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Canada on track for national palliative care framework

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$6 billion placed in federal budget for end-of-life care
By Deborah Gyapong
Photo caption: Conservative MP Marilyn Gladu expects her Bill C-277 calling for a national palliative care strategy will pass the House and the Senate before the summer break. (Deborah Gyapong)
With $6 billion earmarked for home and palliative care in the 2017 federal budget, Canada is on track toward making quality end-of-life care more accessible.
“This is really good news,” said Conservative MP Marilyn Gladu, whose private member’s Bill C-277 calling for a national palliative care framework has passed the House of Commons Health Committee. It will come up for vote on third reading in April.
Gladu said this is the first time the Liberal government has mentioned palliative care in the budget.
“Everyone is really excited and on board,” she said. “There’s money in the budget and the health minister is moving in a supportive direction. It’s all good news.”
“The demand for home-care services is growing,” Budget 2017 said. “Today, approximately15 per cent of hospital beds are still occupied by patients who could and would prefer to receive their care at home, or would be better off in a community-based setting.”
The $6 billion, spread over the next 10 years, is designed to improve “access to home, community and palliative care services,” the document said. Gladu noted the money is going to start flowing immediately.
Gladu sees momentum for developing a national palliative care framework not only through the budget announcement, but also in the support Bill C-277 is getting. After hearing witnesses, the Health Committee made some minor amendments to the bill. Gladu expects it will pass both the House of Commons and the Senate before the summer break.
The Quality End-of-Life Care Coalition of Canada has already proposed a framework called The Way Forward using federal funding two years ago, Gladu said. The Quality Coalition includes 39 organizations such as the Catholic Health Alliance of Canada, palliative care and home-care associations; groups representing health-care professionals such as the Canadian Medical Association, and organizations such as the Heart and Stroke Foundation and the Canadian Cancer Society.
“It’s a well-written document and the committee heard evidence on it,” she said. “They don’t have to start from scratch.”
Sharon Baxter, executive director of the Canadian Hospice Palliative Care Association that managed The Way Forward project led by the Quality Coalition, said the $6 billion announced in the 2017 Budget was expected because “that’s been in play” in discussions the federal government is having with the provincial and territorial governments.
It remains to be seen, however, where the money will be spent, she said.
Though encouraged by the announcement of the money, the association, which operates as a secretariat for the Quality Coalition, will be pushing all levels of government to fund “new initiatives over and above what’s already existing.”
The “health-care system funds specialist care and palliative care provided in hospital settings,” Baxter said. Other settings, such as long-term care homes or care beds at home are “not part of the Canada Health Act.”
Provinces have set up their own home-care systems. “What’s included in coverage is different in each province,” Baxter said.
“We know clearly Canadians are saying they want their care delivered in the community and at home as long as possible, so we really need to look at how we provide services across all the settings, not just at the hospital,” she said.
With legalized euthanasia and assisted suicide, but no “universal coverage for palliative care, it would be a shame if a Canadian chose to hasten their death because they were in pain.”

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