The Reforms to Human Services Inquiry Report, initially released to Government in October last year, focuses on finding ways to put the people who use human services at the heart of service provision, detailing six services that require the introduction of greater user choice, competition and contestability, in turn improving outcomes for the people who receive them.
In addition to recognising palliative care services as an area for great improvement, the report also makes note of social housing, family and community services, services in remote Indigenous communities, patient choice over referred health services, and public dental services.
Authors of the report, the Productivity Commission, say when it comes to palliative care, “few of those who would prefer to die at home are able to do so”, adding that developing end of life care services and improving access to high-quality care would enhance community welfare, by enabling people to have more choice about where they are cared for and where they die.
“The aim of reforms to end of life care should be to provide the growing number of people needing end of life care with services that better match their preferences,” the Commission says in the report.
“These reforms should ensure that Australians receive high-quality care across all major settings - hospitals, residential aged care facilities and at home.”
The report notes impending improvements to end of life care in acute hospitals, in the form of a range of new practices, which will be implemented alongside an updated version of the National Safety and Quality Health Service (hospital accreditation) Standards in 2019, which contain new end of life care standards.
However, the Productivity Commission states in their report that “additional reforms are needed” to ensure high-quality care is available for people wishing to die at home and for those in residential aged care.
To address their concerns that “few people can access community-based palliative care” and that “residential aged care is ill equipped to meet end of life care needs”, the Commission recommends:
State and Territory Governments should increase the availability of community-based palliative care so that people with a preference to die at home care access support to do so
End of life care should be core business for aged care facilities, and the quality of end of life care in residential aged care should align with the quality of that available to other Australians
The Australian Government should promote advance care planning in primary care
The Australian Government should amend the aged care Quality of Care Principles to require that residential aged care facilities ensure that clinically trained staff hold conversations with residents about their future care needs
The Australian, State and Territory Governments should, through the Council of Australian Governments (COAG) Health Council, ensure that there is cross-jurisdiction co-operation
These recommendations, and further notes on how these recommendations can be implemented by Government, have been welcomed by Palliative Care Australia (PCA) Chief Executive Officer Liz Callaghan.
Ms Callaghan says she is pleased with the Productivity Commission's report, endorsing and commending them for a number of their recommendations.
“Palliative care is a great model of care [and] ensuring the quality of life right to the end of life is important no matter what age you are,” she explains.
“This multidisciplinary model puts the consumer truly at the centre of care, with all the clinicians working together with the aim of ensuring quality of life until the end of a person’s life.
“The Commission’s report provides a range of recommendations that will require support across Governments as well as significant investment.
“It seems the Commission is clearly saying that everyone in Australia should have access to high quality care, right to the end of their lives [and] PCA agree with this as it is only then can Australians make real choice about how they want to live until they die.
“This is an issue important to all Australians, you only due once and as a community we only have one chance to get this right. The time to act is now.”
The Commission also states in the report that in 2025, the COAG Health Council should commission an independent review of the effectiveness of end of life care across all settings in which it is, or should be, provided.
They add that the review “must include” an assessment of consumer protection, such as quality standards.