paul mallet stands for greater investment by the state in palliative and end-of-life care to ensure every Tasmanian has the support they need. paul wants every Tasmanian to live well, and when the time comes to die well – with dignity, choice and compassion.

paul acknowledges that end-of-life care is a complex issue with profound impacts on people, families and communities. paul understands that Tasmania already does many things well — but strengthening workforce training, rural access, culturally safe models, and family supports could make it one of the best small-region palliative care systems in the world.

paul proposes investment to make Tasmania a national and global leader in compassionate, accessible, high-quality end-of-life care by addressing gaps in rural access, workforce capacity, community awareness, and family support. The expected benefits would include:

• Higher patient and family satisfaction.
• More people able to die where they choose.
• Lower avoidable hospital and ICU admissions.
• Greater workforce capacity and job satisfaction.
• Reduced stress and burnout for carers and families.
• Position Tasmania as a model for small-region, high-quality end-of-life care.

As way of background, paul understands that, Tasmania performs relatively well for its size in hospice and palliative nursing. paul acknowledges that specialist palliative care teams operate through major hospitals and community health centers, and he understands the Tasmanian Palliative Care Service (TPC) offers home-based care, consult services, and support for advanced care planning.

That said, there remain gaps and challenges in Tasmania, and paul stands for additional resources and strategies to address:

• Rural access: Many remote Tasmanians still struggle to get timely palliative care support at home.
• Workforce constraints: Shortages of trained palliative specialists, especially GPs with advanced training.
• Aged care integration: Gaps in training for staff in aged care facilities, leading to avoidable hospital transfers.
• Community awareness: Advanced care directives and conversations still not routine for many families.
• Bereavement services: Patchy access to consistent grief counselling, especially outside Hobart and Launceston.

paul stands for additional investment in our state, with a desire to create a  “best in class” system for Tasmanians, including:

• Hospice and home-based care — well-funded hospice systems and community outreach teams. Making death at home easier by improving home-based care packages including 24/7 nurse access and equipment supply. Plus, expand support for carers, ensuring respite care, short states, and emergency home support is available.
• Integrated care — clear pathways from hospital to home, so patients don’t bounce between systems.
• Training and workforce — nurses, doctors, GPs and aged care staff receive strong palliative care training. Incentivise this or make this training mandatory if necessary to build the capability of the workforce, particularly in rural areas. Build a workforce pipeline.
• Early conversations — proactive advanced care planning is normalised in Tasmania. Including public campaigns so families talk earlier and reduce conflict later.
• Equity — good outreach to rural, indigenous and low-income communities. Expand work with Aboriginal health services to embed palliative care that respects cultural needs and traditions.
• Bereavement support — families get counselling and follow-up, not just medical care. Including the embedding of grief counseling as part of standard care, not just an optional extra.
• Patient-centred choices — emphasis on dying at home or place of choice, not in hospital if avoidable.

paul also supports the value of partnerships with charities, and would support strong fundraising and volunteer networks to complement the state funded services, particularly as a way to better service rural communities and expand the reach of bereavement support.

Insights Informing Policy

Tasmania has an ageing population — by 2030, 1 in 4 Tasmanians will be 65 years of age or older. The demand for palliative care is projected to rise by 50% within a generation.

Leading countries, like the United Kingdom, New Zealand, and Singapore, show that integrated, community-focused, culturally safe palliative care delivers better outcomes and saves on high-cost hospital stays.

International benchmarks come from the Economist Intelligence Unit (EIU) Quality of Death Index, which ranks countries by the quality of palliative care and end-of-life support. The latest comprehensive version is over a decade old, but it is still widely cited. Australia ranked number 2 in the world for its high quality palliative care services, good community hospice access, and funding models that integrate palliative care in maintain stream health. paul remains concerned that the EIC ranking uses aggregated Australian data. paul stands for greater investing in Tasmania giver our regionally disbursed population and the limited availability of services and supports outside of urban centres.

paul has also taken insights from Karen Hitchcock’s Dear Life: On Caring for the Elderly. Hitchcock’s text offers a profound examination of how society treats its aging population, particularly in the context of end-of-life care. Drawing from her extensive experience as a physician, Hitchcock critiques the systemic ageism that often leads to the elderly being perceived as burdens rather than individuals with unique needs and desires. She emphasizes the importance of seeing the elderly as integral members of society, deserving of dignity and personalized care. paul agrees with Hitchcock’s call for a full system of supports, but not her view on euthanasia. paul supports voluntary assisted dying.

Reflection

Like everyone who has lost a loving grandparent, paul is reflective of the time he had with them and the intense feelings of grief and loss when they passed. For paul, the passing of his paternal Grandmother while receiving palliative care at home in 2004, and his paternal Grandfather while in residential aged care in 2007, unpin his stand on the delivery of high quality end-of-life care. paul witnessed the deeply compassionate work of palliative care staff and aged care nurses with both his grandparents, and stands for investment in this state to ensure every Tasmanian has the support they need at the end of their life.

Key Actions

Rural Hospice and Community Care Expansion

• Develop a Rural Hospice and Respite Network in key regions (North-West Coast, West Coast, East Coast, Midlands).

• Co-fund community-led hospice projects with local communities and charities.

Workforce Capacity Boost

• Fund scholarships and training placements for GPs, nurses, allied health to gain advanced palliative care qualifications.

• Embed palliative care modules in all aged care workforce training.

• Support rural outreach teams with telehealth and mobile hospice nurses.

Normalise Advanced Care Planning

• Make advanced care directives a standard part of GP check-ups and hospital admissions.

• Launch a public awareness campaign.

• Support families to have conversations early.

 Strengthen Home-Based End-of-Life Packages

• Increase funding for flexible, rapid-response home palliative services.

• Expand respite options for family carers — emergency stays, overnight care.

• Provide essential equipment and meds free at point of care.

Embed Culturally Safe Care

• Partner with Aboriginal health services to co-design culturally respectful palliative pathways.

• Train palliative teams in cultural competence and family-centred models.

Universal Bereavement Support

• Guarantee bereavement counselling for families after a death, not just ad hoc.

• Fund partnerships with trusted community organisations for grief and mental health support.

Funding Reforms

• Leverage state–Commonwealth partnerships under National Palliative Care Strategy.

• Pool Primary Health Network and Tasmanian Health Service resources.

• Encourage philanthropic co-investment (e.g., community hospice foundations).

• Build an all-party commitment: bipartisan support ensures long-term policy continuity.