Wayne Naylor: Hospices uniting across NZ to keep up with rising demand for care

OPINION: Hospice is grassroots. It was founded in the 1960s by UK palliative care pioneer Dame Cicely Saunders, who believed everyone deserved to die well after she witnessed undignified and painful deaths in hospital. The first hospice was set up in New Zealand in 1979, with more following in the early 1980s, set up by passionate people who saw a need for this type of care here, too. Hospice has remained at the heart of communities across Aotearoa since then.

Our philosophy of care looks at the whole person, not just their disease or symptoms. Everyone is treated as an individual. What matters to them matters to us, and through this approach, we explore and support all aspects of a person – their physical, emotional, social and spiritual needs. We help people live every moment right to the end.

Last year, hospices provided free care to nearly 18,000 people plus their whānau. But it wasn’t cheap. This essential service cost $186 million to provide. The government funded less than half this cost, and hospices had to raise more than $94 million from their communities to bridge the gap.

I can’t think of any other essential health service out there that depends on second-hand shops and the goodwill of communities through fundraising and donations, to cover over half of its running costs. But this reliance on community giving is unsustainable, so we must rethink our future in order to survive.

Our vision is seeing equitable hospice care available for all New Zealanders, whenever they need it and wherever they are. Dying well is a human right, but we will not get there if we just keep going cap in hand to the government.

So, hospices have come together as a unified sector to co-create a fairer and more sustainable model to fund hospice care.

Some might say it is overly ambitious to get 32 individual hospices to collaborate on a cohesive approach. But frankly, we have been around long enough to have learned that people help those who help themselves. And we are determined to help ourselves. We recognise that by working together, by being more efficient, by learning from each other and by working closer with our health-sector partners, we will better serve our communities. This gives us the confidence to do the hard work of delivering change.

We are focused on staying one step ahead of the health reforms. By empowering and backing ourselves to make changes, we can be a model for how the new health system can work better for all. Our hoped-for solution includes having a nationally agreed range of services and a fair price for hospice care, being ready to commission and negotiate contracts regionally, while still upholding the autonomy of each hospice. Staying local matters. Hospices’ connection to local communities, including our partnerships with iwi, is vital.

We are up for having some hard conversations about future funding, particularly as the need for our services will increase as our population grows older and people live longer. It is predicted that the number of people needing palliative care will jump 50% by 2040. Hospice will be ready for that.