The federal government needs to ensure there is money for palliative care in the budget next week as part of a down payment on a much larger repair project, health advocates say.

The Canadian Cancer Society said the Liberal government needs to urgently address the glaring holes in end-of-life care.

The debate following the Supreme Court of Canada's decision on assisted death has shown people often fall through the cracks of the health-care system and improvements are needed to address the patchwork of care available, said Gabriel Miller, the society's public issues director.

During the election campaign, the Liberals promised to spend $3-billion over the next four years to improve access to home care, including family and palliative care.

Money could merely camouflage cracks in system

Miller said the cancer society expects to see the government follow through on this investment, but he warned money cannot be used just to camouflage the biggest cracks in the system.

The funding needs to signal more than just temporary relief, he added.

"It needs to promise permanent solutions," Miller said.

"That means really beginning with a recognition of the scale of the problem, the government's responsibility to fix that problem for everyone ... and then to set really clear targets and timelines for making the change."

Access to palliative care is an essential part of the end-of-life discussion, said Cindy Forbes, president of the Canadian Medical Association.

"No one should be choosing an assisted-death for a lack of either palliative care or chronic pain management or other medical services that are available to some Canadians."

Northern Ontario NDP MP Charlie Angus agrees and has been pushing for a national palliative care strategy.

Angus made the proposal, which received widespread support, during the last Parliament but he said the previous government failed to act.

There is now a sense of urgency for the federal government to tackle the palliative care problem because of the upcoming right-to-die legislation, Angus said.

"We'll have a situation where it is possible to have the right to die in Canada, but not necessarily the right to access palliative care — that just doesn't seem fair," he said.

"Because the Supreme Court has made its decision, because the federal government is going to move on right-to-die, they also need to put up the money and put up a plan to work with the provinces and the territories on offering good quality, palliative care."

The provinces and territories are working to tackle this issue but it is clear a well-co-ordinated, effective system is needed in Canada, said John Fraser, parliamentary assistant to Ontario Health Minister Eric Hoskins.

Fraser said he became passionate about the issue when his father was able to access palliative care.

"It was a very humane way for him to pass on," he said.

The court's decision on assisted death essentially boils down to a matter of choice, Fraser added.

"In order for people to have choice, they need choices," he said. "In that context, we need to improve palliative care."

In an interview with The Canadian Press late last year, Health Minister Jane Philpott acknowledged palliative care is inadequate for many.

Care as close to home as possible

Philpott, who spent 30 years working as a doctor in Canada and abroad before entering political life, said the health-care system needs to be reformed to reflect the demand for care as close to home as possible.

"I know that Canada is flush with experts who have done very well in delivering palliative care and addressing the needs of Canadians at the end of life so we will be consulting broadly in terms of how to do this best," she said.

Miller said Philpott is absolutely right that structural reform is needed to address the palliative care crisis but he said this can't be used as an excuse for not taking urgent action.

"When your house has cracks in the foundation or a hole in the roof, you take immediate steps to stop the worst of the damage and then you have a clear plan to fix what needs fixing for the long term," Miller said.

"What we have ... is a system that has been repaired with Band-Aids and patches over and over again for decades and as a result, it is costing us more money and we still haven't fixed the fundamental problems."