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Pre-Budget Submission 2019

Dying is Everyone’s Business. Can we afford to forget Grief?

Today, the Irish Hospice Foundation (IHF) is calling for the government to show a more strategic approach to bereavement, palliative care and end-of life issues.

At their Pre-Budget Briefing this morning, the country’s only charity dedicated to dying, death and bereavement, strongly advocates for more joined-up thinking on a national strategy on palliative care, end of life and bereavement to include both health and non-health areas of public policy.

This underpins all 10 IHF recommendations for budget 2019. The recommendations are founded in the responses to the 2016 “Have Your Say” survey in which 3,000 people in Ireland expressed their views, fears, hopes and anxieties on dying, death, care and loss.

Death is an inevitable and universal experience – a fact of life. Dying, death and bereavement present a myriad of challenges to the health service, to other state services and to wider society. The IHF believe dying, death and bereavement are everyone’s business with the assumption that healthcare and other services will recognise and address its citizens’ needs.

In the next 10 years[1]:

  • Almost 300,000 people will die in Ireland
  • Over 3,000 of those deaths will be of children
  • Over 250,000 will be of people over 65 years of age
  • Almost 3 million people will be bereaved[2] and up to 150,000 of these will encounter significant difficulties or ‘complicated grief’[3]
Marie Lynch, Head of Healthcare Programmes (left) with Sharon Foley, CEO and Orla Keegan, Head of Bereavement and Education and Angela Edghill, Advocacy Manager (right), pictured at the launch of the Irish Hospice Foundation (IHF) Pre-Budget Briefing held in Dublin.  Pic. Robbie Reynolds

Grief is the common ground on which we all stand. We urge the Government and all Oireachtas members to ensure bereavement issues are priority areas for policy development and investment.  If current trends continue 5% of grieving people will require specialist mental health services/psychological intervention[4].

Despite the universality of loss and grief, bereavement is invisible in public policy.  It needs to be brought into the mainstream in policies from education to employment, from health to social protection.

Given this evidence, it is essential the healthcare system meets the needs of people facing dying, death and bereavement and ensures everyone gets equal access to good care.   By careful planning, the IHF directly and indirectly invest in the care of the dying and the bereaved, and, crucially, this planning includes helping people to live well until they die.

Sharon Foley, CEO of the IHF said:

“The implications of bereavement stretch across our communities – all ages, all circumstances, all cultures.  The cost of building caring communities is a small investment for long-term gains.  Amongst the calls being made by the Irish Hospice Foundation is one for research to uncover the economics of bereavement on people in Ireland. Currently in Ireland, there is little data however we know from experience and international research the many expenses families can face.”

“Everyone in Ireland deserves a good death.  For this to happen, improvements are needed in Primary Care, Residential Care and in Hospital settings.  These improvements need to specifically focus resources and expertise available outside traditional working hours as well as the development of Specialist Palliative Care in the Midlands and North East.”

The IHF asks the Government to:
  1. Ensure everyone has access to the best care at end of life and in bereavement through a political and public policy commitment to a strategic, responsive, population-wide approach to end of life issues and
  2. Ensure the health care system delivers best palliative, end of life and bereavement care in all care settings.

The IHF believes that with a more strategic approach, better end-of-life and bereavement care can make a real difference to both the quality of healthcare provided to the citizen and the cost of health and social care to the State – a view supported by an Oireachtas Committee in 2014. [5]

Angela Edghill, Advocacy and Public Engagement Manager said:

“There is no need to reinvent the wheel. The Government’s way forward is to be found in actually implementing current framework documents, reports and policy.

We very much welcome the “Palliative Care Services: Three Year Development Framework (2017-2019)” charting the future for this vital service throughout the country and in all care settings.   The detailed recommendations in Senator Marie Louise O’Donnell’s comprehensive “Finite Lives” Reports of 2015 and 2017[6] provide a blueprint for better integration of State services outside of the health service and a more strategic approach to issues arising in dying, death, loss and care.  They also very much reflect the views of those people who responded to our Have Your Say survey in 2016.”

In some cases the challenge is to simply join the dots – to enable, encourage, mainstream and replicate good practice and innovation across the whole of government and community areas.”

A full copy of the IHF Pre-budget submission is available here.

For more information on Have Your Say, click here.

[1] Figures estimated from CSO statistics of 2015: Vital Statistics 2015 Yearly summary (29,952 deaths in 2015)

[2] Estimate based on 10 people directly affected by each death

[3] Kersting A, Brähler E, Glaesmer H, Wagner B. Prevalence of complicated grief in a representative population-based sample. J Affect Disord 2011;131:339-43 and Newson RS1Boelen PAHek KHofman ATiemeier H. The prevalence and characteristics of complicated grief in older adults.  J Affect Disord. 2011 Jul;132(1-2):231-8. doi: 10.1016/j.jad.2011.02.021. Epub 2011 Mar 12.

[4] Aoun SM et al. A public health approach to bereavement support services in palliative care. Australian and New Zealand Journal of Public Health. 2012; 36: 14–16. doi: 10.1111/j.1753-6405.2012.00825.x. pmid:22313700

[5] Report on Palliative and End of Life Care in Ireland.  Houses of the Oireachtas. Joint Committee on Health and Children July 2014

[6] Finite Lives: Dying Death and Bereavement An Examination of State Services in Ireland: May 2017; Finite Lives: A study in how the State deals with issues relating to end of life: Part 1-  A Report on how the Civil Service deals with dying, death and bereavement among its own members (2015) Senator ML O’Donnell