Pharmacological treatment at home for terminally ill patients will not be a guaranteed service from public funds – it results from the draft amendment to the regulation on palliative and hospice care prepared by the Ministry of Health.
As stated in the explanatory memorandum, the project changes the catalog of guaranteed palliative and hospice services provided at home, excluding pharmacological treatment, and adding the prevention of complications and examinations ordered by a doctor.
The spokesman of the Ministry of Health, Piotr Olechno, emphasized in an interview with PAP that the provision of the draft regulation is only a clarification. Pharmacological treatment of terminally ill patients at home has never been a guaranteed service. They have the right, like other patients, to use drugs reimbursed from the National Health Fund. Pharmacological treatment in stationary conditions, e.g. in hospices, is completely free of charge – added Olechno.
In turn, in the opinion of the chairman of the parliamentary health committee, Bolesław Piecha (PiS), the provision from the regulation will introduce confusion and misunderstandings. It is about savings, of course, but they will not be large. It is introducing unnecessary trouble. The nurse who comes to these patients should have a first aid kit with him and give the medicine free of charge, Piecha told PAP.
The spokesman for the Hospice Foundation, Piotr Kławsiuć, emphasized in an interview with PAP that the regulation did not answer the question of what should be done with hospice patients who cannot even afford to buy reimbursed drugs. The drug treatment record is actually an endorsement of an existing practice. On the other hand, the provision enabling the provision of adult patients with guaranteed services under palliative care for children should be assessed positively. It does not change the practice, but it will make it easier to obtain funds from the National Health Fund – said Kławsiuć.
The negative issue is the lack of abolition of the obligation to have infusion pumps. Today they are very rarely used in home hospices for adults, for many hospices they will freeze several thousand zlotys – he added.
Pursuant to the new regulation, patients receiving home hospice services will not be able to benefit from long-term home nursing care.
In addition, the project introduces the requirement for a doctor working in a hospice to present documents confirming the completion of courses on pain, somatic and mental symptoms, organized by a university or a unit authorized to specialize in palliative medicine.
Nurses will also need to complete or specialize in palliative care, cancer nursing, or a qualification or specialist course.
The draft introduces the possibility of providing adult patients with guaranteed benefits as part of palliative care for children, if their disease is congenital or life-limiting and was diagnosed before reaching the age of 18.
In addition, the regulation changes the number of infusion pumps: currently 1 for every 5 beds – after changing 1 to 15 beds in palliative and hospice care provided in stationary conditions, and in home conditions – 1 to 20 As stated in the justification, pumps in palliative medicine departments are used mainly for the administration of morphine by the subcutaneous route. However, it can also be administered with a needle, which is the most common method. (PAP)