THE NUMBERS of beds and staff available to treat terminally ill patients still falls far short of what was recommended in a report which became government policy seven years ago.
The revelation comes in a fresh review of resources in the sector published yesterday by the Irish Hospice Foundation.
The review, which measured the position at the end of last year, indicates there are still 610 fewer staff and 237 fewer beds in the hospice/palliative care sector than was recommended in the Report of the National Advisory Committee on Palliative Care back in 2001.
However, the foundation, in its latest report, states that some progress has been made since it last reviewed the situation in 2004. While it says “major deficits in staff and bed numbers remain in all former health board areas”, staff numbers in the sector have increased by 116 (20 per cent) over the past three years while specialist inpatient bed numbers have increased by 22 (17 per cent).
But the report says: “Despite these welcome additions in resources, much remains to be done to achieve the staffing levels and specialist inpatient services consistent with agreed national policy.”
It says there are still wide regional variations in the provision of hospice/palliative care services. “Patient and family access to comprehensive services largely depends on the region of the country in which the patient resides,” it says.
Three former health board areas – the midlands, southeast and northeast – had no inpatient palliative care/hospice beds in 2004 and still have none three years on. Wicklow has the most under-funded community palliative care service.
The review puts the annual cost of making up the current staff shortfall at €40 million and of making up the bed shortfall at €35.5 million. Extra staff required, it says, include nurses, care attendants, physiotherapists, social workers and occupational therapists.
The position might have been improved further since 2004 had the Health Service Executive (HSE) not diverted half the funds it was allocated to develop palliative care services in 2006 and 2007 into other areas where there were budgetary pressures.
However, the Oireachtas health committee heard last week that the HSE will in future no longer be able to divert funds allocated for one area to another without the prior approval of the Departments of Health and Finance. It also heard, however, that the development funding diverted to other areas in 2006 and 2007 was now gone and could not be reallocated to palliative care services.
Eugene Murray, chief executive of the hospice foundation, said the review showed the palliative care budget of €75.5 million would need to double to meet staff and bed needs. “There is strong evidence that this investment will actually save money when compared to current expenditure in end-of-life care,” he said.
The HSE is preparing a five-year plan for the development of hospice/palliative care services. Mr Murray said this plan must have multi-annual funding attached.