Page 277 - Week 01 - Thursday, 24 February 1994
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The Government also agreed in principle to the provision of $3m for a hospice in the 1992-93 capital works program. This commitment has been made by the Government for the benefit of all the potential patients of the hospice and their families and friends.
My Government has investigated fully the possibility of co-locating the hospice with an acute hospital and has made the final and irrevocable decision that this is no longer an option. This decision has not been made without a great deal of investigation, discussion and consideration. The Government has considered a range of views, including those of the medical and nursing professions, the Hospice and Palliative Care Society, the AIDS Action Council, religious and non-religious groups, and the management and staff of almost every hospice in Australia. In fact, over 20 different hospice facilities have been consulted by members of the hospice working party. All the parties consulted agreed that a hospice did not need to be co-located with a major hospital.
Once again, I will detail the reasons for the Government's decision to build the hospice away from a major hospital. There is a world of difference between a hospice and a hospital. A hospice is a specialised health facility that employs complex techniques for symptom control and pain management. It is not a place where people go to be cured. It is also apparent from the available evidence that the closer a hospice is built to an acute hospital the more acute interventions will be carried out.
Mrs Carnell: There is no evidence at all of that.
MR BERRY: Because you would like that. You are an apologist for the people who want it close. The Calvary Hospice at Kogarah in Sydney is a freestanding facility, and staff there have found that only a very small number of patients - less than 3 per cent - need to be transferred to an acute hospital for procedures. This contrasts with the Daw Park Hospice in the grounds of the repatriation hospital in Adelaide, which transfers approximately 8 per cent of its patients to the hospital for treatment. The difference in the intervention rates will be borne out by an analysis of any number of hospice facilities.
Mrs Carnell: That is because they can actually do it.
MR BERRY: The evidence is flying in your face. It is obvious to all of those working in palliative care, Mrs Carnell, that the difference in transfer percentages relates directly to the location of the hospice and the nearest acute hospital. The clinical nurse consultant at the Mary Potter Hospice in Adelaide has stated that being adjacent to a hospital will dictate practice. It follows, therefore, that, while there may not be a substantial difference in the total costs associated with caring for palliative care patients in either a hospital or a hospice, the recurrent costs associated with acute intervention procedures will be substantially lower with hospice care. I must state again, Madam Speaker, that any number of interventions will not provide a cure for those patients and that the overwhelming need is for pain management and symptom control so that these people may spend the last few weeks of their lives pain free and die with dignity.
Do not forget also that the hospice on Acton Peninsula will be supported by the home based palliative care service. The home based service will support patients who wish to die at home, whenever this is manageable by the patient's family and in accordance with the patient's wishes. A great majority of people suffering terminal illnesses die in their own homes. The home based
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