Palliative care funding in Victoria unable to meet demand

In 2017, when the Victorian government proudly unveiled its euthanasia legislation, the then Minister for Health Jill Hennessy confidently declared that:

“Voluntary assisted dying is not a substitute for palliative care, and will not preclude access to the high standards of palliative care enjoyed by Victorians.

Voluntary assisted dying is not an alternative to palliative care and, if the bill is passed, every Victorian will remain entitled to high-quality palliative care. The request and assessment process in the bill, which clearly requires medical practitioners to discuss palliative care options, will also ensure that people will never turn to voluntary assisted dying because they have not been provided with other options, including palliative care.”

And yet, just five years later, a new report commissioned by the peak body for palliative care in Victoria, Palliative Care Victoria (PCV), has found that unless funding for palliative care in the state is increased dramatically to meet the escalating demand for palliative care in the state, “30,000 terminally ill people will die in pain and unsupported within three years”. [Emphasis added]

The report found that the increased costs were due to rising wage bills, which had doubled from $40 million in 2017 to $85 million in 2021. Following this trajectory, this figure would rise to $165 million by 2025.

“KPMG warned that government funding had not kept pace.

“The Covid-19 pandemic has exacerbated the increase in demand for palliative care services as individuals who would normally be admitted in a ward choose to stay at home due to visitation restrictions on family.

“Additionally, restrictions have also created screening or monitoring delays that have allowed diseases to progress and are only diagnosed in more advanced stages.”

PCV chief executive Violet Platt has stated:

“Demand for palliative care services in Victoria far exceeds the funding available to even get close in covering this increase in demand and cost to provide services.

“The government in 2016 predicted demand for services would increase by 4 per cent each year, but what has been demonstrated by this report is that it is growing at a rate of 11 per cent.”

The findings of this report contradict statements contained in the latest Report of Operations from the Voluntary Assisted Dying Review Board, which has declared that “[p]alliative care services are available to all Victorians, with care available dependent on individual need”.

Given that one of the 68 so-called safeguards contained in the Victorian legislation is that a doctor must discuss palliative care options with a patient before approving euthanasia or assisted suicide, the fact that demand in Victoria now far outweighs the funding needed to provide these services means that this is a hollow safeguard indeed. You can give a patient all the advice in the world about palliative care options, but if no services are available, what use is that?