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A Priority Highlighted By Lesley Martin's Trial

From: Hospital Palliative Care New Zealand
30 April 2004

Hospital palliative care provision: A priority highlighted by Lesley Martin's trial

Comprehensive nationwide hospital palliative care is essential for ensuring that tragic situations highlighted by the trial of Lesley Martin are reduced in future.

Jean Clark, Hospital Palliative Care Clinical Nurse Specialist, speaking on behalf of Hospital Palliative Care New Zealand (HPCNZ) says "Much of the suffering of Joy Martin and her family may have been alleviated or prevented by timely involvement with a dedicated hospital palliative care service. Unfortunately, hospital palliative care provision is patchy nationwide and not seen as a priority for development in many areas. HPCNZ has a goal of ensuring that all New Zealand public hospitals have a fully developed palliative care service to adequately meet the needs of patients and families who are often so vulnerable and in need of support."

The need for hospital palliative care provision is compelling. 41% of New Zealanders will die in a public hospital. Even more will have significant contact with hospitals around the time of diagnosis of an incurable illness, for treatment, and for follow-up. The hospital experience is often a bewildering and disempowering one. It is estimated that between 11-15% of all patients in an acute hospital have palliative care needs. However a large body of evidence suggests that the needs of such patients in hospitals are not met - in particular adequate control of symptoms, psychosocial support, family support, communication issues and discharge liaison. Furthermore, the vast majority of these patients will never encounter a hospital palliative care service.

Hospital Palliative Care New Zealand (HPCNZ) is a group of specialist palliative care doctors and nurses who work in acute hospitals. Their objective is to promote the development, integration and culture of palliative care within New Zealand Public Hospitals at local regional and national levels, in order to improve the quality of care available to patients with incurable illness and their families/whanau. They work both to teach other hospital health professionals basic palliative care skills, and to spend time with patients and families helping to address the particular issues that concern them. Hospital palliative care teams see patients with both cancer and non-cancer illnesses often at the time of diagnosis, and work alongside the other health care teams involved in the care of patients. They also help ensure that by the time people leave hospital or clinic they have appropriate community support available to them. This may include being referred onto local palliative/hospice services, district nursing support and ensuring that GPs are fully informed. Ensuring a smooth transition between inpatient care and community services is vital for patients and families.

"Until there are comprehensive and adequately funded hospital palliative care services, we will be failing in our duty to support and care for many New Zealanders. Ongoing unrelieved suffering is a major argument for legalizing euthanasia. If we do not deal with the issues regarding care and support in our public hospitals, where we know the need is huge, we are failing in our duty of care" said Dr Grundy, Hospital Palliative Care Specialist.


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