Health NZ is carrying out a consultation process on the disestablishment of the two roles set up in 2022 to develop a national policy for palliative care. Photo: 123RF
The head of the Society of Palliative Medicine is warning inequities in palliative care around the country will only deepen if roles looking at a national policy are dropped.
Health New Zealand is carrying out a consultation process on the disestablishment of the two roles set up in 2022 to develop a national policy for palliative care. The consultation comes to an end on Monday, 10 February.
Dr Catherine D'Souza, the New Zealand chairperson of the Australia New Zealand Society of Palliative Medicine - the professional body representing palliative medical specialists - said there was no consistency around the country with palliative care, and the two roles were taking the first steps to change that.
She said they had started working on a model of care for adult palliative care, with local areas finding ways to provide the service required.
"So we have just about drawn up the plans," D'Souza said, "and now once again the positions look like they have been pulled and the plans will sit in a dusty cupboard somewhere."
D'Souza said if the roles were cut, it would be a massive step backwards for ensuring quality, cost-effective healthcare was delivered to terminally ill New Zealanders.
"The roles facing disestablishment were charged with planning to ensure every person who needed palliative care in New Zealand would be able to receive it, saving the health system a huge amount of money by keeping terminally ill Kiwis out of hospital as much as possible, by supporting them to receive care at home or hospice."
Dr Catherine D'Souza, the New Zealand chairperson of the Australia New Zealand Society of Palliative Medicine. Photo: Supplied / Health NZ
Funding gap
Hospice care relied on a mixture of government and community funding, with the government funding less than half the cost of running hospices.
Figures from Hospice NZ showed in the 2022-23 year it cost $200 million to provide hospice care across New Zealand, with the government providing $97 million, and the other $103 million coming from community fundraising.
D'Souza said if nothing was done to come up with a national policy, geographic inequities would deepen.
"If you have a hospice that has been able to do really good fundraising in your area, and you are in a well-off area and the hospice is well-funded, you may have a really good service.
"If you are not, you may not have good services. And those inequities will continue to get deeper as we struggle to fundraise.
"You are asking people to do cake bakes and sell things in op shops to provide when people are at their most vulnerable. That's pretty shocking, when you are at your most vulnerable and you are depending on someone down the road to do a cake bake for your care."
Dr Warwick Jones, director of clinical services at Northhaven Hospice in Whangārei and a palliative care specialist for Northland/Te Tai Tokerau, said the current model was not sustainable.
He said Health NZ's contribution to the four hospices in his area varied from around 35 to 60 percent, with the rest coming from local fundraising.
"We still need to raise millions of dollars from the community, which is amongst the poorest communities in New Zealand. And the further north you go the greater the area of deprivation that exists. That in itself creates inequities in what a service can provide or aspire to become. "
Jones had worked in the sector for 30 years, and the latest attempt to get a national policy in place was the fourth he had seen.
"These two positions have been so productive in pulling the whole sector together and creating a workable timeframe and work plan, and they are halfway through that. Unless we finish that, we won't have any substantial plan at all."
In a statement, Health NZ co-director community and mental health Debbie Holdsworth said the consultation documents released at the end of last year were proposals at this stage.
"While changes are proposed to the structure of the planning, funding and outcomes team, we recognise the critical importance of palliative care and our focus and commitment in this area will continue. We are asking for feedback, from staff and unions on our proposals, and we encourage feedback on the consultation documents.
"All feedback will be carefully considered before final decisions are made. Any decision will be communicated to our staff and unions in due course."
Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
