IMPLEMENTING measures drawn up to address shortcomings in the State’s palliative care services will present “a significant challenge”.
The admission is contained in Palliative Care Service – Five Year Development Framework (2009-2013), to be published by the HSE today.
The framework of actions identifies 41 national priorities required to address deficits in palliative care service provision in the four HSE regions around the State.
More than 6,000 people use hospice services every year and it is estimated that, because of Ireland’s ageing population, up to 13,000 patients will use hospice services each year by 2016.
Of the 41 priorities, 12 relate to home care deficits; six relate to specialist inpatient bed deficits; 15 to capital developments; and eight to acute hospital support. It identifies 16 immediate priorities: four in the area of home care, four to address inpatient bed deficits, five relate to capital developments and three relate to acute hospital services.
Implementing the framework would cost €308.8 million, which equates to €237.3 million in capital investment and €71.5 million in revenue costs over the five-year period. Over 70 per cent of the total capital requirement is proposed for draw-down between 2010 and 2012.
The document says that funding for the works may be achieved through a combination of the reorientation and reconfiguration of existing resources and by identifying additional resource requirements when funding comes on stream.
A HSE spokeswoman said its priority had been completing the framework and that ways of implementing its suggestions now needed to be found. She could not yet say how the framework would be funded, but said no firm financial commitments were in place.
The document says nine new hospitals need to be built. However, none of the 15 capital developments will be completed before the end of 2010.
It says the number of hospice beds in the State should be increased from 153 to 356, and that extra therapists, consultants and clinical nursing staff should be hired.
In the HSE South region, for example, 82 specialist inpatient beds are required, as is access to specialist palliative day care in six local health areas and six specialist palliative care-in-the-community posts need to be filled.
It says the recruitment of suitably trained staff will continue to be a challenge, particularly in the area of home care and community-based services.
The HSE produced the plan with input from key stakeholders such as the Irish Hospice Foundation, the Irish Cancer Society, the Irish Association for Palliative Care (IAPC) and the Hospice CEOs group.
There is considerable variation in the availability of palliative care across Ireland – with no inpatient hospice facilities in some areas.
Eamon Timmins of Age Action Ireland said the report was welcome as it attempted to close some serious gaps in regional palliative care services. “It acknowledges one of the big issues we would push to have addressed, which is that there are major tranches of the country, particularly in the midlands, where there are shortages of access to palliative care,” he said.
Irish Hospice Foundation chief executive Eugene Murray said the framework would go a long way in tackling some unacceptable inequalities that exist in the service, if implemented in full.
However, he said funding such an ambitious plan could prove difficult in straitened times. “Ensuring a good death for patients should not be dependent on our economic health,” he said.
