A fundamental human right is the right to live and die in dignity. Unfortunately, the situation of palliative medicine in Poland is dramatic. The answer to this state of affairs is the newly established Civic Alliance for Palliative Medicine. The conference inaugurating the Agreement’s activity was held on April 17 in Warsaw.
It is a violation of human and patient human rights to not have access to appropriate care in a timely manner, including pain management, for patients who need it. In Poland, as in other European countries, there is a constant development of palliative care. However, there are still a number of unresolved problems that reduce the quality of care for terminally ill. The oncology package, introduced in January this year. it did not include palliative and hospice care, while the number of those in need grows. In view of the demographic (aging) and epidemiological changes (increasing the number of cases of cancer and other poorly prognosticated serious diseases that cannot be treated by causal treatment), the number of people needing palliative care will increase rapidly.
Services related to palliative medicine in Poland are on the guaranteed list, however, Dr. Aleksandra Ciałkowska-Rysz, head of the palliative medicine department of the clinical hospital. WAM in Łódź, drew attention to the diversity of access to palliative and hospice care in individual provinces – in some it is available immediately, in others you have to wait up to 3 months for it.
Almost 90% of patients dying from neoplastic disease have been in contact with palliative care. However, this does not mean that everyone has received a form of palliative care that is appropriate to their stage of disease and at the right time, as the average duration of home care is around 30 days, which means late reporting or waiting too long to receive due care. The financial resources allocated in Poland for symptomatic treatment and care for a patient in the advanced stage of cancer, who is only under the care of a palliative medicine doctor, are many times lower in comparison to the financial outlays for oncological therapy. Hospitalization in an oncology or internal medicine ward is valued by the National Health Fund higher than a stay in a palliative medicine ward, which, according to Dr. Tomasz Dzierżanowski from the palliative medicine laboratory of the Medical University of Lodz, stigmatizes and even discriminates against a large group of patients.
Dr. Maciej Sokołowski from the Dolnośląskie Hospice Agreement also spoke about the valuation. He emphasized that the valuation of palliative care services has not changed since 2009. The Ministry of Health decided that this year they would be valued again by the Agency for Health Technology Assessment and Tariffs, but the new valuation will be in force at the earliest at the beginning of 2017. NFZ It does not limit coming into the world, it does not limit births, so let it not limit dying, ‘appealed Dr. Sokołowski.
In response to the above-mentioned situation and in order to improve it, the Civic Agreement for Palliative Medicine was established. OPMP was founded on the initiative of Jacek Gugulski – the President of SPBS and Dr. Aleksandra Ciałkowska Rysz – former national consultant in the field of palliative medicine, who is the substantive supervisor of the initiative. The mission of the agreement is to ensure a dignified life and death for all patients, in accordance with the human rights guaranteed by the constitution. OPMP will focus on helping patients suffering from progressive, life-limiting, incurable diseases as well as on proposing legal and systemic solutions in this regard. The initiative has already been supported by many organizations and individuals. The invitation was also accepted by an outstanding actress and patient activist, Maja Komorowska. The originators of the Agreement hope that more and more organizations and institutions as well as people interested in changes in palliative and hospice care will join this socially necessary and important undertaking.
During the meeting, the experts agreed that it is necessary to develop and implement the National Plan for Palliative Medicine in Poland, because this is the only way to provide terminally ill patients with decent care in the last stage of their lives.
The honorary patronage of the conference was the spouse of the president, Anna Komorowska. The Polish society is aging, as we all know well, which is why it is so important today to take the necessary measures to alleviate the suffering of patients in their final stages of life – she wrote in a letter addressed to the participants of the meeting.