clinical focus
$365m request
Palliative Care Australia
cites huge savings potential
with more funding.
By Conor Burke
A
new report has called for a
yearly additional investment
of $365 million for palliative
care to “bring the system up to speed”
and address significant “service gaps, meet
future significant demand and reduce
avoidable costs”.
The report, which was commissioned by
Palliative Care Australia (PCA) and prepared
by KPMG, states that the investment would
yield savings of $464 million a year to the
healthcare system.
Dr Chris Schilling, KPMG health
economist and report author, said his team
looked at the way palliative care is currently
set up across three areas – home and
community, aged care and hospitals – and
found that using multidisciplinary palliative
care teams that included GP or palliative
care specialists could help people to be
more comfortable in their own homes and
to live well and stay in their homes longer
in their later years, as well as save on costly,
avoidable hospitalisation.
KPMG estimates that the cost of death
in Australia is $7.8 billion each year,
with approximately $4 billion of that in
hospital costs.
The report recommends that $240 million
be invested to increase funding and access
to home and community palliative care,
and $50 million to increase palliative care
services in hospitals.
They also recommend a $75 million
investment in specialist palliative care and
support across residential aged care.
The KPMG team set up a trial across 12
care homes that placed a palliative care
nurse practitioner in the home, and found
that this reduced hospitalisation days by 12
days a month per facility.
“I knew what palliative care was, but I
hadn’t researched it in detail. And when I
went to the literature and consulted with
Palliative Care Australia and our steering
group, and just heard firsthand of what
palliative care can do for people with a
life-limiting condition, it really was an eye
opener to me,” Schilling said.
“The other thing that really surprised me
the most was that we weren’t providing, as
a society, the level of funding for palliative
care, particularly in aged care settings.
“The way that it’s funded under the
current system, under the ACFI funding
arrangement, was really only providing
palliative care in literally the last day or
two of life.”
Recently, Aged Care Minister Richard
Colbeck spruiked $57.2 million in palliative
care funding – already announced in
previous years’ budgets – “to help reduce
physical and emotional distress for
individuals and their families”.
PCA’s chief executive Rohan Greenland
said that any funding is welcome, but
stressed that more needs to be done to
keep up with an ageing population.
“There are gaps in the existing approach,
and with an ageing and growing population,
unless we address those gaps now, we
will have no chance of meeting the future
demand for palliative care services,” he told
Aged Care Insite.
“As the population ages and grows, and
people are living longer with more complex
and chronic conditions, the demand for
and the need for palliative care is going to
go through the roof. So we’ve got to get
our house in order now. And if you overlay
a COVID-19 pandemic on top of that, it’s
really important.
“One of the lessons about being well
prepared for health emergencies and
pandemics is that if you manage your
palliative care needs well, you will help keep
pressure off the front end of hospitals in a
way that will ensure that you not only meet
the needs of people who have life-limiting
conditions and their families and carers,
but you also make sure that you’ve got the
capacity in your health system to meet
emergency situations.”
Greenland and PCA are also calling for
a national agreement on palliative care
between the Commonwealth and the states
and territories, and a new full-time palliative
care commissioner to advocate on the
behalf of patients.
“It’s just a way of oiling the wheels to
make sure things happen,” he said of a
commissioner position.
“And to really help connect up systems
and to break down silos, if you like, and
to improve collaboration and make sure
people are on track to meet agreed
benchmarks and targets,” Greenland said.
“And oil the wheels of government in
particular, particularly the difficulties we
often experience with a federated structure,
so that we can get to better coordination
across jurisdictions to achieving agreed
priorities and targets.”
Greenland argues that Australia is
successful when administering palliative
care but now needs the funding to give
access to those who miss out.
“When I first arrived at Palliative
Care, one of the people I spoke to was
Professor Stephen Duckett from the
Grattan Institute. And he made the point
saying: ‘The greatest challenge confronting
palliative care is actually a failure of policy,
more specifically funding policy.’ And he
really, I think, hit the nail on the head,”
he said.
“We have very good outcomes data in
Australia through the work of the Palliative
Care Outcomes Collaboration at the
University of Wollongong; we know that
when people get access to palliative care,
they tend to get very good outcomes and
we’ve got consistent data over many years
that demonstrates that.
“It’s the problem of access. And if we
invest in services to make sure those
services are available to people when and
where they need it, it means that they will
get better quality of care, and palliative care
is all about quality of life through providing
holistic care approaches. And we can
achieve that. And particularly for those who
are missing out on that care now, that’s the
key thing.
“I think the report is really important
for governments because it actually shows
that when they invest in palliative care,
it’s not just cost effective, it’s actually
cost saving. And the report makes that
incredibly clear.” ■
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