Stirling Griff (SA, Nick Xenophon Team) Share this | Link to this | Hansard source

As the saying goes: nothing is certain except for death and taxes. But while taxes will always remain painful, death doesn't need to be. Pain and symptom management, along with being surrounded by family, are most important to people who are dying. Australians deserve to die with dignity and to be surrounded by the people that they love. Sadly, the wishes of thousands of gravely ill Australians to die without pain and to be surrounded by friends and family is going unmet. Why? Because palliative care services fall severely short in Australia and, in particular, in my home state of South Australia.

Families are being forced to helplessly watch someone they love die without receiving adequate care, pain relief, nursing support or information about end-of-life care options. Palliative care helps terminally ill people live the ends of their lives as fully and comfortably as possible. It can be provided at home, in hospitals or at aged care facilities. This specialised care includes pain and symptom management, help for families to talk about sensitive issues, and psychological and spiritual support for the patient and their loved ones. Palliative care, especially in South Australia, has been ignored by the major parties for a very long time.

Palliative care in South Australia is currently in the worst state it's been in since 1980, when it was first implemented in the South Australian health system. At present, the number of people wishing to die at home with the support of community based palliative care services far exceeds the availability of that care, particularly for those with illnesses other than cancer. For many, access to community based palliative care is determined by where they live rather than where they prefer to die. Palliative Care Australia, the peak body, estimates that, while 70 per cent of Australians wish to die at home, only around 14 per cent do: 70 per cent wish to die at home but only 14 per cent do! South Australia, in particular, lags behind the other states, with three out of four South Australians not getting access to palliative care. This is totally unacceptable.

The Productivity Commission released a draft report in June 2017 which examined reforms to human services, and specifically palliative care services. It stated:

Each year, tens of thousands of people approaching the end of life are cared for and die in a place that does not reflect their choice or fully meet their needs. Most people who die do so in two of the least preferred places – hospitals and residential aged care.

The commission also said that patients' end-of-life journey will likely be punctuated with unavoidable or unwanted admissions to hospitals and the confusion, loss of dignity and loss of control that comes with it.

Australians deserve much better than this. The Productivity Commission's draft report argued that reforms in this area should be a high priority for government. The Nick Xenophon Team couldn't agree more. More community based palliative care services are needed to enable more people who wish to die at home to do so. The Productivity Commission also argued that end-of-life care in residential aged care needs to be better resourced and delivered by skilled staff. There are just 213 palliative medicine specialists across all of Australia—213! That should shock everybody in this place. That's just one palliative medicine specialist for every 704 deaths in Australia: 704 for one palliative care specialist! Inadequate funding of palliative care services is a major and damning cause of the pain and stress that terminally ill patients are forced to endure. Many family members feel they have to go it alone in the last few weeks and months to ensure that their loved one has help to use the bathroom, reach a drink or wash, and this causes an enormous amount of strain at an already stressful time. It's incredibly traumatic for many families to see a loved one dying without access to adequate care and support. Better funding for palliative care is essential. South Australia and other states desperately need to regenerate the investment in palliative care so people can be supported to live, die and grieve well.

The government must make palliative care a top priority. The current fragmentation of palliative care services in Australia needs to be addressed by the appointment of a national palliative care commissioner. A national palliative care commissioner should examine existing palliative care services and programs nationally to assess their efficiency and effectiveness in supporting terminally ill individuals and their families to live as well as possible right to the end of life. Palliative Care Australia has outlined the role of a national palliative care commissioner, saying they need to:

very important—

The job description for the national palliative care commissioner is very much detailed and arduous. However, to fail to have a policy overhaul in this area of palliative care is not an option. To quote Dame Cicely Saunders, 'How people die remains in the memory of those who live on.' We are all part of this story. We must do better. Death is inevitable, but dying unsupported should not be.