Health policy-makers may have underestimated demand for palliative care and are still coming to terms with how increased demand for before-death care will affect stretched resources, Hospice New Zealand chief executive Mary Schumacher says.
"My sense is that we are still really trying to understand the true extent of the demand for palliative, and that we have some way to go before we know how much work we need to do to meet future demand," Ms Schumacher, in Dunedin to visit the Otago Community Hospice recently, said.
"We need to know what the need is, in which sectors, and which parts of the country it is, so we can know what to put in place to make sure we can provide to the levels expected.
"Right now, this is still unclear."
Ms Schumacher is a member of the pan-sector Palliative Care Council, which has launched the country's first attempt to understand demand for palliative care and how that demand will change on the back of the growing and ageing population.
The survey came out of the Positioning Palliative Care in New Zealand report, released in February, which found there was a relatively poor understanding of the need for care and a lack of information on the services being provided.
The survey will help identify gaps in care and gather information officials can use to plan how best to provide the resources needed to cope with demand.
It may yield enough to help plan for new medical specialists, nurses and even palliative care beds.
Ms Schumacher said it was perhaps easier to quantify the work done by New Zealand's hospices - about 14,000 people were in hospices last year, including 360 in Dunedin - but that many more people received palliative care in hospitals and rest-homes, and at home from nurses, family doctors, and those closest to them.
Quantifying that would probably lead to some significant rethinking on primary healthcare planning.
"I think we in the health sector have underestimated the need and probably the cost and probably, I think, who will provide that care into the future," Ms Schumacher said.
"There is still a lot of work to do, but my sense is that the report will recognise that other areas, such as aged care, district nurses, GPs and family play a significant role.
And if we can determine that extent, then we can plan appropriately."
The Health Ministry recently signalled an extra $15 million a year for the next four years allocated to Hospice New Zealand last year might be the last significant funding boost for a while, she said.
The Government contributed between 60% and 70% of hospice funds and the rest - about $30 million last year- had to be raised elsewhere.
Otago Community Hospice has to raise $1.2 million this year.
Hospice New Zealand recognised the sector had to work out how to deal with increased demand without a corresponding increase in funds.
It needed to support others already providing palliative care in a role that might evolve a new emphasis on educating and supporting primary carers, while continuing to provide care for people with complex needs, Ms Schumacher said.
