Analysis of Submissions on the Pallaitive Care Strategy Discussion Document

Analysis of Submissions on the Palliative Care Strategy Discussion Document
Date of publication: November 2000

Executive Summary
Public consultation on the discussion document “The New Zealand Palliative Care Strategy” was held between July 2000 and September 2000. The document outlined a vision and strategies for the future of palliative care services in New Zealand. 114 submissions were received and a number of public and focus group meetings were also held.

Key findings from submissions, public meetings and focus groups included:

Support for the definition and principles, vision and essential services outlined in the strategy discussion document, although there were some additional issues identified.

No clear support for having one provider co-ordinate services. Only 51.8% of submissions agreed that this could work. There was support, however, for palliative care services becoming better co-ordinated.

No clear support for Regional Palliative Care Services. Only 52.7% of respondents agreed that regional services would work. Many of the respondents felt that these functions would be better carried out at the District Health Board level. While some people at public meetings supported regional services and “Centres of Excellence” others were concerned that they should not be developed at the expense of local palliative care services. Some thought that the role of regional services of overseeing the quality and education of local palliative care providers could be carried out at a national level. Many were concerned that links between palliative care services and hospitals should be wider than with Oncology Centres.

No clear support for Regional Hospital Palliative Care Teams (44.6%). However, many supported the role of the Hospital Palliative Care Team but commented that Hospital Palliative Care Teams should be available in all hospitals and not just tertiary hospitals. Some respondents thought that a palliative care team would be best affiliated with a community/primary care team than an oncology team.

In addition to the above, submissions indicated a need to consider:

Increased funding for palliative care services and the need for a shorter time frame for implementing the strategy.

The availability of palliative care services on a 24 hour basis and the importance of access to palliative care services for people in rural areas.

A greater recognition of the role and funding of the GP in providing palliative care services particularly in rural areas.

How the needs for palliative care for people with non-malignant disease and children should be met.

How people who do not fit the DSS definition of disability (for example, those with cancer and multiple sclerosis) access DSS support services including home support and longer term beds, particularly for people under sixty-five. Also, how care can be tailored to meet the specific needs of these people, for example, accredited rest homes were suggested.

How income support could be made available on a needs basis.

More education of the public and training of all providers in palliative care.

Māori submissions indicated a need to consider:

The availability of more information on palliative care services particularly around the time of diagnosis.

How to increase the understanding of mainstream services on the role of the whanau in caring for dying family members.

Including Māori providers in the multidisciplinary team. There was support for a Māori care co-ordinator linked to a Māori provider organisation.

Better co-ordination of services particularly between mainstream and Māori providers.

The possibility of a pilot project which would provide Marae based palliative care services.

Training in palliative care for Māori providers.

For Pacific people the issues were similar and include:

How to increase the understanding of mainstream services on Pacific people’s culture and their beliefs in terms of care of the dying.

How to increase the number of Pacific health professionals working in mainstream palliative care services so that care can be provided in a “culturally safe” way.

How to disseminate more information on what palliative care services are available to Pacific people.

How to provide support (both physical and financial) to non-resident Pacific people with family members who are dying.

Training in palliative care for Pacific people.

The above findings will be taken into consideration in the development of the final strategy document for palliative care services in New Zealand.

Please note that two additional submissions have been received and have not been included in this analysis. The issues raised will, however, be taken into consideration in developing the strategy further. The issues raised are similar to other issues that have been identified.

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