Karnataka government’s Palliative Care Policy is set to focus on providing evidence-based cost-effective total care to morbid life limiting illness like cancer, HIV, end stage renal disease. The state is the third in the country after Kerala and Maharashtra to launch the policy.
The government will also approach the Medical Council of India to permit MD in Palliative Care in the state to offset the shortage of dedicated experts. In the next two years, efforts will be made to offer palliative care across 6 districts namely Bengaluru, Raichur, Mysuru, Shivamogga, Mangaluru and Kalaburagi through Survana Arogyashree Suraksha Trust which would empanel the hospitals.
So long India reported poor palliative care for cancer primarily because of reluctance by doctors and nurses. But in 2010, MCI recognised this as a speciality. In 2012, Union government formulated a national programme for palliative care (NPPC). Further, there is a paucity of oral morphine drug, lack of training to use narcotics.
The key objective of the palliative care policy is to ensure appropriate standards are made available to patients suffering from pain. “Karnataka government has been proactive in approving and recommending the policy to be implemented and integrated into the existing health care system. Its implementation would decrease unnecessary admission to ICU, make care economically viable and enable required medical care to patients at their residences,” stated Dr PP Bapsy, president, Bangalore Oncology Association.
To begin with, Kidwai Memorial Institute of Oncology, Bengaluru’s Dr PV Ramamani senior specialist along with Vivekananda Youth Moment, Mysore will impart training on symptom management, drug procurement and dispensing to one doctor, nurse and pharmacist from each district’s community health centre and primary health centre. Each district hospital will set up palliative care unit to ensure availability of morphine, monitor and document the programme. Palliative care will be included in the curriculum of medicine, nursing and paramedical courses at graduate level.
The WHO recommends palliative care policies to be integrated into public health system to improve quality of life, decrease suffering besides extend psychological and emotional support to patients and families.
In Karnataka, around 4.5 million succumb annually of cancer. It is estimated that 60 per cent of this population would benefit from palliative care whereas less that 2 per cent actually have access to it.
According to Dr. KB Lingegowda, director Kidwai Memorial Institute of Oncology, the lacunae existing in the education system and the drug availability are the main reasons for poor palliative care in the country. With poor awareness, palliative care is often misconstrued as terminal care. Hence patients from other medical centres do not get a reference on time. Although palliative care commenced in 80s, facilities are scattered and scanty even in the metros with hardly any in the rural areas.
Paucity of palliative care facilities cripples patients. Kidwai which competes with corporate hospitals is ranked fifth in the country and in the government sector it is the second after Tata Memorial Cancer Hospital, Mumbai, stated Dr. Lingegowda.