Maharashtra Palliative Care Policy continues to be a promise, an unfulfilled promise. A promise made by the government to make end of life care a priority, but not kept even today, six years later.
It’s six years since Maharashtra adopted a Palliative Care Policy, on paper, in 2012. In real, nothing has changed, except the funds kept aside for the same being unused, year after year.
A comprehensive policy is in place, with areas to work clearly stated, and funds allocated. There is an enthusiastic group of doctors, nurses, counselors, volunteers, who are part of the Mumbai Palliative Care Network dedicated to the cause comfort care to the terminally ill or other end of life care candidates such as the elderly. They meet senior officials in the health ministry on a regular basis to nudge the policy into action.
So far all they managed to do is identify eight districts in the state to pilot run the policy and train a few doctors and nurses from a couple of hospitals in the city. In villages however, social health activists (asha workers) with basic training received have been trying to spread word about end of life and palliative care, often referring patients and relatives to hospitals and hospices offering this specialist care. But is this enough, for a six year old policy?
Is nobody bothered?
"Of course it is highly frustrating, disappointing," said a palliative care specialist at a gathering held recently to plan Mumbai's World Palliative Care Day event.
A group of palliative care specialists and end of life care advocates who had gathered at the Mumbai Press Club expressed disappointment at the non-starter which they all hoped to take off in the state in a big way.
"Telungana, which does not even have a palliative care policy in place, offers palliative care at every health centre! That's initiative. Maharashtra, which has been sitting on a policy for the past six years is still taking one step forward, two step backward," said a palliative care doctor," who did not wish to be named.
"Every year, most of the funds allocated for palliative care goes wasted, which runs in many lakhs," she explained. "What little is spent goes in training contract appointees who leave for greener pastures wasting precious money, which should have been used in relieving patients’ suffering from life-limiting illnesses of excruciating pain and discomfort."
So, why is the Maharashtra Palliative Care a non-starter?
Experts in the field say it is because it is totally dependent on bureaucrats in the health
department. Most of them are apathetic to the cause. There is hardly any political or bureaucratic will in implementing the policy seriously since it mostly concerns those at the end stages of life, the chronically ill or fragile elderly.
Mumbai Palliative Care Network organised an awareness walk and street plays under the theme ‘Because I Matter’ at Bandra to mark World Palliative Care Day on October 13.