Recognising the political context of palliative care

Professor Jennifer Tieman, Director, RePaDD


Written by Professor Jennifer Tieman, Director, RePaDD.

Australia is gearing up for an election in 2022 and there will be a state election in South Australia in 2022 as well. Many organisations and community groups are preparing budget submissions and election campaigns to position their needs within the electoral cycle. Advocacy and lobbying are increasingly part of the health and aged care landscape. The International Association for Hospice and Palliative Care (IAHPC) has noted the need for advocacy to develop the political will to facilitate the funding for palliative care training and service provision. Public policy is the mechanism by which access and care are enabled.

The basic assumptions comprising the IAHPC advocacy theory of change are that (1) palliative care is an element of the right to health, not a privilege, and that (2) since rights, by definition, are universal and publicly guaranteed, implementing them entails the development of public policy. [1]

Palliative Care Australia (PCA) leads the policy debate on palliative care in Australia and the last few years have seen broad ranging policy responses. They have been active in providing policy advice on issues relating to Covid-19. They have also addressed key policy issues including their Palli8 response to the Royal Commission into Safety and Quality in Aged Care and their economic analysis of the value of palliative care. Locally, Palliative Care SA (PCSA) is promoting the benefits of palliative care funding using an “Investing to Save” theme.

There are many palliative care issues that will influence policy and voting at the next election. We are in a period of significant and unexpected social and health disruption arising from Covid-19 and this will continue as the community and the health system grapples with surges, long covid and the impacts of grief and bereavement impacted by the pandemic. Reforms that reflect changing societal priorities including Voluntary Assisted Dying (VAD) and Royal Commissions into Aged Care and into Disability will also influence how care is provided. Voluntary Assisted Dying legislation has now been passed in four states and is being actively debated in a fifth jurisdiction. Aged care reform is continuing at a rapid rate and care for older Australians at the end of life has been acknowledged as a critical element of a mature system. This will require clarity as to how capability is developed, and responsive systems enabled. All of these will have profound effects on death and dying in Australia.

However, we also need to remember that palliative care will continue to support individuals and families across the life course, across the community, and across the health and social care systems. As a community we need to recognise that we will increasingly be addressing the realities associated with death and dying and the need for palliative care and care at the end of life. These are issues that all Australians should consider when deciding political leadership for the next period.


1. Pettus KI, de Lima L. Palliative Care Advocacy: Why Does It Matter? J Palliat Med. 2020 Aug;23(8):1009-1012. doi: 10.1089/jpm.2019.0696.

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Death and dying across the community Palliative care across the health system

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