Filenews 18 July 2024 - by Marilena Panayi
A bill that aims to alleviate suffering, ensure human dignity and support patients and their families, the bill that provides for the operation of palliative care facilities, comes to fill a huge gap in the health sector in Cyprus.
It had been put to the public consultation process at the end of 2023 and the Ministry of Health is now ready, after the remaining checks are completed and its content is finalized, to forward it for voting by Parliament.
With its enactment into law, on the one hand it will fill a large legislative gap and on the other hand it will pave the way for the creation of the necessary structures, which, in the absence of legislation, until now are almost non-existent in Cyprus. Besides, the absence of a law does not allow the provision of these services to all patients who need them through the General Health System, which is limited, for the time being, to serving only cancer patients.
Of course, the thousands of Cypriot patients who until now do not receive the necessary, specialized and complete care and either end up in structures that do not have the relevant expertise, such as nursing homes, or receive services piecemeal, often paying out of pocket (if they can afford it), in their homes.
The services offered by specialized hospital departments, independent structures, hostels, mobile units or home care teams will not only concern the patient or only his medical care, but the bill also provides for psychological and other support and support of both the person facing a serious disease, life-threatening or not. as well as his caregivers and family.
"The provision of palliative care aims to improve the quality of life of patients (and their families) facing problems related to life-threatening diseases or complex and complex health problems, through the prevention and alleviation of suffering, thanks to early identification and appropriate assessment and management of pain and other physical problems. psychosocial, spiritual problems and needs by a specialized multidisciplinary team", states the preamble of the bill, which has been formed on the basis of the World Health Organization's definition of palliative care.
The provision of palliative care, it added, "is an integral part of the provision of health care services and must be offered in specialized centers and/or structures by multidisciplinary teams operating on the basis of high standards and standards."
"Palliative care facility" is defined as specialized inpatient units, shelters that will provide these services internally, mobile teams that will provide services to patients who are in hospital or hosted by various care centers and day care units.
In order to provide palliative care services, each facility must have a full multidisciplinary team, consisting of at least five members. The members of the team must be scientists of various specialties, such as doctors, nurses, psychologists, social workers and physiotherapists or even nutritionists, occupational therapists or priests / spiritualists, if this is deemed necessary for the needs of a patient and his family.
For each category of provider (hospital, hostel, day care unit, etc.), the bill sets conditions and operating criteria and defines the various levels of palliative care as follows:
Basic Palliative Care includes the identification of patients in need of palliative care and their referral for specialized palliative care services, provided by health professionals who work in any health environment and have been trained in the fundamental principles of palliative care with relevant certification by the National Palliative Care Council, whose operation is also provided for in the bill.
General Palliative Care includes patient populations in need of palliative care and is provided by health professionals who undertake treatment and care of patients with life-threatening diseases without these services being their main occupation.
Specialized Palliative Care is provided only within the framework of Shelters / Centers / Palliative Care Units, to patients with life-threatening diseases and complex and complex health problems, by health professionals who have been trained and have palliative care as their sole object of work.
The way of providing services and the personalized services that will be provided will always be determined in cooperation with the patient himself (if he is able to participate) or with the family and / or people who care for him.
As the bill provides, "the patient, their family, and their caregivers work with the multidisciplinary team to discuss and plan patient care through informed decisions."
It is also provided that, "Subject to the provisions of the Law on the Safeguarding and Protection of Patients' Rights Law, in case the patient is unable to participate in the planning of care or to make decisions that affect him, a patient representative should be appointed who will act guided to the maximum extent possible by the goals and preferences of the patient, within the framework of the relevant legislative provisions".
Home care and care for special patient groups and children
For a large percentage of patients in need of palliative care, the provisions they provide for the provision of home services are of particular importance.
According to the relevant provisions, "Home Palliative Care Service" means a multidisciplinary team that provides specialized palliative care to patients with life-threatening diseases or complex and complex health problems, at the patient's site, with the appropriate equipment, at a frequency and duration corresponding to the patient's needs.
The bill also provides for the provision of palliative care to children in need. "Paediatric palliative care means holistic care that meets the physical, mental, social and spiritual needs of children combined with providing support to the family and other important persons in the child's life."
Finally, the categories of patients are defined, according to their particularities and the needs of people belonging to specific groups of the population such as the elderly, the homeless, people with disabilities, migrants and others are taken into account.
