Health Quality Ontario report outlines state of palliative care in the province

By Jennifer Bieman, St. Thomas Times-Journal

Elgin-Middlesex-London MPP Jeff Yurek is urging more government action to keep Ontario’s palliative care system from flat lining.

The PC health critic is responding to a Health Quality Ontario report released last week outlining the state of palliative care in the province. The publication, Palliative Care at the End of Life, brings together data from several sources to draw a clear picture of end-of-life care programs in Ontario.

“The people that are doing palliative care in the province are dedicated, loving people and we’re thankful that they’re there, but they need the support from the government in order to deliver palliative care to all Ontarians that need it,” said Yurek.

For Yurek, one of the biggest issues is access to palliative care – specifically how late patients enter the end-of-life program. The health care accountability agency report said 48 per cent of patients start care in the last month of their lives, a statistic that Yurek said just isn’t good enough.

“There’s too many people not receiving palliative care until the last month of their life … The sooner people are introduced and offered palliative care, the longer they may live and the more enjoyment they will have during their end stages,” he said.

Personal benefits of palliative care aside, Yurek said early entry to the end-of-life program reduces unplanned emergency hospital visits for infirmed patients – trips that are costly for the health care system and unnecessarily stressful for patients and their families.

“Everybody wins, all around, when we can introduce palliative care quicker,” he said.

But it’s not just the ‘when’ about palliative care that’s got Yurek concerned. The PC health critic is focusing on how and where palliative care services are administered as well.

Though 75.7 per cent of patients received at least one home care visit in their last month of life, the Health Quality Ontario report found 43.3 per cent weren’t even able to receive intensive in-home palliative-specific services– a program that requires more bedside hours each week than regular home care.

And with two thirds of Canadians surveyed saying they’d prefer to die at home, but nearly two thirds dying in hospital instead, Yurek said expanding in-home palliative care is more important than ever.

“This report flags that issue that people aren’t having the choice they would like to have about dying at home. Too many people are having to go to the hospital,” he said.

“I think the government has done well with this past budget infusing some money into the system, but they have to remove barriers and at the same time make sure the money they are infusing reaches the front line health care professionals.”

The PC health critic is calling for more doctor and patient access to end-of-life resources, including reducing red tape for palliative-specific drugs.

“The easiest fix would be to streamline the access to medications. There’s quite a bit of red tape and barriers,” said Yurek.

“There’s a list of medications that they utilize in palliative care and in order to get access to it the doctor has to either make a phone call to Ontario Drug Benefit, which makes it difficult for someone to access the medications after five o’clock or on the weekends.”

Though Yurek said there are larger structural issues in the health care system that need to be addressed, he’s confident making sure palliative-specific medications are covered by the Ontario Health Insurance Plan and reducing unnecessary policies will go a long way to help patients.

“There’s certain things the government can be doing in the short term to alleviate some of the barriers that do exist,” he said.

In March, the provincial budget included a three-year, $75 million investment to strengthen community-based hospice and palliative care and then followed it up with an additional $13.9 million commitment in June.

“The government is committed to supporting high-quality palliative and end-of-life care for all Ontarians who need it,” said Ministry of Health and Long-term Care spokesperson David Jensen.

Jensen said the multimillion-dollar funding pledge will help the ministry support existing palliative care services and help it expand hospice capacity throughout Ontario over the next three years.

With end-of-life care improvements in mind, the ministry launched its Ontario Palliative Care Network  – an partnership that brings together Local Health Integration Networks, Cancer Care Ontario, Health Quality Ontario and other community representatives around the common palliative care cause.

“It will act as the ministry’s principal advisor on palliative care; drive consistent, quality palliative care programs across the province through regional coordination and leadership; and monitor system-level performance in strengthening palliative and end-of-life care,” said Jensen in a statement.