Push for palliative funding overhaul

Victoria’s palliative care sector has forecast a $91m annual funding shortfall by 2025, based on modelling by KPMG.

Palliative Care Victoria warns the sector’s lack of funding will result in 30,000 terminally ill people dying ‘in pain and unsupported’ within three years.

Victoria’s palliative care sector has forecast a $91m annual funding shortfall by 2025, based on modelling by KPMG that shows providers are being crunched by soaring wage bills and exponential growth in demand.

The findings have prompted peak advocacy group Palliative Care Victoria to warn the sector’s lack of funding will result in 30,000 terminally ill people dying “in pain and unsupported” within three years.

The body has called for a review of Victoria’s funding model, and for the commonwealth to implement a national palliative care workforce plan to train new workers and retain staff.

A KPMG report commissioned by PCV looked at 30 palliative care providers in the state (40 per cent of the total respondents) and found the increase in their costs was driven largely by rising wage bills, which represented about 70 per cent of total costs. Their total wage bill had more than doubled from $40m in 2017 to $85m in 2021 and, based on this trajectory, would rise to $160m by 2025.

KPMG warned that government funding had not kept pace. It found that between 2017 and 2021, the 30 palliative care providers had their funding increased from $47m to $69m and predicted it would rise to $102m by 2025, covering only 63 per cent of projected total wages.

The report found the sharp increase in wages had been driven by soaring demand for services as Australia’s population aged. Covid-19 was also found to have placed an extra strain on the system.

KPMG said the number of visits made by palliative care workers at the 30 organisations it sampled rose from 195,000 in 2017 to almost 355,000 in 2021. Under this trajectory, it said visits could be expected to rise to more than 650,000 by 2025.

“The Covid-19 pandemic has exacerbated the increase in demand for palliative care services as individuals who would normally be admitted in a ward choose to stay at home due to visitation restrictions on family,” KPMG said. “Additionally, restrictions have also created screening or monitoring delays that have allowed diseases to progress and are only diagnosed in more advanced stages.”

The palliative care sector is co-funded in partnership between the federal and state governments, and PCV chief exec­utive Violet Platt says the state’s funding model needs a complete overhaul and a national palliative care workforce plan.

The plan – which she said should be developed in collaboration with stakeholders – would ensure a sustainable workforce amid concern employees would leave the sector under the pressure of enormous workloads.

“Demand for palliative care services in Victoria far exceeds the funding available to even get close in covering this increase in demand and cost to provide services,” Ms Platt said.

“The government in 2016 predicted demand for services would increase by 4 per cent each year, but what has been demonstrated by this report is that it is growing at a rate of 11 per cent,” Ms Platt said.

“The last End of Life and Palliative Care framework was released in 2016, which is the main government document for the sector. It needs a full review, as well as a full financial analysis.”