Hospice movement in the Czech Republic [Новость добавлена - 04.12.2008]

The idea of hospice movement first appeared in the 1980s. The integration of hospice care in the Czech health care system was a problematic issue, giving raise to misunderstanding on behalf of authorities as well as professionals and public.
 
The first hospice was built and inaugurated in December 1996. In the next 10 years further 10 hospices were opened, and additional two hospice projects started. At the time hospices were mainly the initiation of civic associations (non-governmental organisations) without signifi-cant support from the state. Due to the fact that hospices were not enacted within the Czech legal system, the financing of provided services was insufficient. Hospice workers created a certain community, and became to know each other. Although there was mutual cooperation among members of this work community, the deputies of hospice organisations had to negoti-ate constantly with state authorities and insurance companies in order to reach their aims related to financial support. Ten years after opening the first hospice, the hospice situation became critical mainly due to insufficient financial sources.
 
There was a breakthrough in 2005 when several hospice leaders agreed on establishing a professional organisation that would unite all hospice providers in the Czech Republic. The Association of the Hospice Palliative Care Providers was founded in June 2005, and most hospice care providers in the Czech Republic joined as members. The Association represents all hospice providers, negotiates with state authorities, and its activity resulted in the enact-ment of inpatient hospice palliative care (and a year later also mobile hospice palliative care) within the Health Insurance Code. A successful outcome of the negotiations carried out by the Association was that hospice care was agreed to be financed from the public health insurance. The refund covers 60% of the costs.
 
At the moment, we are negotiating about financing the mobile hospice care.
The Czech legal system strictly separates health and social services and this means that the health and the social services provided in hospices have to be subsidized from different funds and sources. The care providers find themselves in a difficult situation, as they have to sepa-rate those two services. Hospice, as an institution, was not recognised as social care provider within the new Code of Social Services valid since the 1st January 2007. As a result, social services provided in hospices were excluded from the state financial system and hospices lost their possibility to apply for state support for the social services. We hope that this situation will be resolved soon, as providing hospice services will be included in the updated Code of Social Services, which is being presented in the Parliament of the Czech Republic.
 
The Czech Republic needs 515 beds to ensure full accessibility of hospice care. There are 14 hospices in the Czech Republic with altogether 325 beds. The extent of mobile hospice care is seen as a problem, as there are only 6 mobile hospices. Many home care providers are ready to start the mobile hospice care once the financing of mobile hospice care is solved. In the Czech Republic there are neither day care centres nor hospice palliative units in hospitals.
The hospice movement is a relatively new tradition in the Czech Republic, therefore the education and training of health workers in the field of palliative care is also a novel issue. A special hospice palliative training for nurses and physicians has been available only for the past 4 years.
 
The workers involved in the hospice movement endeavour to make hospice care accessible for everybody in the Czech Republic. They work on developing the Standards of the hospice palliative care, and support education in this field. We also aim to promote the idea of hos-pice, to open discussions about death and dying in media. The problem we are facing in the society at present is a growing focus on young look, health, well-being while illness, death and dying are still considered taboo. We believe that this anxiety can be moderated by the enduring education of the general public and by appropriate presentations of hospice issues in media.
 
Eva Černá
General Secretary
Association of hospice paliative care providers (AHPCP)
U Modré školy 1/2337, 14900 - Praha 4
Czech Republic
Tel: +420 242 485 823
Fax: +42 267 910 518
email: asociacehospicu@email.cz
http://www.asociacehospicu.cz

The Palliative Care in Central and Eastern Europe and Former Soviet Union Countries Monthly Email Newsletter Vol.IV. No.10. October 2008