Budapest Commitments: Update from Italy

Dr Carlo Peruselli

Dr Carlo Peruselli

Carlo Peruselli, Board Member of the European Society for Palliative Care (EAPC) and Board Member of the Italian Society of Palliative Care (SICP), concludes our series on the Budapest Commitments.

Using the framework of the Budapest Commitments, we committed ourselves to improving the development of Palliative Care Networks in our country and to improving education for all professionals involved in palliative care.

Policy
I think that much of our success in achieving our goals is down to the introduction of a new law. On 15 March 2010, the Italian Parliament approved ‘Law N.38/2010’, the first national law about palliative care in our country and a fundamental step on the road to the development of palliative care in Italy. In its first article, this law states that palliative care is a fundamental right of all Italian people: all local health services must implement palliative care networks to guarantee this right. The law requires that every region offers two separate but integrated networks for adult patients (palliative care network and pain therapy network), and one network for pain therapy and palliative care for children. The law also indicates standards for the accreditation of services and the professional requirements for doctors and nurses to work in palliative care teams. Moreover, each year the Ministry of Health must present to parliament a report on the development of palliative care and pain therapy networks in different Italian regions.

Access to medication
In Italy, all strong opioids are available in pharmacies. By law, ‘special’ prescriptions are now required only for parenteral injections of strong opioids and for methadone. There is no ‘special’ prescription for oral opioids and patches. All opioids are free of charge for patients.

Research
Several palliative care centres are involved in European Collaborative Research Projects, such as Milan, Genoa and Forli, and many others promote research in palliative care at a local level.

Education
Before 2012, some universities organised different post-graduate programmes in palliative care. But under the new law, the National Health Service has to promote specific educational programmes for palliative care.

In April 2012, Masters’ courses for doctors, psychologists and nurses in adult and children’s palliative care were established by law, The two-year course includes 1,500 hours’ classroom-based teaching and 1,500 hours based in an inpatient unit/hospice/home care or consultation setting. Recently, the government has approved and defined the new discipline of palliative care.

Quality
Law 38/2010 has also required that an office at the Italian Ministry of Health be dedicated to supervise the development of Regional Palliative Care Networks, as well as to monitor the opioid consumption and control the quality of the activities of these networks. Several important documents, approved since 2007, define standards of activity and accreditation norms for Palliative Care Networks in Italy.

The future…
I think that the future of hospice and palliative care development in Italy is positive: the new Law 38/2010 is an important contribution to this positive evolution. Its approval has promoted better public awareness about palliative care and about care of the dying in general in Italy. The main problem at the moment is the economic crisis; it has created some doubts about the future development of the National Health System in Italy.

I think that it’s also really important to maintain the close collaboration of our two national palliative care organisations; they have always strongly promoted the integration of palliative care into the Italian Public Health System.

The Italian Society of Palliative Care (SICP) is the national scientific society and representative of all palliative care professionals in our country, while the Federation of Palliative Care (FedCP) represents the many non-governmental organisations that provide and support palliative care in Italy.

Find out more…


 

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2 Responses to Budapest Commitments: Update from Italy

  1. Pingback: Budapest Commitments: Update from Italy | EAPC Blog | All Things Palliative - Article Feed

  2. Dear Dr Carlo Peruselli,
    It’s very interesting Your Article which is a Calling-For. Your very important words ‘,,, promote specific educational programmes for palliative care’ ask for those educational programmes wherein KNOWLEDGE, SKILL AND BEHAVIOUR (Sheila Payne) can operate simultaneously for-and-before the Patient, in-and-within the Patient. I am a Linguist, and an Individual Member of the European Association for Palliative Care and Individual Member of the International Children’s Palliative Care Network. The field of my studies and researches is the Non-PharmacologicalCare for PreverbalOncologicChildren. The power of language, the power of sign and gesture and the power of pain. The way owing to which You can speak to a Preverbal Child in Pain, His listening to, His participating, His learning signs and gestures in order to express His feelings and emotions, translated into His behaviour, all That permits to enter His ‘Private world’ to share His own and private pain. The PreverbalOncologicChild asks urgently-and-immediately, in His Silences, to feel understood, because when He feels understood new emotions, sensations and perceptions find their space and time within Himself and a New world within His painful Private world is born.
    Luisella Magnani http://www.luisellamagnani.it

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