Wednesday, 13 October 2021 HOUSE OF ASSEMBLY Page 7704/7705/7709
Introduction and First Reading
The Hon. A. PICCOLO (Light) (11:28): Obtained leave and introduced a bill for an act to provide for an inquiry into palliative care in South Australia to be conducted by the Health Performance Council, and for other purposes. Read a first time.
Standing Orders Suspension
The Hon. A. PICCOLO (Light) (11:29): I move:
That standing orders be so far suspended as to enable the bill to be taken through all stages without delay.
The SPEAKER: An absolute majority not being present, please ring the bells.
An absolute majority of the whole number of members being present:
The SPEAKER: I accept the motion. Is it seconded?
An honourable member: Yes, sir.
The SPEAKER: Member for Light, do you wish to speak to the suspension?
The Hon. A. PICCOLO: I think the house should support the suspension of standing orders and consider all stages of the bill. I gave notice of this bill some time ago. I circulated the bill on 26 August to all members. I also provided a briefing on 6 September, including the Minister for Health and Wellbeing. It was deferred. It is basically a one clause bill.
The Hon. A. PICCOLO (Light) (11:32): I move:
That this bill be now read a second time.
The Hon. A. PICCOLO: The aim of the bill is to ensure that South Australians have a world-class palliative care system so people have a real choice in how they wish to be cared for at the end of their life. The bill directs the South Australian Health Performance Council to undertake an inquiry into the South Australian palliative care system and make recommendations on how it can be made better to ensure that all South Australians have equitable access to it. By equitable access, I mean both geographically and financially.
Why the inquiry? The Joint Committee on End of Life Choices, of which I was a member, along with other members here, made the following findings in relation to palliative care. Based on submissions from professionals in the field, a number of consistent themes emerged including, and I quote from the report:
- Palliative Care is a critical part of our health and wellbeing system although it requires a greater level of funding to ensure that it provides more consistent and equitable access.
- Any improvements to the Palliative Care system should design services that are appropriate and accessible for people in regional areas, Aboriginal people and those for whom English is not a primary language.
- A key focus of Palliative Care should be on the dignity of people who are approaching the end of life.
- There is a general need to improve data collection and reporting on palliative care—including the experiences of patients, their families and loved ones, clinicians and carers.
I have chosen to have the Health Performance Council undertake the review and that is based on feedback given to me during the voluntary assisted dying debate. The Health Performance Council is best placed to undertake the inquiry. There is legislative intent that it undertake such inquiries. I have consulted with the Health Performance Council, and they have indicated to me that the inquiry could be undertaken and also in the time frames I suggested to them. I have been advised that the review will probably take about 12 months to be completed, and they advised that they have the capacity to do that. The functions of the Health Performance Council—to read out the relevant portion—include:
(1) such other functions—
(i) assigned to the HAC under this or any other Act;
This bill is consistent with the act itself. I seek the support of this bill at this time because I want to ensure that, when the voluntary assisted dying legislation comes into effect in about 12 to 18 months’ time, our palliative care system is ready to make sure that people have a real choice.
One of the fundamental questions put by people who supported voluntary assisted dying was that people should have a choice at the end of life. Choices have to be real, not just theoretical. For people to have a real choice, we make sure we have a care system that actually provides that. The evidence is—certainly the evidence I have received in support from regional members—that it is patchy across our state, and that is why it is important that we do this now. In 12 months’ time, the government of the day will have the recommendation to make sure that when VAD comes into effect we also have a palliative care system ready to respond to that challenge.
The SPEAKER: Member for Frome.
The Hon. G.G. BROCK (Frome) (11:51): Thank you, Mr Speaker, and congratulations on your appointment. I would like to briefly talk about this bill, the Inquiry into Palliative Care Bill 2021. As other members have mentioned here, this is something that is very important to everyone across all of South Australia, but in particular to regional South Australia. First up, let me say that I have the greatest admiration for the staff who look after people in the Port Pirie palliative care system and others I have visited and come across.
In regional South Australia in particular, most of the people who look after those who have to be admitted to palliative care know them and they know them very closely. They get very personal with them and it also becomes part of their lives and the way those staff and the nurses perform their duties there. Also, they take that memory home to their families and they have to put up with a lot of the emotional impact of that, and I can talk from previous experience.
My late father-in-law had a very aggressive form of cancer. He was admitted to the palliative care system in Port Pirie, where the staff themselves were absolutely fantastic. There was a separate room for these people, and there was a chapel, not that he was very religious, but he had the opportunity to go in there a couple of times with the minister of his choice at that particular point. My partner, Lyn, and I were in the room at the same time. We spent the last few nights there just before he passed away. He opened his eyes and said how he had enjoyed life and things like that.
I have had my mother-in-law do the same thing—she had to go into palliative care—and in the last five or six weeks I have had personal friends who have had some form of cancer and had to be put into palliative care. On three occasions, they were diagnosed with some form of cancer and admitted into palliative care, and one passed away within two weeks and another within six days.
People will look at this from outside an inquiry. Sometimes, people perceive an inquiry as not that particular avenue, or what you are inquiring into may not be working properly. I think that palliative care is doing a good job out there. I think we need to have inquiries into whatever we do.
We do that with our own lives: we inquire about how we perceive ourselves, how we manage ourselves every day, and try to improve. This bill will only do that, in my view. It will look at opportunities of how we can improve palliative care facilities, their operation and the attractiveness of how we can make it a lot easier for families and things like that.
The member for Giles mentioned the regional people. Some people out there cannot get to a location—and this is getting more prevalent—or maybe cannot get into a local palliative care facility and may have to go away from their own communities and therefore have the extra burden and the impost of not having the family come in to visit and so forth.
It is about how we can improve the services. As I said earlier, the staff are fantastic. I take my hat off to the people who do this. I personally would not emotionally be able to handle the job they do. We also need to look at the opportunity to train more of these specialised people to be able to come from the health system into palliative care because, if we do not have those people trained in the near future, some of them will get emotionally worn out.
A lot of them are under stress and some, unfortunately, go a bit further and have mental health issues. I know one person, in actual fact, went to the degree that they just about lost their life because of the pent-up emotion that built up over a period of time. Also, I think we need to understand what is the quality of the infrastructure out there and whether we have enough rooms, and the locations and things like that.
Another thing I would encourage if this bill gets through relates to the staff themselves. I would make certain that they have some form of counselling, as I said, especially in regional areas where they know personally those people; they take it home with them and it impacts their own families. They have to be able to have some counselling. I know there is some at the moment, but we need to make sure that there is plenty of counselling out there.
As the member for Giles has indicated, if this bill gets through, we need to have this commence sooner rather than later. We do see lots of things that take a long time to commence. The longer we leave this, the worse it is going to be. We should do this as soon as we can. We should have a complete inquiry and look at all the avenues—I talk about regional South Australia in particular—and then in actual fact we can bring that back to the parliament, bring that back to the ministers and to relevant government agencies to look at the infrastructure and move forward on this. I congratulate the member for Light on bringing this bill here and I will certainly be supporting it.