In an important article outlining inequalities in access to palliative care in regional Victoria compared to Melbourne, the Minister for Health Jill Hennessy is reported as having “rejected suggestions that patients suffering from poor access to palliative care were more likely to opt for voluntary assisted dying.”
If the Minister has been correctly reported, this reckless and heartless dismissal of a genuine concern is appalling.
The article was based on data released on 25 October 2017 by Palliative Care Victoria in a document entitled “Regional Inequalities in Access To Palliative Care Across Victoria”.
The data in this document demonstrates:
- Lack of genuine choice for Victorians with life limiting illness in relation to access to palliative care.
- Supply constraints on palliative care impeding access by Victorians who would benefit from palliative care prior to their death.
- Significant regional inequalities in access to palliative care, when and where it is needed
Funding of palliative care for admitted inpatients in the Hume Region for 2016/17 was a massive 57% less than the Victorian average per death.
In both the Barwon SW and Gippsland regions funding for palliative in the community, that is at home where many Victorians prefer to die, was 39% less than the Victorian average per death.
And total palliative care funding in Loddon Mallee was 22% less than the Victorian average per death.
Another area of serious shortfall in palliative care funding is in relation to elderly Victorians in residential age care.
In 2014/15, the latest year for which data is available, nearly 14,000 Victorians died in residential aged care. Only 1,740 of these Victorians received palliative care. About 8,750 were likely to have needed palliative care but did not receive it. This represents a shortfall of 82%. That is to say that more than four out of every five Victorians who die each year in aged care and who could have had their pain, suffering and discomfort relieved by palliative care cannot access that care.
The Liberal/ National pledge of $140 million for extra palliative care funding will go some way to meet these shortfalls.
It is possible that in a cynical move to meet the concerns raised by several MLCs who supported the Voluntary Assisted Dying Bill at its second reading vote the Andrews government might suddenly find the money and the will to match the Coalition pledge.
However, those who are genuinely concerned to ensure that every Victorian has equitable access to gold standard, world’s best practice palliative care regardless of whether they live in regional or metropolitan Victoria or die as an inpatient, a home or in aged care will understand that any such funding will take several years to produce such equitable access.
Victorians deserve better from the Minister for Health than a choice between no access to palliative care and facilitated access to the administration of a substance “for the purpose of causing the death of a person” as Ms Hennessy’s Bill puts it.