Many Queenslanders die before their palliative care packages are approved, doctors say in a damning submission to a state government inquiry.
The state government is delving into the adequacy of aged care, end-of-life and palliative care, and whether there is support for state laws to allow
voluntary assisted dying.
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Specialist palliative care doctors say there's a yawning gap between demand and the capacity to support dying Queenslanders, and the situation can no longer be ignored.
They say patients and their families are struggling to negotiate the complexities in arranging care and sometimes it's not available, particularly in regional and remote communities.
Wrangling with the likes of National Disability Insurance Scheme, My Aged Care and Queensland Community Care is resulting in "unacceptable delays in provision of care, or in some instances no care at all".
"Many patients die before their package is approved," the Queensland Specialist Palliative Care Services Directors' Group says in its submission.
The doctors paint a dire picture of what it's like for terminally ill Queenslanders in regional and remote centres, which often lack direct access to specialist palliative care.
"Clinicians in these places and their surrounds spend time ringing around the state to ask for specialist palliative care advice.
"Clearly, this make-do model is not sustainable," they said.
They also detail a "postcode lottery that will determine what home equipment dying people can access, depending on which Hospital and Health Service (HHS) they fall under.
"Some patients in a HHS will be funded for equipment, where as those in other HHS (areas) will not."
The doctors also say patients typically can't arrange urgent palliative care visits outside business hours, forcing them into hospital emergency departments.
The doctors and the Australian Medical Association of Queensland (AMAQ) have expressed deep frustration that serious deficiencies in palliative care, brought to the government's attention years ago, remain unresolved.
Those deficiencies included serious understaffing, under-resourcing, insufficient beds and inadequate after-hours cover.
Care is even lacking for terminally ill patients living in retirement and aged care facilities (RACFs).
"GPs report that they find it extremely difficult to treat their patients in RACFs due to limited organisational support at some, and poor financial incentives," the AMAQ says.
"Many GPs are forced to relinquish giving care to these patients."
The AMAQ said the state and federal governments must accept shared responsibility for addressing unmet demand for palliative care across the state.
It's seeking the introduction of specialist palliative care teams in all regions of the state, with doctors, oncologists and GPs working with carers to ensure dying people get what they need, wherever they are living.
The AMAQ echoed the position of the national Australian Medical Association in opposing any shift to voluntary assisted dying laws.
"Doctors should not be involved in interventions that have, as their primary intention, the ending of a person's life."
The inquiry is due to report back to the government by November 30.
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