Interview with Dr Agnes Ruzsa – conducted by Michael Wright, Budapest
(October 2003)

In 2003, Dr Agnes Ruzsa, Second President of the Hungarian Hospice-Palliative Association (HHPA), was interviewed by Michael Wright in Budapest. In this interview, Agnes describes how she first became interested in oncology through a personal experience involving a family friend, and how she eventually began working as a full-time oncologist and part-time hospice physician. Agnes details the events that led to the formation of the HHPA in 1995, and the challenges faced during this period, including the difficulty in providing comprehensive palliative care coverage, numerous financial barriers, and the absence of a minimum decree standard. Agnes also discusses the ethical dilemmas involved in the provision of palliative care in Hungary, particularly in relation to the concept of ‘truth-telling’ and the stigmatised and taboo status surrounding death and dying, and highlights the role that spirituality plays in relation to the provision of palliative care, with particular emphasis on the difficulty of maintaining religious and spiritual belief during the period of Communism.

Interview with Dr Agnes Ruzsa – conducted by David Clark, Miskolc
(April 2004)

Agnes Ruzsa was interviewed again in Miskolc in April 2004 by David Clark. In this interview, Agnes discusses her role as President of the HPPA and her work as an oncologist at Zala County Hospital, and the ways in which these dual roles interact and intertwine with each other. She describes her increased involvement in developing palliative care education programmes for oncologists (for example, in ‘breaking bad news’) and also provides insight into the new quality-of-life research programmes that are being developed. Agnes describes the OSI meeting in Budapest, and the changes taking place at the policy level in Hungary (for example, the introduction of palliative care as an integral part of the National Cancer Control Programme).

Interview with Katalin Muszbek – conducted by David Clark, Budapest
(April 2004)

Katalin Muszbek took her degree in Medicine in Budapest and her diploma in psychiatry in 1978. She was Assistant Professor of Psychiatry at the Jahn Ferenc Hospital, Department of Psychiatry, and Chief of Psychiatry at the National Institute of Mental Health, Department of Psychotherapy. Later, she was Chief of Psycho-Oncology at the National Institute of Oncology, and at St. Stephen Hospital, Gyneco-oncology Department. She is currently Director of the Hungarian Hospice Foundation.

Katalin was a founding member of the Hungarian Hospice Foundation in 1991, and was President of the Hungarian Hospice-Palliative Association from 1995 until 2001. At present, she is also honorary president of the Hungarian Psycho-oncology Society and Vice-president of the Eastern and Central European Palliative Task Force (ECEPT). Katalin is also an editorial board member of Progress in Palliative Care and her curriculum vitae lists numerous international presentations.¹¹⁷

In 2004, Dr Katalin Muszbek was interviewed by David Clark in Budapest. In this interview, Katalin describes the changes in the provision of hospice and palliative care in Hungary since she was interviewed in 2002. These include the recent National Congress, palliative care education and training programmes, and the continuous lack of finance.

Katalin details the lobbying activities that both she and Katalin Hegedus had been involved in over the last few years with the National Health Insurance Fund, involving the financing and regulation of hospice and palliative care. She recalls their delight at finally establishing a minimum decree standard following a lengthy and difficult administrative process.

Katalin speaks at length about the definition of hospice and palliative care in relation to funding; she also highlights the importance of obtaining funding from other sources and the ways in which this might be achieved. Finally, Katalin describes the difficulties in communicating the meaning of hospice and palliative care to the general public and the ways in which the television publicity campaign featuring Hungarian celebrities improved public perception.

Interview with Katalin Muszbek – conducted by Tom Lynch, Budapest
(March 2007)

In March 2007, Katalin Muszbek was interviewed by Tom Lynch in Budapest, and highlighted the importance of recent policy changes in the country and the impact these changes had on the provision of hospice and palliative care. These policy changes included: the 2004 Ministerial decree relating to the minimum standards for hospice and palliative care; the 2004 National Health Insurance Fund/Ministry of Health decision to fully integrate hospice and palliative care into the Hungarian health care system; and the 2006 Ministry of Health National Cancer Control Program. In addition, Katalin spoke about the public perception of hospice and palliative care in Hungary following the recent television publicity campaigns, and the ways in which the provision of psycho-social support provided to hospice and palliative care patients has evolved in recent times.

Interview with Professor Katalin Hegedus – conducted by Tom Lynch, Budapest
( March 2007)

Katalin Hegedus is President of the Hungarian Hospice Palliative Association and Associate Director at Semmelweis University, Institute of Behavioural Sciences, Budapest. Katalin took her MSC degree in Sociology in Budapest in 1976, and her PhD in 1994. She began working in palliative care in 1992 as a hospice volunteer at the Hospital of Újpest and after that in St. Stephan's Hospital, Budapest. Following completion of her psychological training in 1996, Katalin began work as a mental health specialist at St. Ladislaus's Hospital, Hospice, Budapest. From 2001- 2004 she was hospice mobile team leader at the Jewish Charity Hospital, before commencing her position at the University of Semmelweis.

Katalin has attended a number of training courses in Europe, the Unites States and Israel, and is generally acknowledged as having made a major contribution to the palliative care education and training system in Hungary. For the period 1997-2001, Katalin won the Szechenyi Scholarship for research activities into topics that included the rights of dying people, ethical aspects of euthanasia and ethical aspects of palliative care. Her research/development projects since 1992 have included: attitudes of physicians, nurses and medical students towards death and dying; introducing hospice/palliative care into the curricula of medical faculties; and the construction and development of professional palliative care guidelines for dealing with terminally ill patients suffering from malignant tumours.

Katalin is an expert member of the Council of Europe: Committee of Expert on the Organisation of Palliative Care, the national coordinator of the European Association of Centres of Medical Ethics, and a member editor for the Hungarian Society of Thanatology. Katalin is also responsible for the Central and Eastern European and Former Soviet Union Palliative Care Online Newsletter, edited in English and Russian languages. This monthly newsletter covers palliative care activities in these regions and is developed by the Hungarian Hospice-Palliative Association, with the support of the Open Society Institute Network Public Health Program's International Palliative Care Initiative and the European Association for Palliative Care. The goal of the newsletter is to communicate the activities, diversity, challenges and progress being made in palliative care development, to foster networking, communication in Central and Eastern Europe and the Former Soviet Union, and also to inform those throughout the world about the regional effort.¹¹⁸

Professor Katalin Hegedus, Semmelweis University Institute of Behavioural Sciences, Budapest (March 2007)

In March 2007, Katalin Hegedus was interviewed by Tom Lynch in Budapest, and described a number of recent policy changes in Hungary relating to the provision of hospice and palliative care. These policy changes included: the 2004 Ministerial decree relating to the minimum standards for hospice and palliative care; the 2004 National Health Insurance Fund/Ministry of Health decision to fully integrate hospice and palliative care into the Hungarian health care system; and the 2006 Ministry of Health National Cancer Control Program. In addition, Katalin spoke about the ongoing development of hospice and palliative care education and training initiatives in Hungary, and discussed some of the ethical dilemmas associated with the provision of hospice and palliative care in the country. The forthcoming EAPC Congress to be held in Budapest in June 2007 was of particular relevance to Katalin, who has been on the board of the EAPC since 2003, and is the chair of the Local Organizing Committee of the Congress. During this interview, Katalin stressed the importance of being the first Eastern European country to host the Congress and the ways in which she hoped this would result in promoting an enhanced sense of inclusivity amongst the countries of Central and Eastern Europe and Commonwealth of Independent States.