Hospices warn critical services under threat amid funding crisis
By Ruth Hill of RNZ
Hospices are warning that critical services for the dying are under threat, with nothing for palliative care providers in the Budget.
Hospice NZ says government funding only covers about half of what it costs to run New Zealand's 28 publicly funded hospices, but if services collapse, it will end up costing taxpayers millions of dollars more.
Jen Nolan, whose younger brother Matt died at Te Omanga Hospice in Lower Hutt in 2019, said she dreaded to think how those final days would have gone without that "incredible, wrap-around care".
The weeks following Matt Nolan's diagnosis with stage four melanoma were brutal: brain surgery, radiation, immunotherapy - nothing worked.
It was a devastating blow when doctors said there was nothing more they could do - but Matt Nolan's admission to Te Omanga offered a different kind of healing.
"When we walked in, I turned to one of my sisters and said 'God, it's like we've left Hell and we're in Heaven's waiting room'."
Her brother's seizures and complex pain needs made it impossible for him to be at home, but Te Omanga became their home.
"We could come and we could bring our dogs, he had a lovely room that opened out to the garden. His friends could come.
"I walked in one day, and there he was, fast asleep, with two of his buddies also asleep in chairs. They were having a little nap together."
Matt Nolan died in July 2019, three months after diagnosis. He had just turned 49.
Six years on, Jen Nolan said it was heartbreaking that hospice services were only available to one in three New Zealanders who were dying.
"If you face the death of a loved one, and you haven't got the option to go into hospice care, I think that would be a bloody grim place to be.
"It was the most supportive and gentle place for us all to be with him. The care he received was outstanding. And I feel what we were shown as we navigated this incredibly difficult time was the best humans can be for each other."
It cost $226 million to run the country's hospice services last year, with just half of that provided by the government.
Hospice New Zealand chief executive Wayne Naylor said it was disappointing to not even rate a mention in the Budget - especially coming on top of the scuttling of the pay equity claim for hospice nurses.
They are currently paid up to 35% less than Health NZ nurses.
"That was a real out-of-the-blue sideswipe for hospices and hospice nurses in particular, to have our pay equity claim, which was almost completed, just stop."
Indications that the government would not be covering future pay equity settlements for the funded sector were "very problematic".
"That then falls back on community to provide more money to support their local hospice.
"The alternative is that hospices have to make some staff redundant so that they can increase the salaries of other staff, and that leads to a reduction in services." Health NZ has enough money - Health Minister
Health Minister Simeon Brown said the government "values the work of hospices", but he said it was up to Health NZ to do its own negotiations with providers.
"This Budget has provided $1.37b to Health NZ to not only deliver an increase in investment for those front-line hospital and specialist services, but also an uplift in investment to that funded sector, which includes primary care, which includes aged care, which includes palliative care."
However, Naylor was not optimistic following meetings with Health NZ officials, the most recent one this week.
"They told us they had no more funding, that they have no contingency that they can call upon, and the people with whom we met said they had no authority to allocate funding from anywhere else.
"So essentially it's a no to funding from Health NZ right now."
Assisted dying services receive about $11m a year from Health NZ, in order to ensure equitable access.
"Which is fine for the fewer than 1% of people who seek it," Naylor said.
"But for the 99% of people who die from an expected illness, only about a third can access hospice care. So there still remains that inequity that needs to be addressed."
For dying children, access to specialist palliative care services were even worse.
A recent MartinJenkins report found New Zealand's 28 publicly-funded hospices are returning at least $1.59 in health benefits for every dollar of taxpayer money received, including fewer ED and hospital admissions or rest home stays.
Add to that the clinical services they directly fund themselves, the public benefit is even higher.
Most patients under hospice care are able to stay in their own homes, with brief admissions to hospice for respite or to adjust pain medication. Government 'exploiting' good will - nurses
Nelson-Tasman Hospice nurse Donna Burnett loves her work, which is why she has stayed in the job for 36 years.
However, the Nurses Organisation delegate said that good-will was being taken for granted by the government, and the end result for many was "burnout".
"We can't keep giving the way we are.
"Often we're short-staffed. We keep that patient centred care going, but it's coming at a cost.
"We can't keep giving like we are and working understaffed because that has an impact on your wellbeing."
In a written response, Health NZ said it would shortly begin seeking feedback from the public and the sector on a model of care proposal for adult palliative care.
It plans to finalise both the paediatric and adult models of care by the end of the year.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Scoop
2 days ago
- Scoop
17,096 Kiwis Call For Urgent Action To Fund Keytruda For New Zealand's 'deadliest Breast Cancer'
Breast Cancer Foundation NZ is proud to support Auckland woman, Catherine Cooke, as she presents her petition to MP Hon. Mark Mitchell, urging the Government to fund the cancer drug Keytruda for early stage triple negative breast cancer (TNBC). Catherine is presenting the petition at Breast Cancer Foundation NZ office in Parnell on 27 June at 2pm. The level of support for this petition is significant and shows New Zealanders are fed up with falling behind the rest of the world in terms of access to life-saving treatment. Catherine was diagnosed with early TNBC, an aggressive form of breast cancer in November last year after her yearly mammogram. She was told Keytruda with chemotherapy would give her the best chance of survival – but the drug would only be funded if her cancer was advanced. Instead, Catherine has had to put most of her work on hold and sell her family home to fund the treatment - which is costing around $85,000. Around 350 women are diagnosed with triple negative breast cancer every year, which is approximately 10% of all breast cancer diagnoses. It is also more common in younger women with nearly 15% of diagnoses in women under the age of 45 being triple negative. For one in three women with early triple negative breast cancer, it will return and become incurable within five years. It is the deadliest form of breast cancer and is harder to treat. Unlike most other breast cancers, triple negative breast cancer doesn't respond to hormone-blocking treatments and targeted drugs. Keytruda is an immunotherapy drug, and it is the only targeted treatment that works to fight triple negative breast cancer and is given to patients alongside chemotherapy. It's fully funded in 40 other countries including Australia, Canada and Britain. New international research was published last year and showed that Keytruda can stop women dying from triple negative breast cancer because it's highly effective at preventing cancer coming back. Patients with early triple negative breast cancer receiving Keytruda in a clinical trial were 34% less likely to die and 32% less likely to have their cancer spread beyond the breast. It is widely accepted by the medical community internationally as the best drug to treat early triple negative breast cancer and New Zealanders deserve access to this treatment. Breast Cancer Foundation NZ Chief Executive, Ah-Leen Rayner said 'women like Catherine are having to go through drastic lengths to be able to pay for Keytruda. It's atrocious that New Zealanders are selling their homes, asking for help from their parents or complete strangers to find hundreds of thousands of dollars, or potentially simply going without treatment that could save their lives. 'We are so grateful to Catherine for working tirelessly for better drug access for New Zealanders in the future, but she shouldn't have to. We're urging the government to ensure Pharmac has the budget it needs to fund these essential medicines that are standard of care around the world.'
Scoop
2 days ago
- Scoop
Strong Interest In New Programme For Overseas-Trained Doctors
Minister of Health A total of 180 overseas-trained doctors have expressed interest in a new Government-funded training programme aimed at boosting New Zealand's primary care workforce, Health Minister Simeon Brown says. 'New Zealand needs more doctors – particularly in primary and rural healthcare care settings – and this Government is taking action to make that happen,' Mr Brown says. 'That's why we've launched a new two-year training programme to support up to 100 additional overseas-trained doctors across the country.' Announced in March, the programme supports qualified international doctors to become registered in New Zealand, with a particular focus on those wanting to enter general practice roles – creating a clear pathway for doctors already in the country and ready to contribute to our health system. 'It makes no sense that overseas-trained doctors already living here, ready and willing to work in primary care, are held back simply due to a lack of supported clinical training opportunities. We are changing that.' Applications for the programme closed on 31 May, with 184 expressions of interest received – well exceeding the number of places available. The first group of 10 overseas-trained doctors will begin in Waikato this July, with Health New Zealand currently working to match the remaining placement locations with district and primary care providers. 'This strong response shows the scale of untapped potential in New Zealand. These doctors are eager to work where they are most needed – and this Government is opening the door for them to do so. 'I've also requested advice from Health New Zealand on how to provide clear, structured pathways for doctors who have passed the NZREX to begin practising under limited scopes while they wait for a placement in general practice training. 'This is part of our broader plan to strengthen primary and rural healthcare and ensure New Zealanders get timely access to the care they need, no matter where they live,' Mr Brown says. Notes: Cohort timing and planned numbers July 2025 Cohort - 10 October 2025 Cohort - 30 January 2026 Cohort - 40 April 2026 Cohort - 20 This investment is part of the Government's comprehensive primary care package announced earlier this year, including: Increased access to urgent and after-hours care Recruitment incentives for up to 400 graduate nurses annually for five years 100 additional doctor training places over the course of this Government Up to 50 graduate doctors training in primary care annually Up to 120 training places for nurse practitioners in primary care Accelerated tertiary education for up to 120 primary care nurses A $285 million uplift to funding over three years for general practice from 1 July, in addition to the capitation uplift general practice receives annually Better access to 24/7 digital services.
Scoop
2 days ago
- Scoop
System C Unifies Maternity And Neonatal Care Across New Zealand
System C is proud to announce the continued expansion of the comprehensive BadgerNet Maternity and Neonatal services across New Zealand's hospital districts. This initiative marks a significant step towards unifying maternity and neonatal care in the country. This six-year partnership between System C and Health New Zealand will run until March 2031. The adoption of BadgerNet aligns with both long term goals of New Zealand's Heath Strategy, aiming to achieve health equality and improving the health outcomes for all New Zealanders. System C's maternity and neonatal solutions are built with expectant parents in mind as well as clinicians with the Badger Notes app providing pregnant women with access to their pregnancy notes, empowering them to be involved in their care and promoting a woman-centred approach. Alongside the national adoption of BadgerNet across all hospital districts, System C have also implemented a bespoke Perinatal Spine technology that allows midwifery providers using alternative systems to integrate seamlessly into the national shared care record. Trusted British Tech in New Territories With a strong heritage in the UK as the leading provider of maternity and neonatal solutions across both the NHS and private sector, System C's BadgerNet Neonatal Clinical Summary technology is used in 99.9% of clinical settings in the UK. BadgerNet Neonatal technology ensures that interfacing, charting, clinical care plans and task lists are integrated into one system, supporting clinicians' efficiency their day-to-day activities. System C's BadgerNet Maternity is the only comprehensive solution that enables real-time recording of events and care throughout pregnancy, from pre-conception to postnatal, including early pregnancy and gynaecological care. It offers locally configurable pathways and tasks, eliminating the need for paper records. Guy Lucchi, Managing Director – Healthcare, System C said"We are delighted to bring our cutting-edge maternity and neonatal solutions to New Zealand. This partnership underscores our commitment to enhancing healthcare outcomes through innovative technology. By integrating our BadgerNet systems, we aim to provide seamless, real-time access to critical patient information, empowering clinicians and improving patient care. We look forward to supporting New Zealand's healthcare professionals in delivering the highest standards of care." Aligning with the four priorities for women's health in New Zealand System C is proud to partner with the New Zealand government during this pivotal time, as Aotearoa New Zealand introduces its first Women's Health Strategy. This strategy sets long-term priorities to guide the health system towards equity and healthy futures for women. The four key priorities are: Priority 1: A health system that works for women Priority 2: Improving health care for issues specific to women Priority 3: Better outcomes for mothers, whānau and future generations Priority 4: Living well and ageing well. The need for the investment in maternity services leading to a reduction in overall spend is echoed by a recent study conducted by Science Direct. Utilising real-world data from New Zealand, the only country with fully integrated midwifery continuity-of-care, the study established that midwifery care is cost-saving for public healthcare systems compared to maternity care provided by private obstetricians.' (The impact of caregiver and intended mode of birth on the public cost of care: Cost analysis of maternity and neonatal care in New Zealand - ScienceDirect) This partnership represents a significant milestone in the advancement of maternity and neonatal care in New Zealand. By leveraging System C's innovative technology and expertise, we are committed to supporting healthcare professionals and improving health outcomes for women and their families. Together, we are paving the way for a healthier future, ensuring that every mother and baby receives the highest standard of care.
