Jane Prentice (Ryan, Liberal Party) Share this | Hansard source

I am pleased to have the opportunity to contribute to this discussion about National Palliative Care Week and its theme: dying to talk; talking about dying won't kill you. I thank the member for Wakefield for bringing this motion to the attention of the House. Dying is something that many people still find difficult to talk about. Indeed, issues of life and death are still largely taboo subjects, but they do not have to be. Australians actually do want to talk about dying. Research conducted by Palliative Care Australia shows that 65 per cent of women and 56 per cent of men believe that death and dying are not discussed enough, telling me that this number increases to 73 per cent among respondents aged 65 and over.

Perhaps these numbers will change as the baby boomer generation tackles end-of-life decisions. Indeed, the baby boomer generations will provide us with many challenges. Elderly residents in care today have come through the Depression, World War II and are generally very appreciative of any support and care they receive. Not so the baby boomer generation, who expect services to suit their needs, not the other way around. They are the ones who should be considering these crucial issues now.

When we do talk about death and dying, sometimes the results can be surprising. Survey results show that Australians over 65 are six times more likely to prefer dying at home than in a hospital and are three times more likely to prefer home over a hospice. This poses a policy challenge for government because, in practice, most patients still die in hospital beds. Historically, palliative care has been seen as something that takes place in hospitals and hospices. Clearly, this needs to change, but it will require more than just a change in government policy. Culturally, the health system has always been about curing people and keeping people well. This is, of course, understandable and appropriate. It is also understandable that doctors, conditioned to want to cure and make well, are sometimes slower to recognise a patient that needs palliation and not cure. The hospital bed, which is the most appropriate place to treat a seriously-ill person, can be the least appropriate place to provide palliation. What is required is a system that can more quickly recognise patients requiring palliation and a system flexible enough to support patients dying at home, according to their wishes, as long as their condition enables it.

Support and advice is available to those who need it. In Queensland, there is PalAssist, a 24 hour, seven-day-a-week free telephone and online service available for palliative care patients, carers, family and friends seeking practical information and emotional support. The service is funded by the Queensland government and provided by Cancer Council Queensland.

But what this week is really about is having a conversation with those close to you to celebrate life and to talk about death. It is about encouraging people to be comfortable and confident to ask for the care that they want. Sadly, at the end of our lives not all of us will be in a condition to be able to direct the care of our choosing. That is why it is helpful to develop an advanced care plan so that health professionals, family and friends can conduct our care in the manner and location of our choosing.

Different states have different resources available. In Queensland we have advanced health directives, sometimes called living wills, that can be established by any adult to give instructions about their future health care. Advanced health directives can outline what treatment of health care a person wants if they are no longer able to make decisions for themselves. They enable people to appoint an attorney for health and personal matters, and they can include information that health professionals should know, including health conditions, allergies and religious, spiritual or cultural beliefs that could affect care. Importantly, in an advanced health directive it is possible to outline the level of incapacitation beyond which you would want life-sustaining intervention withdrawn. This can reduce the decision-making burden on family and caregivers as the end of life nears.

None of this is possible without first starting the conversation about dying. So, in the spirit of National Palliative Care Week, let us not be afraid to all go out there and start a conversation.

Debate adjourned.

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