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Palliative care cash first step: advocates

OTTAWA—The federal government needs to ensure there is money for palliative care in the budget next week as part of a down payment on a much larger repair project, health advocates said yesterday.

The Canadian Cancer Society said the Liberal government needs to urgently address the glaring holes in end-of-life care.

The debate following the Supreme Court of Canada’s decision on assisted death has shown people often fall through the cracks of the health-care system and improvements are needed to address the patchwork of care available, said Gabriel Miller, the society’s public issues director.

During the election campaign, the Liberals promised to spend $3 billion over the next four years to improve access to home care, including family and palliative care.

Miller said the cancer society expects to see the government follow through on this investment, but warned money cannot be used just to camouflage the biggest cracks in the system.

The funding needs to signal more than just temporary relief, he added.

“It needs to promise permanent solutions,” Miller stressed.

“That means really beginning with a recognition of the scale of the problem, the government’s responsibility to fix that problem for everyone . . . and then to set really clear targets and timelines for making the change,” he noted.

Palliative care is an essential part of the end-of-life discussion, agreed Cindy Forbes, president of the Canadian Medical Association.

“As little as 15 percent of Canadians have access to palliative care and we feel that it’s got to change,” she said.

“No one should be choosing an assisted-death for a lack of either palliative care or chronic pain management or other medical services that are available to some Canadians.”

Northern Ontario NDP MP Charlie Angus has been pushing for a national palliative care strategy.

Angus made the proposal, which received widespread support, during the last Parliament but said the previous government failed to act.

There now is a sense of urgency for the federal government to tackle the palliative care problem because of the upcoming right-to-die legislation, Angus noted.

“We’ll have a situation where it is possible to have the right to die in Canada, but not necessarily the right to access palliative care—that just doesn’t seem fair,” he reasoned.

“Because the Supreme Court has made its decision, because the federal government is going to move on right-to-die, they also need to put up the money and put up a plan to work with the provinces and the territories on offering good quality, palliative care,” Angus argued.

In an interview with The Canadian Press late last year, Health minister Jane Philpott acknowledged palliative care is inadequate for many.

Philpott, who spent 30 years working as a doctor in Canada and abroad before entering political life, said the health-care system needs to be reformed to reflect the demand for care as close to home as possible.

“I think where we are really going to see movement, in terms of that system transformation, is through my discussions with my provincial and territorial counterparts to make sure that we look at best practices and look at the best models that have been put in place across the country,” she noted.

Miller said Philpott is absolutely right that structural reform is needed to address the palliative care crisis, but said this can’t be used as an excuse for not taking urgent action.

“When your house has cracks in the foundation or a hole in the roof, you take immediate steps to stop the worst of the damage, and then you have a clear plan to fix what needs fixing for the long-term,” he remarked.

“What we have . . . is a system that has been repaired with Band-Aids and patches over and over again for decades and as a result, it is costing us more money and we still haven’t fixed the fundamental problem,” Miller warned.

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