1. Palliative care in accessing and new EU member states Daniela Mosoiu MD. Hospice Casa Sperantei Romania

2. 22.408.393 INHABITANTS 238.391 KMP ROMANIA:

5. Joining EU 2004 Czech Republic, Cyprus, Estonia, Hungary, Latvia, Lithuania, Malta, Poland Slovakia, Slovenia 2007 Bulgaria, Romania

6. GDP/capita Int$ Slovenia 19 600 Czech Republic16 800 Hungary14 900 Slovakia14 500 Estonia14 300 Lithuania12 500 Poland12 000 Latvia11 500 Bulgaria 8 200 Romania 7 700 The World Fact Book www.cia.gov/cia/publications/factbook/rankorder/20 04rank.html

7. Human Development Index Slovenia 0.879 (29) Cyprus0.873 (30) Czech Republic0.849 (33) Hungary0.835 (35) Slovakia0.835 (36) Poland0.833 (37) Estonia0.826 (42) Lithuania0.808 (49) Latvia0.800 (53) Bulgaria 0.779 (62) Romania0.775 (63 ) UNDP Report 2002

14. Ratio of palliative care services/million population, (2002) Estonia1: 0.14mPoland1: 0.15m Slovenia1: 0.32mBulgaria1: 0.36m Hungary1: 0.37mLatvia1: 0.48m Lithuania1: 0.62mCzech R1: 1.02m Romania1: 1.07mSlovakia1: 1.33m Source: Clark D, Wright M (2002) Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia. Buckingham: Open University Press

15. WHO Recommendations

18. Education of professionals Palliative care recognized as a medical specialty /subspecialty: Poland Czeck Republic Romania Lithuania

19. Doctors650 Nurse and nurse assistants1560 Social workers66 Home care assistans143 Psychologists21 Pharmacists136 Volunteers82 Clerics6 Fundraisers10 Managers8 Students295 International participants56

20. Public awareness Hungary 2000 public campaign raised awareness with 36% free TV air time for spots for 2 months 100 billboards across Budapest Adverts in media Interviews, charity events Poland Warsaw-children’s hospice

21. Funding Palliative care free of charge for the patients International grants, fundraising in the communities Through the Insurance system, government (Poland, Hungary, Lithuania, Romania, Slovenia, Bulgaria)

22. National Policy national committees in the government to address the issue of palliative care Poland Slovenia Lithuania Hungary +/-Romania

23. Conclusion Initiatives and models of good practice in all the countries Services offered mainly for adult cancer patients, few services for children Development of services not directly coordonated with economic indicators Low coverage under 5-10% except Poland Funding coming mainly from the voluntary sector

24. I will just once pass through this life. Thus, if I can offer a little kindness, or do good even in a small way to a fellow human being, I promise to do it now, without hesitation, because there will be no second chance. William Penn