Questions in Western Sydney over Silver Chain funding and care arrangements.

Aleading palliative care specialist and advocate has questioned the funding and model of care involved in the privatisation of community-based palliative care services in Western Sydney Local Health District (WSLHD).

Dr Yvonne McMaster, a retired palliative care specialist who received the Order of Australia Medal, campaigns for increased palliative care funding in NSW.

She collected over 86,000 signatures on a petition for the cause.

Dr McMaster wants to know why WSLHD’s privatised service has been allocated almost 40 per cent of additional palliative care funding provided for the whole of NSW.

The Silver Chain Group took over in-home palliative care services in WSLHD in July.

The government says the contract to care for people needing palliative care in the last three months of life, is expected to be worth $80 million over seven years.

The June state budget included a $100 million increase in palliative care funding over the next four years.

In her newsletter Push for Palliative Dr. McMaster said $38.9 million of the increased funding would go to Silver Chain for services in WSLHD.

She wrote: “Being just one LHD and representing only 7 per cent of the NSW population, while costing 38.9 per cent of the total $100m enhancements for NSW, we ask whether the other 14 LHDs will see similar enhancements.”

Other LHDs shortchanged

She told The Lamp, “It’s a lot of money to spend on one LHD.  Other LHDs have been shortchanged because they are getting what’s left over. Fourteen of them will have to share the remaining $61 million.”

She said palliative care services in the other 14 LHDs were mainly provided by public health services
in combination with non-government organisations under long-established partnerships.

“The Silver Chain arrangement is part of a social impact investment which is supposed to save money for the government. But I don’t see those savings coming back to palliative care.”

‘Social impact investment’ is an increasingly common euphemism for privatisation and contracting out, which – as surveys show – the public overwhelmingly oppose.

Dr McMaster said the public health system in western Sydney once provided 24-hour home visits to palliative care patients but the service had gradually been cut back.

Her newsletter noted: “We are pleased to learn this (Silver Chain) service will offer patients in Western Sydney 24/7 access to palliative care, including home visits by RNs in the last three months of life – though we note this was available in WSLHD years ago before being cut, and find it troubling that the medical aspect of this new service will be mainly delivered by GPs.”

“We contend that a model which employs specialist physicians, nurses, and allied health, with end-of-life home care and 24/7 palliative care access to home visits, should be the focus of investment for the other 14 LHDs.

“This model could be provided for a fraction of the cost of the WSLHD investment, with similar savings, and greater support.”