Government funding imperative to keep up palliative care

Hospice forced to dip into its savings

I would never expect my doctor’s paycheque to come from “cakes and op shops.” But for New Zealand’s palliative care services, this is the reality.

Palliative care is an important healthcare specialty providing holistic end of life care right through the dying process. And with a rapidly ageing population our need for palliative care services is quickly growing.

Despite being one of our largest palliative care providers, fundraising is required to cover about half of the costs of Hospice NZ each year. While Hospice receive about $78 million in government funding annually, another $77 million must be fundraised every year to cover the shortfall. With much of that funding coming from op-shops, Covid-19 restrictions have not made it any easier. In fact, Taranaki Hospice report that they lose “$75,000 a week when the five shops shut,” and for the first time in their history are having to dip into savings.

Impact of End-of-Life Choice Act

You might assume that the need for such significant funding is because palliative care is an expensive medical specialty. In reality, however, studies show that palliative care services actually lower healthcare costs.

With the introduction of assisted dying in the End of Life Choice Act—which, in contrast to palliative care, will be fully funded by the government—it is essential that palliative care services are not forgotten. This means that government providing the necessary funding so that all New Zealanders have the care they need available at the end of life. Without it, New Zealanders will not have a true choice.

As Stephen Connor of the Worldwide Hospice Palliative Care Alliance has said, “the ultimate test of whether palliative care is effectively implemented in a country is the willingness of governments to reallocate funding to palliative care, especially in non-hospital settings.” Currently we are failing this test miserably.

Opportunity to make amends

Government changes to the New Zealand health system, however, present an opportunity to make amends and appropriately prioritise our palliative care services. As stated in a recommendation from our paper Ending Well: The urgent case for palliative care released last week: this should include increasing funding so that all end of life care is free and universally available throughout New Zealand.

That is, all New Zealand hospitals should have provision for palliative care services, and all of New Zealand’s hospices—whatever their location or ability to fundraise—should no longer need to worry about the impact of closing op-shops on reaching fundraising goals and providing this necessary care.

Our Prime Minister often talks about being kind to others. If the government truly want to be kind and caring to all New Zealanders, they should not ignore people at the end of life.

The government need to put their money where their mouth is, stop just talking about caring for all New Zealanders, and pay for it as well, so that we can really see the results. By actively and financially caring for our palliative care services all New Zealanders will have a much better chance at ending well.

Danielle van Dalen is a Researcher at Maxim Institute based in Auckland.