Hospices At Risk Of Disappearing

Hospices around Aotearoa New Zealand are at risk of
cutting services as underfunding by the government pushes
them to the brink.

Last year Hospice provided free
care to nearly 11,000 people who died last year, almost a
third of all deaths in New Zealand, along with another 9,000
people living with a terminal illness. This essential
support to people and their whānau cost $226
million.

While the government provided
$114 million, hospices had to raise a further $112 million
through Hospice Op shops, community donations, fundraising
and bequests, to keep their doors
open.

Wayne Naylor, Chief Executive,
Hospice New Zealand, which represents New Zealand’s 32
hospices, says without fair and sustainable funding,
hospices, and the critical services they provide, are at
risk of disappearing.

“This Hospice
Awareness Week our message has never been clearer. If
the Government doesn’t act now to invest fairly in hospice
care, it is the terminally ill in need of Hospice care and
their loved ones who will pay the price.

“Hospices
are already facing major disruption and reducing
offerings.

“Without more funding, we risk losing
these vital services when people need them most,” says Mr
Naylor.

The unprecedented strain on hospices comes
despite the recent release of the Report ‘Sustainable
Funding for Hospice Services, by research agency Martin
Jenkins. The report
shows that Hospices are not only a smart investment
economically for the health system, they also provide better
outcomes. Through providing free, end-of-life care to
thousands of New Zealanders every year, they’re relieving
the pressure on Emergency Departments and freeing up
hospital beds.

Local hospices are providing taxpayers
value by saving the public sector a conservative $110
million dollars per year and returning at least $1.59 in
health benefits for every dollar of government
funding.

Hospice care in the community relieves an
already overstretched health system which would otherwise
have to care for the thousands of patients and families who
use it.

Mr Naylor says that a new sustainable funding
model needs to be implemented, rather than just talked
about.

“We now need to have hard conversations about
future funding, particularly as the demand for hospice care
continues to rise, as our population grows older and lives
longer. It is predicted that the number of people needing
palliative care will increase by 50% by 2040.

“We
want the government to act and invest now if it is to
appropriately meet current and growing future need for high
quality end of life care,” says Mr Naylor.

A Post
Code Lottery

“Many communities aren’t in a
position to provide the additional millions of dollars
required to keep services free, never mind expanding hospice
care and extending it to those currently missing out because
of where they live or their diagnosis.

“We can’t
keep relying on the generosity of community to keep our
doors open, when costs far exceed our funding, “says Tony
Paine, Chief Executive of Mary Potter Hospice in Wellington.
“We are making savings in non-clinical areas where
possible but there’s no room to expand our services to
meet the needs of a growing population with complex
needs,” he says.

Hospices are already making
cutbacks that include reducing inpatient beds, keeping
clinical roles vacant and restricting
admissions.

“Many remaining doctors and nurses are
even having to take on extra workloads to cover for
overstretched GP clinics and aged care facilities in their
regions.

“It is the persistent case of post-code
lottery that the Government says it wants to remove with its
health reforms. Many people are missing out due to their
diagnosis, age and where they live,” says Mr
Naylor.

“The situation every hospice is in, means
having to make some unprecedented decisions this
year.

“We don’t want to end up in the crisis
currently facing hospices in England and Wales where dying
people cannot access the care they need when they need it
most.”

In Numbers: 

In 2023/2024
Hospice across Aotearoa

• Provided care to 19,151
  people, plus their whānau.
• Cared for 10,860 people
  who died.
• Provided 313,911 face to face
  visits.
• Made 394,215 telephone and telehealth
  interventions to patients and whānau members.
• 40%
  of hospice patients died in their own home (compared to just
  22% of general population / all deaths
  stats).
• Provided 25,105 grief and loss
  contacts.
• Had to raise over $112m through their
  second-hand retail shops, fundraising, donations, and other
  sources, including from reserves, to keep
  afloat.

What a shortage of funds looks like in
terms of disruption and responding to patient
needs:

• Reduction in inpatient
  beds
• Delays and freezes on
  recruitment
• Restricting admissions and
  stricter on referrals (meaning those patients on the
  periphery of need are missing out)
• Reduced
  community care – ie stopping the hospital liaison nurse
  service that helps to support a safe discharge from hospital
  back into the community
• Nurses for In-patient beds
  moving to 12-hour shifts
• An inability to grow in
  line with demand is, in itself, a barrier to delivering
  equitable and timely access to high-quality palliative
  care.
• Using hospice doctors and nurses to fill the
  gaps that GPs and ARC facilities are not able to do at
  present.

The recent Martin Jenkins Economic
Report : ‘Sustainable
Funding for Hospice Services: is
both compelling and conservative:

• Every
  $1 taxpayers invest in hospice services yields at least
  $1.59 in system savings
• Hospices currently save the
  health system $110 million per year in direct clinical
  cost
  • They generate $48 million in quality-of-life
    benefits for patients and their whānau (e.g. returning to
    work and school earlier with bereavement
    support)
• Hospice care reduces ED
  admissions and hospitalisations
• Hospices directly
  support primary and aged residential care
  teams

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