Hospice Care: Saving the Taxpayers' Money

Eugene Murray

Issue 392, vol.98, Winter 2009

A patient could use the hospice-centre itself for symptom-control, for respite, or for the end of life – and could visit the day-care services to access therapies, and professionals such as social workers, psychologists, psychotherapists.

With palliative care, patients are found to live longer, and to die in comfort and dignity…Ensuring that a loved one has a good death, should not depend on our economic well-being as a nation : we are more than an economy, we are a society. No one should have to linger on waiting-lists for specialist help; no one should have to travel from Kilkenny to Dublin for hospice care.

Aside altogether from humane and ethical considerations, palliative care actually reduces costs to the tax-payer. In the US, palliative care was found to reduce costs to Medicare by 25%. And costs to the hospital were reduced by 57% (according to one 2003 study). It is worth noting that, of the average €300,000-worth of health care which each of our citizens incurs over a lifetime, 25% to 33% is incurred during the last year of life. Indeed, the cost-figure for the last year of life represents 10% to 15% of a country’s total health-care budget. (The annual budget for Irish hospice care – at €75 million – is less than 5% of what the country spends on final-year care).

Here in Ireland, most cancer sufferers still die in hospital if they happen to live in a county which has no hospice. And local provision varies greatly : three former Health Board Areas have no hospice, and one such Area lacks either a hospice or (contrary to government policy) a specialist team for any hospital of over 150 acute beds.

Current users of hospice services in Ireland number 6,000 – which is expected to rise to 13,000 by 2016 (given population increase, especially in the older bracket). According to the 2008 Health Service Executive 5-year Plan for Palliative Care Services, the country’s hospices are to be doubled – from nine to eighteen. But, it is believed, many deficits in the palliative care network could be remedied by re-allocating beds and staff – without adding to the total number of State-funded beds.

Eugene Murray is Chief Executive of The Irish Hospice Foundation. He joined the IHF in 2004. He is an economist and worked in the past as a journalist and senior management executive. He was a member of the National Advisory Council on Palliative Care and the Government Policy Group on Children’s Palliative Care.

He was formerly a member of the Executive Board of RTE.

A former Chair of the Governing Body of Dun Laoghaire Institute of Art, Design and Technology, and of Arthouse and The Broadband Factory, Eugene Murray has also served as a member of the Information Society Commission. He is currently a Board member of St Luke’s Hospital.