Concetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | Hansard source

I rise to support the comments of Senator Siewert and Senator Moore in relation to this Community Affairs References Committee report and say that it was very important for the senators participating in this inquiry to make sure that our report was one that was agreed to across party lines. Whilst there were some minor issues on which we made some changes, it was really good that we were able to deliver a report that certainly reflects and does credit to, as Senator Moore said, the evidence that was given to us in the various hearings. Also, it respected the difficulty that many encountered in giving evidence that was so personal. When one talks about dying it is never easy, particularly when one talks about how one wants to die and is facing those issues that many of us do not want to talk about as we think that we are going to go on and on and on. The story of Kim and the story of so many others demonstrated that while we are here today we may not be here tomorrow and how we exit this life is certainly very confronting for many.

I would like to touch on a couple of areas in relation to this. As shadow minister for ageing, obviously my interest was most especially from the ageing perspective and, as Senator Siewert correctly said, whilst most of the palliative care in Australia is delivered predominantly in an ageing setting we cannot forget the young people receiving it. Probably the hardest evidence that we received was from parents of young children and I think Senator Smith will probably say something more about those young children.

I would like to particularly mention a couple of recommendations that were in the Productivity Commission Caring for older Australians report and on which I particularly want to focus from the ageing perspective. Firstly, one of the Productivity Commission recommendations was that the Australian government should ensure that residential and community care providers receive appropriate payments for delivering palliative and end-of-life care and that those payments should form part of an assessed entitlement determined by various processes. Secondly, there was the recommendation that talked about how providers of aged-care services should have staff trained to be able to discuss and put in place advanced care directives, so very much picking up those points made here about advanced care. So I did spend quite a bit of time talking about and exploring the possibility of how an entitlements system could operate in a palliative care setting. Certainly palliative care is very complex and this became very clear throughout the course of this inquiry.

In particular, Senator Moore acknowledged the work of Palliative Care Australia. I acknowledge the presence in the gallery of Dr Yvonne Luxford, the Chief Executive Officer of Palliative Care Australia. As Senator Moore correctly said, they very much drove this inquiry.

In terms of the Productivity Commission and its issues about entitlement, I am very pleased that we were able to explore that in this inquiry and look at the practical way that, under an entitlement system, palliative care could be rolled out and most especially in the home. It became very clear to me that people want to die in their own home. As we look at changes to the aged-care system, we should look at ways that we can facilitate that. Certainly the evidence that was given to us indicated that palliative care can be rolled out quite effectively under an entitlement system.

The other aspect was advanced care planning. I would like to touch just briefly on the cultural reluctance to discuss death and dying. It will be very important if we are going to effectively do advanced care planning in Australia to meet the barriers that do exist in raising awareness, especially in special needs groups, and meeting those cultural barriers which do exist. I was very proud to be part of this inquiry and I commend the report to the Senate.