Hospices At Risk Of Disappearing

Hospices around Aotearoa New Zealand are at risk of cutting services as underfunding by the government pushes them to the brink.

Last year Hospice provided free care to nearly 11,000 people who died last year, almost a third of all deaths in New Zealand, along with another 9,000 people living with a terminal illness. This essential support to people and their whānau cost $226 million.

While the government provided $114 million, hospices had to raise a further $112 million through Hospice Op shops, community donations, fundraising and bequests, to keep their doors open.

Wayne Naylor, Chief Executive, Hospice New Zealand, which represents New Zealand’s 32 hospices, says without fair and sustainable funding, hospices, and the critical services they provide, are at risk of disappearing.

“This Hospice Awareness Week our message has never been clearer. If the Government doesn’t act now to invest fairly in hospice care, it is the terminally ill in need of Hospice care and their loved ones who will pay the price.

“Hospices are already facing major disruption and reducing offerings.

“Without more funding, we risk losing these vital services when people need them most,” says Mr Naylor.

The unprecedented strain on hospices comes despite the recent release of the Report ‘Sustainable Funding for Hospice Services, by research agency Martin Jenkins. The report shows that Hospices are not only a smart investment economically for the health system, they also provide better outcomes. Through providing free, end-of-life care to thousands of New Zealanders every year, they’re relieving the pressure on Emergency Departments and freeing up hospital beds.

Local hospices are providing taxpayers value by saving the public sector a conservative $110 million dollars per year and returning at least $1.59 in health benefits for every dollar of government funding.

Hospice care in the community relieves an already overstretched health system which would otherwise have to care for the thousands of patients and families who use it.

Mr Naylor says that a new sustainable funding model needs to be implemented, rather than just talked about.

“We now need to have hard conversations about future funding, particularly as the demand for hospice care continues to rise, as our population grows older and lives longer. It is predicted that the number of people needing palliative care will increase by 50% by 2040.

“We want the government to act and invest now if it is to appropriately meet current and growing future need for high quality end of life care,” says Mr Naylor.

A Post Code Lottery

“Many communities aren’t in a position to provide the additional millions of dollars required to keep services free, never mind expanding hospice care and extending it to those currently missing out because of where they live or their diagnosis.

“We can’t keep relying on the generosity of community to keep our doors open, when costs far exceed our funding, “says Tony Paine, Chief Executive of Mary Potter Hospice in Wellington. “We are making savings in non-clinical areas where possible but there’s no room to expand our services to meet the needs of a growing population with complex needs,” he says.

Hospices are already making cutbacks that include reducing inpatient beds, keeping clinical roles vacant and restricting admissions.

“Many remaining doctors and nurses are even having to take on extra workloads to cover for overstretched GP clinics and aged care facilities in their regions.

“It is the persistent case of post-code lottery that the Government says it wants to remove with its health reforms. Many people are missing out due to their diagnosis, age and where they live,” says Mr Naylor.

“The situation every hospice is in, means having to make some unprecedented decisions this year.

“We don’t want to end up in the crisis currently facing hospices in England and Wales where dying people cannot access the care they need when they need it most.”

In Numbers: 

In 2023/2024 Hospice across Aotearoa

• Provided care to 19,151 people, plus their whānau.
• Cared for 10,860 people who died.
• Provided 313,911 face to face visits.
• Made 394,215 telephone and telehealth interventions to patients and whānau members.
• 40% of hospice patients died in their own home (compared to just 22% of general population / all deaths stats).
• Provided 25,105 grief and loss contacts.
• Had to raise over $112m through their second-hand retail shops, fundraising, donations, and other sources, including from reserves, to keep afloat.

What a shortage of funds looks like in terms of disruption and responding to patient needs:

• Reduction in inpatient beds
• Delays and freezes on recruitment
• Restricting admissions and stricter on referrals (meaning those patients on the periphery of need are missing out)
• Reduced community care – ie stopping the hospital liaison nurse service that helps to support a safe discharge from hospital back into the community
• Nurses for In-patient beds moving to 12-hour shifts
• An inability to grow in line with demand is, in itself, a barrier to delivering equitable and timely access to high-quality palliative care.
• Using hospice doctors and nurses to fill the gaps that GPs and ARC facilities are not able to do at present.

The recent Martin Jenkins Economic Report : ‘Sustainable Funding for Hospice Services: is both compelling and conservative:

• Every $1 taxpayers invest in hospice services yields at least $1.59 in system savings
• Hospices currently save the health system $110 million per year in direct clinical cost
  • They generate $48 million in quality-of-life benefits for patients and their whānau (e.g. returning to work and school earlier with bereavement support)
• Hospice care reduces ED admissions and hospitalisations
• Hospices directly support primary and aged residential care teams

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