Annette King Address to Hospice NZ Conference
Annette King Address to Hospice New Zealand Conference
Thank you for inviting me to open the 15th conference Hospice New Zealand has convened in association with local hospice.
I strongly support the leadership role your national office is taking to promote quality hospice palliative care for terminally ill New Zealanders.
I also support the hospice movement throughout New Zealand in its aim to affirm life by providing holistic palliative care for those who are dying and their families, in an environment of comfort, dignity and respect.
The hospice service is an excellent example of the community and service providers collaborating for the common good.
Hospice New Zealand is working with the Ministry of Health, District Health Boards, DHBNZ and, of course, hospices to implement the New Zealand Palliative Care Strategy.
As you will recall, I launched the Strategy in Otago in February last year. The release of this strategy was a major achievement as it set in place a systematic and informed approach to providing and funding palliative care services for the first time in New Zealand.
This sort of approach had been discussed for many years, but it was not until this Government came to office, and we were prepared to work with the sector, that we were able to establish a universal policy and funding model for palliative care services. I am still proud of that work.
At that time the strategy was developed, the Government put a significant amount of funding into hospice care to give direction to the development of palliative care services.
As the strategy itself states, there is a need to raise the profile of palliative care among communities and health and disability providers, to increase the awareness of palliative care services among communities, and to develop a ‘palliative care culture’.
I believe that much has already been done to raise that awareness, but much more will be created in the future through palliative care services working closely with the new Primary Health Organisations, the not-for-profit community-based organisations that are gradually being established around the country.
The Palliative Care Strategy identified a set of essential services to be implemented over a five to ten year period for dying people who could benefit from palliative care.
The first priorities were to ensure these essential services are available for all dying people in New Zealand. Each District Health Board is required to have at least one local palliative care service.
It is great to see that significant progress is being made since the introduction of the strategy.
I understand that many more terminally ill New Zealanders are accessing palliative care services, and a number of hospices have been given the confidence to expand their services.
I also note that some primary care services have introduced palliative care programmes.
I predict that this will occur more often as more PHOs are established in the next few months in various parts of the North and South Islands, and as a greater awareness develops of the value of palliative care.
I have recently been saying around the country, to doctors, nurses, dentists, optometrists and anyone who will listen to me, that my vision for primary health care includes a wide range of health professionals working as a team within PHOs.
That vision certainly includes the palliative care workforce, as a key element in providing a wide range of effective services. I hope that many of you will become involved with other health professionals in this way.
As you know it is the responsibility of each District Health Board to provide and fund palliative care services, and many DHBs are working towards developing their local palliative care services.
I am urging all DHBs to work with local hospices to implement both the Palliative Care Strategy and the Service Level Funding Model for Hospices. This model was specifically developed to assist DHBs in developing palliative care services.
I am pleased to note some DHBs have included the needs of the terminally ill and the Palliative Care Strategy in their strategic planning documents.
I want to reaffirm today the importance I place on adequately providing for this vulnerable group, and I would like to take this opportunity to encourage all DHBs to meet the needs of their terminally ill patients and their families. I know many of you are probably doing this already, but I want to encourage all hospices to develop relationships and provide input to their DHB’s strategic planning process.
In some cases this input has resulted in DHBs amending their strategic plan to incorporate the development of palliative care services. This is a positive outcome.
I know that hospices are endeavouring to work with local Maori to ensure that services meet their needs. This Government is committed to reducing inequalities and a shared commitment from your organisation is more than welcome.
I consider workforce development to be an extremely important part of implementing the strategy.
Yesterday I had the pleasure of launching the document Framing Future Directions, a discussion document written by the Health Workforce Advisory Committee setting out a strategic approach to creating a unique New Zealand Health Workforce.
This strategic approach will be fleshed out at a number of public meetings over the coming months and at a summit meeting of health professionals at Parliament in March next year.
There is a very important section on community health services, and I commend the document to you. It doesn’t look at how many doctors and nurses we need, but takes a patient-centred approach looking at the services a person may need over a lifetime.
Some of you will know that ministry officials are undertaking workforce planning for palliative care medicine specialists, and I am pleased to see that the CTA is funding a postgraduate certificate, available nationally, for 40 palliative care nurses.
I am also pleased to see an increase in the number of hospital palliative care teams. This is important in the development of a “palliative care culture” and in ensuring that people who require palliative care are offered it when intervention and treatment is no longer effective.
Such teams can ensure that dying people are appropriately referred to palliative care services to receive the palliative care to which they are entitled. I encourage all hospitals to consider the benefits of establishing hospital palliative care teams.
One other matter I wish to mention today are the Health and Disability Sector Standards.
I know hospices have developed a good reputation for quality patient centred care and that some hospices have gone beyond these standards and have either been accredited or are working towards accreditation.
However, it is important that you all understand that the introduction of the Health and Disability Standards will affect hospices’ inpatient services. These hospices must meet the Health and Disability standards from October 2004. Even though it will be some time before all other hospices are required to meet the Standards I would encourage you to all to work towards meeting them as well as the standards developed by Hospice New Zealand, which I understand most hospices already meet successfully.
I want to mention one other important thing today, and that is the development in New Zealand of a cancer control strategy. We have been lacking this in New Zealand, and late last year I set up a steering group to develop the strategy.
I am absolutely committed to ensuring that the strategy takes into account the continuum of care that palliative services represent.
Yesterday I was sent the latest World Health Organisation document on national cancer control programmes, and I want to read you a couple of quotes from it.
The publication says: “We have learned that no matter what resource constraints a country faces, a well-conceived, well-managed national cancer control programme is able to lower cancer incidence and improve the lives of people living with cancer.
“A comprehensive national cancer programme evaluates the various ways to control disease and implements those that are the most cost effective and beneficial for the largest part of the population.”
The publication goes on to say: “Measures for good palliative care are essential elements in every national cancer control programme.” It would be wrong of me to finish today without acknowledging the role volunteers play in enhancing palliative care services.
I know that many volunteers give their personal time and contribute a lot of value to palliative care services, for example bringing in flowers, undertaking biography services for patients, providing music and art therapy activities.
I will to end with a few more brief quotes from the WHO document:
“As in other fields of medicine, palliative care for cancer patients has progressed over the past decade. The earlier WHO definition of palliative care stressed its relevance to patients not responsive to curative therapy. This statement might be interpreted as relegating palliative care to the last stages of care.
“Today, however, there is wide recognition that the priniciples of palliative care should be applied as early as possible in the course of any chronic, ultimately fatal illness. This change in thinking emerged from a new understanding that problems at the end of life have their origins at an earlier time in the trajectory of disease.
“Symptoms not treated at onset become very difficult to manage in the last days of life.”
I think those words will be useful for you to discuss during this conference.
Thank you again for inviting me and I want to encourage you again to continue to develop services in line with the Palliative Care Strategy and to work together to provide good quality palliative care to all New Zealanders who need it.