The majority of my career has been in public service in SA and there has always been too much time and resource pressure to really focus on the chronically ill children apart from their urgent day to day needs. The senior staff were always more involved in trying to treat those with good outcome expectations and so the difficult conversations that should happen early just don’t happen until a child is near the end of life. By this stage it is usually too late to properly explore what could have been done for the child and family to make their death as comfortable as possible and to avoid complicated bereavement for the family
