Approximately 13% of all cancer patients have access to a specialist palliative care service in Hungary. In rural areas, coverage is provided mainly by home palliative care teams connecting to the regional (not palliative) home services.⁴¹ Katalin Hegedus, President of the Hungarian Hospice Palliative Association, describes some of the problems relating to palliative care coverage:

‘…there are different counties in Hungary, there are 19 counties and Budapest and the coverage for home care, for home hospice care, you can see there are some counties where there is nothing, not anything.’⁴²

Agnes Ruzsa expresses her desire for total palliative care coverage:

‘In the future we are working for the cancer patient but we want to cover all the country, all Hungary, we want to provide this care for all cancer patients and the next step we want to provide for the older patients too.’⁴³

Katalin Muszbek describes the advances made in palliative care coverage in Budapest:

‘So we serve our patients here in 12 districts in Budapest, Budapest has 24 districts and we started to work in 12 because we had a small team and the city is huge so that’s why we did not make a contract with all the districts of Budapest because some of them are far from here; we cannot do that and two years ago we applied for a European union grant to start with networking and we found a small district in north Buda that is south Pest and that’s a very innocent area I mean without any type of hospice care and from this European grant we established an office, we found a senior nurse there and also the disciplinary team members they belong to us so this is under our authority…This group is working doing very well, every month they come here once to our meeting, regularly the senior nurse is doing the case discussion meeting every week as we do here, and the documentation or the administration comes here and we send it to the national health insurance and because this work had started there we decided to add two other districts from this south Pest region to this networking and we applied to the municipality and it was also successful and now it will be about 300,000 inhabitants in that district where we are able to provide care…Then we would like to go to the local hospital to ask them for their support to start with a ten-bed unit there. It should be step by step when we start the next region; the next year if it is possible an in-patient unit behind this region and then if we are successful with this we are going to the south Buda region so there may be three or four regions in Budapest that are able to provide good care for the whole of Budapest.’⁴⁴

At a board meeting of the Hungarian Hospice Palliative Association (HHPA) on 13th March 2007, it was revealed that in regions outside Hungary (for example, in Transylvania, Romania), Hungarian nationals are advised to go to the local hospice, but many prefer to return to Hungary for treatment.⁴⁵

In 2005, the ratio of hospice/palliative care services in Hungary was one service per 0.23 million inhabitants (see Table 3). This compares to one service per 0.37 million inhabitants in 2002.⁴⁶

Table 3: Ratio of hospice/palliative care services per million population; Central and Eastern Europe (2005).

Source: EAPC Taskforce on the Development of Palliative Care in Europe (2005) A Map of Palliative Care Specific Resources in Europe. 4th Research Forum of the European Association for Palliative Care, Venice, Italy, 25th-27th May 2006/ Clark, D., and Wright, M. (2003) Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia. Buckingham: Open University Press

Csaba Simko suggests that:

‘The main aim is to spread hospice/palliative care into those regions of the country, where there is no hospice team now. [This] should take care of about 50% of cancer patients in 10 years. The Hungarian Hospice Palliative Association has to control palliative care teams, [therefore] assuring the good quality of professional work.’⁴⁷