IAPCON 2016 Calls for integration of palliative care across health care continuum and attitudinal change among doctors
Correspondence Address: Source of Support: None, Conflict of Interest: None PMID: 27162433
Source of Support: None, Conflict of Interest: None
Speakers at the 23rd International Conference of the Indian Association of Palliative Care (IAPCON 2016) held in Pune from February 12 to 14, 2016 covered a spectrum of subjects in keeping with the theme of the conference: Engage, educate, empower and excel.
More than 650 delegates participated in the three-day conference and the pre-conference workshops held on February 11. These workshops were about end-of-life care, paediatric palliative care and research in palliative care.
Day one marked the official launch of the 20-module free palliative care elearning course by ecancer, specially developed for India by Cardiff Palliative Care Education in association with Karunashraya.
Pallium India won the Palliative Care Award for the SAARC Countries 2015-16 bestowed by Cancer Aid Society. Dr. M R Rajagopal received the award on behalf Pallium India from Dr. Piyush Gupta, Secretary and Principal Executive Officer of Cancer Aid Society. The award comprised a prize money of ₹100,000.
Dr. Pankaj Singhai from Tata Memorial Centre, Mumbai won this year's Bruce Davis Gold Medal.
Justice S R Bannurmath, Chairman of the Maharashtra State Human Rights Commission, formally inaugurated IAPCON 2016 on February 12, 2016. He asserted that palliative care was a human right and needed to integrated with the national health scheme. He lauded the “services rendered by IAPC for the needy, in the face of heavy odds”.
Eminent surgeon, Dr. V N Shrikhande, regretted that treatments were being offered purely on the basis of diagnostic reports and doctor-patient relationship was on the decline. He added that doctors needed to possess more than medical knowledge—”eye contact, a smile and a touch are all very important, too.”
Ms Anu Aga, acclaimed corporate leader and champion of social work, stressed on the attitudinal changes required in taking care of patients with terminal illness. “We need to be with them in their attitude of need. We need to help them not suffer,” she said.
Others who spoke at the inauguration were Dr. Nagesh Simha, President, IAPC; Dr. Sushma Bhatnagar, Organising Chairperson, IAPCON 2016; Dr. Priyadarshini Kulkarni, Secretary, IAPC and Organising Secretary, IAPCON 2016; and, Dr. Maryann Muckaden, incoming President of IAPC.
The “Pune Declaration”, issued at IAPCON 2016, urged the government of India to give “the rightful place for palliative care in its non-communicable diseases control programme and in its HIV and TB control programmes”, in accordance with the World Health Assembly (WHA) resolution of 2014.
The WHA resolution calls on health systems of all member countries “to integrate evidence-based, cost-effective and equitable palliative care services in the continuum of care, across all levels, with emphasis on primary care, community and home-based care and universal coverage schemes.”
The Pune Declaration further appealed to the Indian government for adequate funding and effective implementation of the National Programme for Palliative Care (NPPC), which was created by the Ministry of Health and Family Welfare in 2012. It also called for nation-wide implementation of the Narcotic Drugs and Psychotropic Substances (NDPS) Act, as amended in 2014. Finally, the declaration asked for undergraduate palliative care education by the Medical Council of India, Indian Nursing Council, health universities and by medical institutions and colleges.
Speaking at a special session during IAPCON 2016 to review the implementation of the WHA resolution in India, Dr. Stephen Connor, Executive Director, Worldwide Hospice Palliative Care Alliance (WHPCA), pointed out that more than 6 million people needed palliative care in India. With 17 percent of the world's population in India, this was more than 15 percent of the global need for palliative care.
Dr. Alok Mathur, Chief Medical Officer, Ministry of Health and Family Welfare assured that the government was already acting on implementing the various provisions of the WHA resolution. While palliative care programmes did not have a separate vertical, he promised that all requests for funds for palliative care programmes from the state governments would be honoured, through the Health System Strengthening initiative of the National Health Mission.
After the expert committee submitted its report in 2012, in 2014 the central government has released funds for palliative care to seven states. Six new states are being provided funds in the current year. While the ministry was getting proposals only from about seven states out of the total of 35 states and union territories, Dr. Mathur assured that that the government had the political will and had earmarked sufficient funds for the implementation of palliative care programmes across the country.
Dr. M R Rajagopal, Director, Trivandrum Institute of Palliative Sciences (a WHO Collaborating Centre) and Founder Chairman of Pallium India, regretted that the National Programme for Palliative Care (NPCC), which raised a lot of hopes, did not take off for want of funds. While the envisaged national palliative care cell has not materialized, the state governments are weary of forming cells as they are unsure about continuity in funding.
He pointed out that the government provisions permit cancer centres to spend up to 10 percent of their budget on palliative care. However, for want of any obligatory binding, this has not been happening. Medical colleges too are facing funds crunch. “These make it difficult to ensure palliative care becomes part of the continuum of care, as the WHA would like it to be,” Dr. Rajagopal remarked.
National Palliative Care Standards; Pain—Policy to Practice; Progress in Palliative Care—Indian Perspective; Palliative Care Networking; How Cancer Can Motivate Many to Care for Others You Can Make A Difference; Palliative Care: Art and Science of Being Present, from Personal Experience; Compassion fatigue; Challenges in Initiating And Delivering Specialist Palliative Medicine Education in Bangladesh.
There more than 65 parallel sessions. The themes discussed during these sessions included: Changing Palliative Care Scenario; Scope of Interventional Pain Management in Palliative Care; Interface between Intensive Care and Palliative Care; ChilDr.en's Palliative Care in India; E-Palliative Care; Recent Developments in End-of-Life Care; Oncology-Palliative Care Interface; Novel Therapies in Palliative Medicine; Advanced Clinical Topics in Palliative Medicine; Comprehensive Care Planning in Palliative Care; Palliative Medicine in Non-Oncology; Rural, Remote and Home-Based Palliative Care; Improving Quality of Care by Integrating Palliative Care with Comprehensive Care of Cancer Patients; Volunteering in Palliative Care; Empathy, Compassion and Spirituality; How to Do Research in Palliative Care; and, Specialist Palliative Care Nursing as a Career Choice.
In addition, on February 13, there was a panel discussion on Establishing Palliative Care in the Private and Corporate Sectors. In the afternoon on the same day, there was a spirited debate on “The earlier the introduction of specialist palliative care, the better the outcome for the patient”. The final day witnessed a keenly-fought quiz contest, involving teams drawn from the north, east, south and west zones.
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Conflicts of interest
There are no conflicts of interest.