Palliative care funding
As people live longer, often with chronic conditions, hospices will have to treat more patients while being forced to raise most of their funds. Meadhbh Monahan reports.
Palliative care is provided by five voluntary organisations in Northern Ireland: the Northern Ireland Hospice, Marie Curie Cancer Care, Macmillan Cancer Care, Foyle House Palliative Care and St John’s House Southern Area Hospice. They offer inpatient beds, respite care and bereavement services free of charge to patients referred by their GP or hospital.
Children with life-limiting illnesses receive nursing care and therapy from the Northern Ireland Children’s Hospice which has one 10-bed facility (Horizon House in Newtownabbey) where families are allotted day and respite stays and care in the home. Horizon West, a facility that will provide respite for four children and two families at any one time has been built at Killadeas, County Fermanagh, but will not admit patients until it has raised a further £500,000 for operating costs
(£1.2 million has been raised to date). Other charities work throughout the province to raise money for the treatment and support of children suffering from illnesses such as cancer or heart disease.
The five bodies received £5.58 million from the DHSSPS in the last financial year. The rest of their operating costs must be raised through fundraising campaigns. The only specialist palliative care beds in Northern Ireland’s health and care system are the 12 in Antrim Area Hospital’s new palliative care unit. A joint project between the Northern Health and Social Care Trust, Macmillan Cancer Support and the department, it cost £5 million. Other hospitals have contracts with the voluntary bodies.
Palliative care is defined as “the active, holistic care of patients with advanced progressive illness.” It aims to ensure a good quality of life from diagnosis to death for adults and children who will never reach adulthood. While each trust has access to palliative care beds, it is accepted that this is not always the most appropriate setting and that most people would prefer to die in their own homes.
A five-year palliative care strategy was released by then Health Minister Michael McGimpsey in December 2009. It aimed to develop a better knowledge of palliative care, identify the patient’s holistic needs and plan care so that a patient can die at home if they wished.
Over 6,000 outpatients were helped by hospital palliative medicine teams in 2010: 4,086 in hospitals in the west, 1,101 in Belfast City hospital, 810 in the six northern hospitals, 386 in the southern area and 26 in the Ulster hospital. Changing demographics (see pages 90 and 91) mean that people are living longer and often with one or more chronic condition.
Heart disease accounted for 31 per cent of deaths in Northern Ireland last year, cancer for 29 per cent and respiratory disease for 13 per cent.
“It’s a real challenge to keep the services running safely for the families who need it,” commented Tina McCrossan, Director of Children’s Services for the Northern Ireland Children’s Hospice.
Day care sister at St John’s House, Newry, Marianne Barry, has explained that “many of the patients come simply to avail of the company of others who understand what they and their families are experiencing.”
When challenged as to why the DHSSPS cannot fund all palliative care, a spokeswoman said that the £4.3 billion health budget provides “a wide range of critical services, all of which are rightly important to the public”. She cited an expected £800 million shortfall by 2014-2015 caused by price inflation and more demand on services which will make it difficult to maintain the current level of services.
