The Barr government ignored advice that it should retest the market for palliative care services, despite external consultants raising concerns about the accessibility of the system more than two years ago.
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ACT Health is in the process of overhauling the territory's palliative care services, as part of a wider reboot of the health system.
They hired health consultants Communio in late 2015 to build on the work of the 18-month-old ACT Palliative Care Clinical Network, and develop a new model of care for Canberra's dying patients.
The firm concluded the government's resources were too focused on inpatient specialist care, services were duplicated, or there were gaps.
They found there was no clear admission criteria for Clare Holland House, and neither staff or patients knew about the full range of palliative care services available in Canberra and the surrounds.
Dying patients had also been subjected to aggressive interventions, and patients who needed palliative care were being identified too late in their illness.
None of this is news to those who have been following the ACT Assembly's end-of-life choices inquiry.
While its focus in recent days has been on voluntary assisted dying and the ACT's inability to bring in a scheme because of federal restrictions, the inquiry has also heard of shortages in palliative care staffing in Canberra Hospital, bed block in Clare Holland House and horror stories of people dying unnecessarily traumatic deaths.
But the government was handed Communio's findings in March 2016, and a road map to fix the problems in May 2017.
Meanwhile the cost of caring for palliative patients in Canberra's acute hospitals has risen by 500 per cent in the past five years, from $362,000 in 2013-14 to $2.47 million in 2017-18.
That correlates with an increase in palliative care hospitalisations from 728 patients in 2012-13, to 1245 in 2016-17.
However the demand for palliative care is rising across the whole country, not just Canberra.
According to the Australian Institute of Health and Welfare, palliative hospitalisations in Australia increased to 73,900 in 2015-16, a rise of 28.2 per cent on 2011-12, compared to a 14.6 per cent increase in broader hospitalisations in the same period.
In 2011-12, the ACT had the third lowest rate of palliative care hospitalisations in the public health system in Australia, at 19.8 per 100,000.
But by 2015-16, that ballooned to 33 per 100,000 - the second highest rate in the nation.
Communio's solution was to overhaul the entire system to provide more palliative care services in the community, with hospital and hospice care complementary.
GPs would be the main point of contact for care continuity, there would be a heightened focus on advanced care planning, and a single database about everyone receiving palliative care.
They urged the government to go to market at the earliest chance for palliative care services and revise contracts for external providers to set new performance indicators.
The rationale was the existing palliative care arrangements had been in place for many years, and a competitive approach to market was required in order to demonstrate value for money.
The government was also advised to develop a communications and engagement strategy if they chose to go to market, to mitigate the potential risk.
Clare Holland House is a beloved Canberra institution, and cared for Love Your Sister cancer charity founder Connie Johnson in her final months last year.
While 32 complaints about the hospice have been made in the last four years, 522 formal compliments were recorded in the same period.
That figure excluded many informal expressions of gratitude made directly to staff, an ACT Health spokesman said.
A government spokeswoman confirmed "retesting the market is not being progressed at this time".
She said the health directorate commissioned work from a wide range of external consultants and their advice did not always form part of the government's ultimate decisions.
She added ACT Health's focus right now was developing a specialty services plan for palliative care, as part of the the territory-wide health services framework.
"As the specialty services plan for palliative care is finalised, a new model of care for palliative patients will be implemented. This will have a greater emphasis on a network of care rather than individual providers," she said.
