Taking charge of palliative care

Palliative Care is firmly on the agenda for Medicare Locals, according to the Australian General Practice Network, which is expected to evolve into their overseer.

Above: Dr Scott Blackwell, president of Palliative Care Australia.

By Stephen Easton

Medicare Locals will drive the expansion and improvement of palliative care over the next few years, according to the Australian General Practice Network (AGPN), which is likely to be appointed to oversee the new healthcare hubs. 

The AGPN Chair, Dr Emil Djakic, said the restructuring and re-organisation needed to deliver better palliative care would be “a key component of the Medicare Local agenda”.

“Part of the broader brief of Medicare Locals will be to look at the health needs of the whole community – so they will look into community needs and be working with the local health districts in looking at areas of need, challenges and opportunities for building services,” Dr Djakic said.

“There’s no doubt that palliative care services have a role in all communities around Australia, and the Medicare Locals will be very interested in looking at how they can act as a coordinator to get efficiencies out of those services.”

Dr Djakic said this would involve multidisciplinary teams, which he described as “very much a foundation stone” of the vision for a new primary healthcare system. 

Currently, he said, palliative care patients were provided services by a wide range of different professionals who often had little or no knowledge of what each other were doing.

The advantage of a new coordinated approach, then, would be to provide greater continuity of care, which he said was “the sort of things we would hope an overarching body like a Medicare Local could coordinate”. 

“There seems to be a really great opportunity for Medicare Locals to join the dots here – so the patient can see that multidisciplinary team as an organised system … and making sure we’re not duplicating or conflicting services.” 

 Dr Djakic added that Medicare Locals could act as a conduit between all health stakeholders and those who decide on funding priorities. 

The president of Palliative Care Australia, Dr Scott Blackwell, strongly supports multidisciplinary teams, and hopes the Medicare Locals really do have an influence on health funding.

“I think they need to look at how palliative care is funded at the moment,” Dr Blackwell said. 

“Palliative care is funded across the country through the sub-acute funding stream and that means it competes with rehabilitation and a lot of other things.

“The Commonwealth money gets divided up by the states according to a number of priorities – some states divide it up one way; other states divide it up completely differently – so inevitably there’s some inequity.

“What we would like to see is … uniform, reliable and secure funding for palliative care around Australia, and we hope that Medicare Locals, through their assessments of need, will prioritise palliative care appropriately and those inequities will have some resources applied to correct them.

“Really, Medicare Locals will be well placed to make [palliative care] a priority, if they choose to.”

Dr Blackwell added that older people in residential aged care or community care clients needed to become “part of the mainstream thinking” in General Practice, rather than an “afterthought”.

He said that in a similar way, palliative care needed to be integrated into the normal work of residential and community aged care.

“We expect Medicare Locals will be a benefit to coordinating the community end of aged care services and, as we’re trying to do in residential aged care, to integrate the principles of palliative care into those services.

“[…] Over the next 20 to 30 years we’re going to see the majority of aged care services being in the home – and we hope that palliative care principles will be a big part of it.”

The AGPN has been invited by the federal government to become the new administrative body for Medicare Locals, which was criticised as an unnecessary layer of bureaucracy by the Australian Medical Association (see AAA article, ‘A Waste of Money‘).

Tags: dr-scott-blackwell, medicare-local, palliation, palliative care, palliative-care-australia,

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