Include palliative care in Medicare reform, says peak body

In light of recent announcements made by the major political parties pledging billions of dollars to a major Medicare overhaul, Palliative Care Australia (PCA) is urging the government not to forget about those at the end of life.

In calling for a better way to remunerate palliative care in primary care, PCA has released a new report using data collected in it's 2024 workforce survey, showing that just 11 per cent of primary care respondents agreed that their practice is adequately funded to deliver end of life care.

‘The case for improved remuneration of palliative care in primary care’ reveals that while the need for palliative care in primary care settings has grown, and many healthcare professionals find the work to be a rewarding part of their job, they are being “held back by funding structures that do not sufficiently recognise this work.”

“These findings echo what we hear every day and align with similar findings and insights from our partners in the sector,” PCA chief Camilla Rowland said

“Primary care has a significant role to play in meeting the growing demand for palliative as Australia’s population ages.

“The conversations and care that happens at this time of life are distinctly different and more complex to other kinds of care offered in primary care settings.

“GPs and nurses need to spend more time with patients and carers talking through a range of sensitive matters including prognosis and treatment, advance care planning, and care coordination.

“And what our survey tells us is that the current system, which is structured around how GPs bill for specific Medicare item numbers, and incentivises short appointments, doesn't fully embrace palliative care.”

Proposed reform

PCA has outlined five key recommendations to address the growing need for palliative care solutions, supported by a number of peak health bodies including the Australia New Zealand Society of Palliative Medicine and National Rural Health Alliance:

1. A new practice-level payment to remunerate palliative care – covering activities undertaken by primary care multidisciplinary teams that are not currently billable to Medicare.
2. Further guidance for general practice about the use of existing longer consultation items (Level C, D and E) to be more explicit about their relevance to palliative care.
3. Additional funding for home visits, after-hours care (in-person and via telehealth), and shared care arrangements with specialist palliative care teams.
4. Creation of an expert working group to advise the Australian Government on how to best increase palliative care activity in primary care.
5. Development of a Palliative Care in Primary Care Monitoring and Evaluation Framework, to fill the gap in knowledge about palliative care provision and quality in primary care.

“It’s encouraging to see those who want to form government after the election are talking about empowering primary care through a stronger Medicare,” Ms Rowland said.

“A stronger Medicare lifts us all, but our health system needs to reward good palliative care if we are going to properly care for Australia’s ageing population.”