Palliative care short hundreds of staff and beds

A SHORTAGE of hundreds of vital staff and beds for terminally ill people has been identified in a new report.

The study by the Irish Hospice Foundation (IHF) found a 610-staff deficit that would cost €40 million to rectify, and a 237-bed shortage that would cost €35.5m to put right.

It also found that access to specialist palliative care is still largely dependent on where the patient lives.

While progress had been made since a previous IHF study on hospice/palliative care up to December 2004, wide gaps in hospice services remain.

The current study reviewed information on staffing and beds in December 2007 and looked at the progress made in the intervening three years.

It found that hospice/palliative care staff numbers increased from 570 to 686 between 2004 and 2007, up 20%, and specialist in-patient beds rose from 131 to 153, up by 17%. Spending on in-patient hospice beds rose from €19 to €23m, up 21%, but this excludes the cost of care staff.

The study confirmed wide regional variations in the provision of specialist palliative care in hospices, acute hospitals, day care services and community-based multidisciplinary home-care services.

State per capita spending on care staff and specialist palliative care in-patient beds varied from €7.90 in the former South Eastern Health Board area (Waterford, Wexford, Kilkenny, Carlow and South Tipperary) to €35 in the former North Western Health Board area (Donegal, Sligo and Leitrim).

Wicklow was found to have the most underfunded community service, with all four community nursing posts vacant. The home care service in Galway was the only service in the country with no statutory funding.

Three former health board areas, the midlands, south-east and north-east, still have no hospice.

IHF chief executive Eugene Murray described progress made in the provision of hospice services in the last three years as patchy with poorly developed areas still lagging behind.

“Much remains to be done to achieve a specialist in-patient service consistent with agreed national policy,” Mr Murray said. “We have an extra 22 beds in the service and an extra 116 staff, if all the 50 posts in the process of recruitment are filled.”

He said the current palliative care budget of €75.5m would need to double to meet staff and bed needs.

The Health Service Executive (HSE) is preparing a five-year plan for the development of hospice/palliative care services. Mr Murray said the plan must have multi-annual funding attached and funds must never be diverted to other areas of the health service as was the case in 2006 and 2007.

HSE chief Prof Brendan Drumm told the Joint Committee on Health and Children that in future the redirection of Government funding would require prior approval from the Departments of Health and Finance.


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