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We Need Your Voice To Be Heard

We Need Your Voice To Be Heard

Scoop15-05-2025

Hospices around Aotearoa 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 NZ, along with another 9,000 people living with a terminal illness. This came at a cost of $226 million.
While the government provided $114 million, hospices had to raise $112 million from Hospice Op shops, community donations, fundraising and bequests, just to keep going.
Wayne Naylor, Chief Executive, Hospice New Zealand, which represents New Zealand's 32 hospices, says without fairer funding, hospices are at risk of disappearing.
'This week is Hospice Awareness Week and our message is loud and clear, if the Government doesn't act now to invest fairly in hospice care, it is patients 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 Hospice is a smart investment for the health system. Through providing free, end-of-life care to thousands of New Zealanders every year and keeping people out of Emergency Departments and expensive hospital beds, local hospices are providing taxpayers 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 are not 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 Barbara Grout, Chief Executive of Hospice Tairāwhiti. '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.'
Cutbacks hospices are already making include reduced inpatient beds, keeping vacant roles vacant, restricting admissions and reduced community services. Hospices are also having to use their own doctors and nurses to help fill the gaps that GPs and aged care facilities are not able to do at present.
'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 all hospices are in, means having to make some unprecedented decisions this year.
'We don't want to end up in the crisis currently facing hospices in the UK – where dying people cannot access the care they need when they need it most.'
Notes:
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 calls to patients and whānau members. • 40% of hospice patients died in their own home (vs general population 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.
Sustainable Funding for Hospice Services: This report's economic case 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 costs • They generate $48 million in quality-of-life benefits for patients and their whānau like • Hospice care reduces ED admissions and hospitalisations

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The Spinoff Essay: A bit of pain
The Spinoff Essay: A bit of pain

The Spinoff

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The Spinoff Essay: A bit of pain

'I'm lucky; I've had it for only five years or so.' David Hill on living with chronic pain. The Spinoff Essay showcases the best essayists in Aotearoa, on topics big and small. Made possible by the generous support of our members. I ache. I'm sore, nearly all the time. I'm one of the estimated 900,000 New Zealanders who suffer from chronic pain. Chronic or neuropathic pain is usually defined as pain that's lasted for more than three months. I'm lucky; I've had it for only five years or so. Multiple thousands of Kiwis have suffered for decades, or their entire life. More statistics. Over 40% of people in the UK are thought to suffer, at various times and to various degrees. (The US estimates almost 50%.) For over-75s in Britain, the figure lifts to 65%. About 80% of this is back and neck pain. In Aotearoa, a 2018 report from research group Sapere suggested that chronic pain costs our health system some $2 billion annually, plus another $15 billion in lost production and benefit costs. Utterly predictably (think housing, working conditions, $60 for a GP visit, $75 for a physio session), it affects lower socio-economic groups more. Oh, and (think trad Kiwi male stereotypes this time), women are more likely to report it than men. In my case, it's cervical spondylosis with foraminal narrowing and radiculopathy. I like to roll out the phrase so I can watch listeners' eyes cross as they wonder how much time I've got left. English translation: my neck is stuffed. Age, plus bad posture at the keyboard, means the cushioning discs between cervical vertebrae have worn thin. Bone spurs have formed. My mobility is limited; I get deep pain in the neck and between shoulder blades, plus intermittent giddiness. I've gone into detail because, like most sufferers – and I dislike that word – I usually don't say much about it. People with chronic pain get little sympathy. Who wants to hear about an ailment that goes on and on, especially when it usually comes with no bandages, slings, plaster, other visible signs of affliction? Like Chronic Fatigue Syndrome and Long Covid, it's easily seen, even by some health professionals, as self-pitying, even malingering. ' Whatever happened to 'pull yourself together'?' I heard one sceptic sniff, after an acquaintance had vented over his months of continuing hip and leg discomfort. It's the least telegenic of ailments; if we do appear on screen, we're usually caricatured as boring old whingers who need to snap out of it. ' It's all in your head,' is another common dismissal. True. Also stupid. Of course it's in the head, because that's where the brain's pain receptors are. We don't register any injury or discomfort till those receptors fire. Trouble is, if the pain continues for more than a few hours, your pre-frontal cortex starts assessing the sensation in terms of what it may mean long-term, and begins reinforcing the synapses associated with stress and discomfort. The brain's 'pain switch' gets stuck in the ON position, and your body becomes convinced of its distress. Neurologist William Davies notes that 'pain carves a path directly between the realms of mind and body'. It's called Control Sensitisation: just as Pavlov's dogs slobbered when a bell rang, almost any tug or tension for a chronic pain sufferer sends those brain receptors into power drive. It means that pain can become a habit, and like many unpleasant habits, it's hard to get rid of. A cycle of discomfort – sleep deprivation – stress – more discomfort and more stress can become established. Withdrawal and depression may follow, with the symbolic Black Dog liable to squat and crap on any of your days. So yes, it is all in the head, and it's utterly genuine. There have been some curious associated discoveries. Women's limbic system responds to pain more than men's, so women often experience greater emotional distress, while the fact that men's pre-frontal cortex is more affected means they may see the issue primarily as a problem to be analysed. And chronic pain may be exacerbated by apparently unassociated events; Brexit, the Covid pandemic, even the Trump presidency saw a rise in reported cases. You're right: the Orange Roughy can indeed become a pain in the arse. Bad news for the next few years. Chronic pain victims make unrewarding patients, even to sympathetic doctors – and not all are. Symptoms are frequently vague and diverse. We're the unwell who can sometimes seem well. 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Public-private healthcare opportunities identified
Public-private healthcare opportunities identified

Otago Daily Times

timea day ago

  • Otago Daily Times

Public-private healthcare opportunities identified

A strategic report focused on the future of public health services in Otago Central Lakes has identified six potential opportunities for public-private collaboration. The Otago Central Lakes strategic health report was sent to Health Minister Simeon Brown in February by the steering group, which was comprised of Southland MP Joseph Mooney, Health New Zealand, the Central Otago and Queenstown Lakes District Councils, rural health providers, iwi, including kaupapa Māori health providers, Act MP Todd Stephenson and Waitaki MP Miles Anderson. Mr Mooney said the group's objective was to "expedite planning and investment in health services and infrastructure in Otago Central Lakes" — Central Otago District Mayor Tamah Alley said 70% of New Zealanders who lived two or more hours from a hospital resided in that region. The report said health service improvements were required to meet the current and future populations' needs. On a peak day, the district's combined population, which included visitors, was 168,000 — expected to nearly double by 2054, it said. "There is a reputational risk to all of Aotearoa New Zealand if adequate healthcare services are unavailable to deal with international visitor illness or injury." The report identified opportunities to increase public health services by partnering with the private sector, but Mr Anderson said the project was "not asking for public funds". The "early stage" public-private partnerships included in the report, which were "ready for collaboration", are: • The Southern Lakes Public Hospital — the location of which is to be determined — which is a proposed privately financed facility with full public hospital services and future capacity to become a regional hospital. • Lakeview Te Taumata Clinic (Queenstown), a private surgical hospital expected to open in 2027, with opportunities for maternity care and workforce development. • Integrated Care Hub (Wānaka), a planned day surgery with potential space for publicly funded after-hours services. • Wānaka Health Precinct, a private surgical hospital designed with capacity to integrate public services. • Aged-care facilities (Clyde), which are under construction, have the potential to expand into a full suite of publicly funded services for older people in Central Otago. • Securing land and investors in Central Otago for future public health infrastructure, based on the outcomes of the other projects. Additionally, the trust was exploring "innovative mobile modular units" which could be used as consultation rooms, clinics or staff accommodation and wanted to find land to host them in areas where they were needed, the report said. The $2 million funding was required to "complete the groundwork" for community consultation, clinical design and planning process, and technical assessments and detailed business cases Health New Zealand could work with — it already had $400,000 seed funding, it said. Subject to Mr Brown's support, a working group would be established to work with Health New Zealand to progress the proposed solutions — community engagement and consultation would follow.

Otago Central Lakes Strategic Health Report Available To Public
Otago Central Lakes Strategic Health Report Available To Public

Scoop

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Otago Central Lakes Strategic Health Report Available To Public

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