state and federal governments refuse to release the independent evaluation of the Better Access to Palliative Care Program, because I'm in no doubt that Palliative Care Tasmania would come up smelling of roses in that review. Then again, we don't necessarily need the evaluation to tell us what a great job Palliative Care Tasmania is doing. Ask anyone who has dealt with them—any individual who has needed their services or has attended one of their events or education sessions, or any service provider in the sector who has sought advice or whose staff have received training from them.

If Palliative Care Tasmania loses its funding, there are only two possible alternatives: either the services they provide will no longer be available to the sector, which would be a huge loss, or they would have to be provided by the Tasmanian Health Service at much greater cost to the taxpayer. Not only would it cost more for these services to be provided by the THS, but they would have to spend years developing the knowledge, the expertise, the resources and the contacts, particularly the contacts in rural and regional areas of Tasmania, that Palliative Care Tasmania currently possesses. All these valuable assets would be lost should Palliative Care Tasmania be forced to close their doors.

The Hodgman government should not let this happen. The Morrison government should not let this happen. I will do everything in my power to ensure that Palliative Care Tasmania is provided with funding certainty and a sustainable future.