Lake Macquarie palliative care services

19th October 2017

Mr GREG PIPER ( Lake Macquarie ) ( 11:46 ): I move:

That this House:

(1) Congratulates the Government and the Minister for Health on the allocation of an additional $100 million over the next four years for palliative care services in New South Wales.

(2) Notes that outreach palliative care services in Lake Macquarie are not pr ovided equitably with a demarcation line at the Fennell Bay Bridge , denying around-the-clock home palliative care to the people living south of the line.

(3) Calls on the Government and Hunter New England Health to ensure that all people in the l ower Hunte r have equal access to this important end-of-life service.

This is an important topic and I am pleased to put this motion forward today. I thank the Government for allowing it to happen. The discussion concerning the end of life can be emotional because it touches on when those closest to us will leave us through death. We all want the best kind of passing for our loved ones and for ourselves. While we can personalise this matter through our experiences or imaginations, as legislators we need to apply what we would want for ourselves and our loved ones to all. Every member of our community deserves a respectful and dignified passing. That is most likely to happen when a person's wishes about how and where their death occurs can be fulfilled. I congratulate the Government on allocating an additional $100 million to New South Wales palliative care services over the next four years.

This is a major step forward and a significant acknowledgement by the Government that palliative care matters. Most people in the Hunter region access palliative care services through the privately operated Calvary Mater Hospital at Waratah near Newcastle or John Hunter Hospital, which is managed by Hunter New England Health. Last year, I met with local representatives of the Cancer Council, who briefed me on their concerns about the future of 24/7 palliative care outreach services in the Hunter. In general terms, the outreach service provides on-call assistance, including phone calls and home visits to patients in the final stage of their lives who have returned home to spend their remaining days with family and friends.

People using this service place a substantially lesser burden on our stretched hospital system than those who receive palliative care in hospital. These valuable outreach services provide terminally ill people with support that provides as gentle and as dignified a death as possible, and also gives support to loved ones in this often difficult time.

However, a concerning deficiency in the current system needs to be addressed. The current 24/7 outreach service operated by Calvary Mater in Newcastle does not serve more than half of my electorate because a boundary is drawn at Macquarie Road in Fennell Bay. People living south of Fennell Bay, for example in the highly populated areas from Toronto through to Morisset, do not have access to the 24/7 service. Instead, they have access to a nine-to-five service operated by Hunter New England Health. I have no idea why someone in the health service would think that such a vital health support would only be needed between 9.00 a.m. and 5.00 p.m. on weekdays in some areas and 24 hours a day in others. I can only assume that it happens for budgetary reasons.

The final stage of life is generally a highly emotional and distressing time. That cannot be changed, but it becomes more stressful than it needs to be when good palliative care is not available. For example, without the outreach service which allows a qualified nurse to visit a patient's home that patient would need to be transported to the emergency department of their nearest hospital for treatment. That not only places an added burden on the ambulance service and hospital emergency departments but also reduces the patient's right to choose where and how they die.

In August this year the Auditor-General tabled an evaluation of palliative care services in New South Wales. The Auditor-General reported that 70 per cent of people would prefer to die at home but only 14 per cent manage to do so. These figures emphasise the looming cost to the Health budget from the growing aged population. Public health costs will always be significantly greater for in-hospital deaths as opposed to those that take place at home, particularly if the percentages do not change dramatically. The overall conclusion of the report was that the approach of NSW Health to planning and evaluating palliative care is not effectively coordinated. It further stated that there was no overall policy framework for palliative and end-of-life care, nor was there comprehensive monitoring and reporting on services and outcomes.

It is pleasing that NSW Health accepted all of the Auditor-General's recommendations in relation to this. We need to begin moving on those recommendations by reviewing current systems, developing an integrated palliative care and end-of-life care policy framework, and providing better, more equitable in-home palliative care services. More than 300 people access the 24/7 palliative care outreach service in the parts of the Hunter in which it operates. As this motion acknowledges, palliative care services provided by Hunter New England Health are good, but they are not provided equitably. Using the Lake Macquarie example, there is a demarcation line at Macquarie Road north of the Fennell Bay Bridge that denies the 24/7 service to those further south.

The Government and Hunter New England Health should ensure that all people in the lower Hunter— particularly those in the most populated areas such as south-west Lake Macquarie—have equal access to this important end-of-life service. In fact, Hunter New England Health should make it a priority to try to extend this extremely important service to all in its area of responsibility. We simply cannot have a health service that is delivered by postcode or determined by where people live. We simply cannot have a gold-class health service for people on one side of the street and a budget version for those on the other side. The 24/7 palliative care outreach services must be extended to the main population centres of the Hunter New England Local Health District, and that includes all of the Lake Macquarie electorate.

I call on the Government to support my motion and to increase its efforts in this regard. I am not dismissing the significant costs associated with it—I genuinely appreciate them, as all members do. As groups such the Cancer Council have emphasised, we acknowledge the Government's recent investment in this area.

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