Above: CEO of CHA, Martin Laverty

By Yasmin Noone

Convicted criminals, people with a mental illness and individuals living with a disability are being denied access to quality end-of-life care services, even though they are entitled to receive palliative care just like any other member of the population.

Catholic Health Australia (CHA) has argued that Australians hailing from a range minority groups are marginalised and, as a result, some individuals are not being treated appropriately at the end of their lives.

The peak body representing Catholic health, community and aged care providers has called upon the Australian Senate to consider the needs of prisoners, people with a disability, those living in rural and remote locations, Indigenous communities, and culturally and linguistically diverse populations when it recommends wide-sweeping changes for the palliative care sector in September this year, following the conclusion of its palliative care inquiry.

CEO of Catholic Health Australia, Martin Laverty, said palliative care service provision to the vulnerable or marginalised is inadequate in many areas.

“We’ve got evidence [about this] from Catholic palliative care service staff who work in the prison system, with people living with a disability and in Indigenous communities, who have described to us the occasional, total absence of palliative care services that should be available to people in their own homes, in aged care facilities and in hospitals,” Mr Laverty said. 

“Across different states and territories, there are different quality outcomes for people who receive palliative care, determined by the luck of the draw. If you are lucky enough, you can be in a well-resourced hospital, or served by a community care provider that has [quality palliative care] resources and the ‘know-how’.

“This means you are going to get a better deal than someone with unfortunate luck who is seeking palliative care services in different circumstances.

“We shouldn’t have a two class palliative care system in Australia.”

Mr Laverty said he recognises the complex nature of support required for people who are in prisons, mental health facilities and psychiatric centres will necessitate specialist palliative care.

But that should not change the fact that all Australians are entitled to receive that care – and receive it to a high standard.

“We, as a country, need to continue to do more to ensure that where someone lives doesn’t have a negative impact on the level of care they receive.”

We needs standards!

The Senate’s Community Affairs References Committee is currently conducting its broadest inquiry into palliative care ever.

The Senate Palliative Care in Australia inquiry, announced late last year, will aim to investigate how Australia’s palliative care system can be improved to better cope with the changing demands placed upon it.

CHA recently provided the Senate inquiry into palliative care with a submission detailing what the organisation believes needs to happen for disadvantage to be eradicated.

The submission outlines a roadmap for how governments and non-government organisations can improve the quality of – and ease of access to – palliative care services in Australia.

One of the key requsets called for in the submission is a national standard for all staff to adhere to when delivering palliative care services.

Mr Laverty said this would ensure a national palliative care system that does not discriminate according to a person’s location, health-care setting or circumstance.

“We would hope that when the Senate reports its inquiry recommendations, the number one recommendation should be that Australians deserve a nationally agreed and nationally applied standard of palliative care, to which all hospitals, aged care providers, prison [institutions], and community care providers are required to live up to for best quality pain management,” he said.

“And that recommendation costs zero. It requires palliative care experts, consumer groups, hospital and aged care [spokespeople] and others to volunteer their time to work out a national benchmark for palliative care for all Australians.

“So, in this period where the government is seeking to achieve a budget surplus, developing a nationally applied standard of palliative care, should be the first step of palliative care reform as it costs nothing.”

President of Palliative Care Australia, Dr Scott Blackwell, supports Mr Laverty’s call to end disadvantage. However, he said, a national set of palliative care standards already exists.

“As the peak body of palliative care in this country, we are standard bearer,” Dr Blackwell said.

“The implementation and assessment of those standards is something we oversee through the National Standards Assessment Program (NSAP).

“NSAP, so far, has mostly concentrated on overseeing the standards in what you call, specialist palliative care services.

“It is now extending itself into [overseeing that the standards are adhered to in] more community-based palliative care services that are not altogether seen as specialist but are specialised.

“The focus of the next round for NSAP is on palliative care in aged care. This is something we support and agree with.”

Dr Blackwell added that the National Standards for Palliative Care was created to cover all circumstances.

So what his organisation wants to see is the “implementation of those standards within all health settings throughout the country”.

“We don’t need to re-develop the standards. We just need to review them and keep them contemporary.”

Dr Blackwell said that the health care sector also needs to change its mindset about palliative care so that it can actually better deliver palliative care services.

“Palliative care is still seen in mainstream health as something you refer to at the very last moment in a person’s life.

“…We need a change in thinking from treating disease to thinking about people.”

Palliative Care Australia is yet to provide the Senate with its inquiry submission.

Catholic Health Australia’s submission to the Senate Standing Committee on Community Affairs can be found on the Submissions page of the CHA website, www.cha.org.au

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