Opening address by Minister White at the Irish Hospice Foundation Conference

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Irish Hospice Foundation Conference on “Living and Dying Well in the Community: the Future of Primary Palliative Care in Ireland”

I am delighted to be here today to open this worthwhile and thought provoking Conference. I would like to thank Sharon Foley of the Irish Hospice Foundation for her kind invitation.

It is one of the great success stories of our age that so many more people are living for so much longer. While many older people enjoy good health for most of their lives, there will also inevitably be increased numbers of people living in the community with chronic diseases and life-limiting illness. As a society, we need to plan now in order to meet the needs of these people. Primary Palliative Care is just one component that we must think about and prepare for.

The implementation of the Primary Care Strategy is a priority for this Government. The Strategy focuses on moving away from the current hospital-centric model of care towards one which treats patients at the lowest level of complexity in a safe, timely and efficient way, as close to home as possible. There is no doubt that most of us, if we were ill, would welcome the choice to be treated within our communities and enabled to stay at home.

Primary Palliative Care places the GP at the centre of a patient’s care. GPs are central to the care, planning and management of patients – particularly those suffering from chronic conditions and those with two or more diseases or disorders.

Primary care teams play a vital role in ensuring the highest possible quality of life for people with life limiting conditions and at end-of-life, who are living in our communities. They work to support, and are supported by, the community-based specialist palliative care teams. Primary care is often where a patient’s health, needs, background, and problems are best understood.

There are challenges in meeting the palliative care needs of patients in the community, particularly outside of normal working hours. I therefore welcome the joint efforts of the Irish Hospice Foundation, the Irish College of General Practitioners and the Health Service Executive in collaborating to improve the interface between GPs, out-of-hours services and the community-based specialist palliative care teams.

The palliative care needs of people with dementia has received increasing attention in recent years. We know that as our population ages, the number of people living with dementia is projected to treble in less than thirty years. My Department will publish a National Dementia Strategy in the coming months which will recognise the vital part played by GPs and their teams, and will emphasise the importance of palliative awareness for all those who deal with people with dementia. The extension of the Hospice Friendly Hospitals Programme, which is an Irish Hospice Foundation initiative, supported by the Health Service Executive, into residential care settings is therefore very welcome indeed. In addition, a Palliative Care Competency Framework to be published shortly by the HSE identifies appropriate skills for all staff, whether specialist or generally trained, to care for the dying patient and their family.

GPs can undertake further study on palliative care through the Irish College of General Practitioners or access continuous professional development through a range of options.

A further initiative is the Rapid Discharge Pathway which will help ensure that people who want to leave hospital to die at home can be facilitated to do so. The Pathway links hospital with ambulance, GP, pharmacy and community services.

In the area of paediatric palliative care, a joint programme between the HSE and the Irish Hospice Foundation is funding the first Paediatric Consultant with a Special Interest in Palliative Care as well as eight Children’s Outreach Nurses to support children being cared for at home and their families. These nurses provide a crucial link between hospital and community-based services, and the work that they do can make an enormous difference to families at very tough times.

All of these initiatives require vision and above all else, effective collaboration to ensure that the services provided for patients are appropriate and of the highest quality. The successful development of palliative care services in Ireland has been based on a long standing tradition of positive engagement between the voluntary, statutory and private sector. For example, the Health Service Executive and the Irish Hospice Foundation are collaborating in a very positive way on a range of fronts to strengthen palliative care.

As we continue to work together, I see great opportunities for increased synergy between the Primary Care Strategy and Primary Palliative Care which will strengthen outcomes for patients in the future. We need to continue to work together to ensure that we achieve our shared goal of providing the best and most appropriate outcomes for the patient.

I wish you every success with today’s conference.

Thank you.