Fighting for palliative care

A RETIRED palliative care doctor has called on Dubbo residents to sign a petition asking the NSW government to boost funding for palliative care in western NSW.

Wahroonga-based Dr Yvonne McMaster visited Dubbo in June to speak at the Western Local Health District's cancer planning meeting after she ran a successful campaign, including a petition, to help restore funding to palliative care in northern Sydney.

Believing a similar initiative could benefit western NSW, Dr McMaster distributed a petition to doctors' surgeries, pharmacies and shops in Dubbo.

Having recently put together a submission for a senate inquiry into palliative care, Dr McMaster said the provision of palliative care came with its own set of difficulties that were compounded in rural and regional areas.

"While I was sounding off about the situation in northern Sydney, it was mentioned to me that I should see how difficult things were for people living in western NSW," she said.

Dr McMaster said her campaign in no way reflected on the performance of existing palliative care staff in western NSW, whom she had nothing but praise for.

"At the conference they were all so positive and competent in the way they were able to highlight the community's needs - I've learned so much from my communications with nurses in the region," she said.

She said Dubbo needed funding for its own specialist palliative care doctor, more specialist palliative care nurses and more administrative support, especially because it was a hub for smaller western communities.

"People with a cancer diagnosis already have poorer health outcomes in terms of diagnosis, mortality and access to services and then have fewer resources available to them when they are dying," she said.

"As well as the shortage of health care professionals across rural NSW in general, there is a shortage of support services such as home visitation to provide weekend support, after hours support, home and community care and community transport that could help to maintain people at home when they wish."

She said more could be done to encourage overseas palliative care specialists from throughout Australia and overseas who wanted to work in rural Australia to do so, such as a doctor trained in palliative care who wanted to work in Orange but for whom there was no funding to employ.

Dr McMaster said a shortage of palliative care personnel in rural NSW meant it was difficult to relieve those staff when they were on leave.

She said palliative care nurses in rural areas often took on extra roles such as educating general practitioners, hospital doctors and other nurses about palliative care, in addition to keeping their own knowledge up to date.

Dr McMaster also said the idea of local health districts funding private nursing agencies to care for people in the last few days of their lives could enable someone to die at home and be more cost-effective than having the patient in hospital.

"In Dubbo I met a nurse running a service that could meet the need for people to die at home," she said.

"Nobody should be at home dying and not have 24-hour cover - they should be able to at least ring a nurse and get advice."

Dr McMaster said when there were 10,000 signatures on the new petition she would take it to Premier Barry O'Farrell.

A spokeswoman for the Western Local Health District confirmed there were no palliative care medical specialists based in Western LHD, but said most areas had access to visiting medical specialists from St Vincent's and RPA hospitals in Sydney.

She said Dubbo was in the analysis phase of a research project comparing face-to-face consultations with the use of telehealth, and the National Health and Medical Research Council-funded project was being used increasingly in oncology and palliative care to improve access for patients.

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