How advocates use health economic data and projections: the Irish experience

Approximately 30,000 people die in Ireland each year. Currently over 6000 people access specialist palliative care services annually, a figure that is projected to rise to 12,500 by 2016. In 2006, the Irish Hospice Foundation entered a joint advocacy alliance with the Irish Cancer Society and the Irish Association for Palliative Care. By speaking with one voice and using quality data, these three national voluntary groups were able to influence government and social partners to address clearly identified regional inequities in the provision of palliative care services. Over the past three years, there has been significant public investment in palliative care services, culminating in the recent publication by the national health agency of a five-year plan for a comprehensive national palliative care service. However, the sudden economic downturn in 2008 and the severe deterioration of public finances threaten the implementation of the plan. New services can only be developed if there is strong evidence to illustrate that they are cost-effective in delivering patient care. Having reviewed the international evidence, the joint advocacy group has used this economic evidence to strengthen the case that the development of palliative care services can actually save money in health budgets. The campaign mounted by the joint advocacy group was greatly facilitated by the existence of good data and an agreed evidence-based policy on what constitutes a comprehensive service.