The European Association for Palliative Care (EAPC) has been integral to the development of this new report. Professor Phil Larkin, President of the EAPC, explains.
The Council of Europe has launched its latest report on palliative care in Europe. The report provides an update to the 2009 resolution 1649, ‘Palliative care: a model for innovative health and social policies’, on the current trends in palliative care models and highlights critical issues that may be of specific interest to all elected European parliamentarians. It expresses regret that much of the 2003 (24) Council of Ministers’ recommendations on palliative care remain unaddressed with continuing lack of access to pain management and palliative care services across European Union states.
EAPC has been integral to the development of this new report. It was fortunate that the Council rapporteur, Senator RónánMullen, is Irish and so, as President, I was able to meet him on several occasions both in the Dáil (Irish Parliament) and in Galway in the West of Ireland, where we both live. I subsequently presented at the European Parliament in Brussels on the development of palliative care across Europe with a focus on the important issues of early integration of palliative care, models of integrated palliative care and the expansion of palliative care across the breadth of clinical need, beyond cancer. Dr Tiina Saarto, EAPC Board Member, and I were then invited to present in Strasbourg at a session to introduce the report to Council members and agree a fact-finding mission undertaken by Senator Mullen.
Although focused on only one country (Spain), the Council chose this as it gave examples of the range of possible palliative care provision – hospital based, home care, day hospice and hospice inpatient centres. It also offered evidence within one country of where services supported at a governmental level, albeit at local level, can flourish, and where the absence of that support can inhibit any such development.
In many ways, this new report supports the findings of its earlier version and calls for action. It is underpinned by the current World Health Organization definition and advocates for the World Health Assembly 96.18 resolution, which remains a key directive for palliative care as an essential component of health care. However, it makes specific note of the impact on healthcare services when palliative care as an appropriate care alternative is not introduced. The report also notes the role of informal caregivers where there is often an expectation on behalf of the system that they take such responsibility without adequate resources or support to do so. Sadly, an all too familiar scenario for those of us involved in community care and home care in particular. It also makes a specific call for respite services which, although always seen as an integral part of palliative care, may have been diminished as the complexity of care needed by patients is such that beds are at a premium and access limited. Overall, this report strengthens the message that palliative care is a human right to be upheld by political and health service providers.
I would like to take the opportunity to thank those colleagues in Spain who graciously gave of their time to meet Senator Mullen, notably members of La Sociedad Española de Cuidados Paliativos (SECPAL), Professor Xavier Gómez-Batiste, Dr Javier Rocafort and Dr Emilio Herrera (there may well be others).
The work of EAPC is essentially one of advocacy and lobbying – using our organisational position to leverage political dialogue and exchange to further the visibility of palliative care and address critical issues to improve people’s experiences of living with and dying from complex, life-limiting illness.This is perhaps a role for which we are less well known, but in this increasingly crowded platform of palliative care agencies it is important that our voice, on behalf of those who are mainly the practitioners of care services in Europe, is heard and valued. I would imagine that as our organisation develops in the coming years, this will need to be a clear component of what we are seen to be doing in the future. Our proximity to the European Parliament in Brussels gives us an excellent opportunity to make sure that the voice of EAPC is heard clearly at the appropriate political table.
I urge you to read the report and reflect on the recommendations for your own country or region. I hope that its findings give insight that can be adopted and shared amongst service providers. But particularly, I hope that this new report provides you with a framework to engage locally and nationally at a political level, to say that palliative care is an essential component of the care that all European citizens deserve and not an ‘added extra, if possible’.