Regional Report by
IAHPC Board Member
Australia
Palliative Care in Australia – state of play
2008 has been a positive and exciting year for the development and integration of palliative care in Australia.
Health System and Service reform – right time, right place
A change in the national government has resulted in a clear determination to reform the health sector and remove barriers that exist in Australia between the national and each of the eight state and territory funded health and community services.
Nicola Roxon, the Minister for the Health and Ageing Department, established the National Health and Hospitals Reform Commission (NHHRC). The commission was given a mandate to provide advice within 18 months on fundamental reforms to improve the Australian health system across the board (i.e. across the commonwealth, state, territory divides; across the acute, sub-acute, hospice, aged care, community divides; and across the many provider and professional divides).
For the first time in Australia, end of life care has been formally recognised in the first NHHRC report Beyond the Blame Game which identifies “care for and respect of the needs of people at the end of life.” This is a key challenge confronting the healthcare system.
This first NHHRC report maps the direction that the Australian Health Care Agreements (health funding) should take over the next 5 years.
As the National Peak Body, Palliative Care Australia (PCA) has activated its networks to engage commissioners and the new government. At this stage, we are highly optimistic that the thrust of the health reform agenda will embrace opportunities that will lead to better access to quality care at the end of life through better integration of palliative care services within the whole health care environment, for example:
- the reorientation of resources and care delivery systems to support people so they are able to die in the best place;
- the coordination and promotion of advance care planning so people have the opportunity to be empowered to take control of the conditions of their care;
- the improvement of workforce education and training opportunities in end of life care and palliative medicine for the full spectrum of specialist, non-specialist health and allied health care workers, and to properly recognise the importance of volunteers and carers;
- the formation of links between existing resources and funding that promote service integration and continuity of care through national standardised referral criteria for seamless pathways between providers of primary, acute and specialist palliative care;
- the commitment to reform population needs-based service provision based on a framework.
Alliance for Quality Care at the End of Life – influence through numbers
A key component of the success of advocacy is the work PCA has championed through the establishment of a broad-based Alliance for Quality Care at the End of Life which represents major national stakeholders who embrace a range of issues that include chronic conditions, aged care, disability, the appropriate role of hospitals, hospices, residential aged care, and community-based services. Also included is access to appropriate medicines, services and health professionals, national guidelines, and the promotion of advanced care planning. Membership in the Alliance includes professional and service partners, organisations devoted to chronic conditions, consumer and disability programs, public health and national palliative care programs.
National Standards Assessment Program – commitment to quality
The National Standards Assessment Program is a core program of PCA that fosters quality improvement. This month a self assessment tool will be implemented as a pilot program involving 30 specialist palliative care services. This pilot will be followed by peer review, and after evaluation, the program will progress to full national implementation.
With the funding provided by the Australia government for research and undergraduate palliative care education in all health science courses, palliative care has come a long way in a short time. We are confident that the care of the dying will become “everyone’s business”.
Professor Margaret O’Connor AM
President, Palliative Care Australia and IAHPC Board Member
Vivian Bullwinkel Chair, Palliative Care Nursing,
Monash University Australia
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