A survey of Irish palliative care services.

There has been no national policy directing the development of palliative care services in Ireland. Over the last 25 years different palliative care services have been established around the country, due largely to a strong and concerted effort on the part of voluntary groups. A study was carried out to determine the structure and process of all adult palliative care services in Ireland, to determine, where possible, the costs of providing these services and to assess the need for palliative care services in Ireland. All adult palliative care services (24 home care services, three inpatient services and one acute hospital service) in existence at the end of 1993 were circulated and 26 returns received (response rate 93 per cent). Twenty-five counties were covered by palliative care services, serving approximately three-quarters of the national population. Less than 10 per cent of patients had non-cancer diagnoses. Wide variation in staffing levels, workload, travelling, assessment of need and finance arrangements was reported. There is a need for further debate on the breadth and scope of palliative care services that should ideally be provided in Ireland, and how they should be funded in the future.