There are three national and professional organisations concerned either totally or in part with palliative care: for example, promoting awareness, organising or advising on training programmes, raising or providing funds for services; the Israeli Association of Palliative Care (Tmicha); the Israeli Cancer Association; and the Israel Palliative Medical Society, which is affiliated to the Israel Medical Society.

Israeli Association of Palliative Care (Tmicha)
Established as a voluntary (not for profit) association in 1993, the Israeli Association of Palliative Care (Tmicha) (IAPC) is an organisation for all health professionals and trained volunteers actively involved in palliative care in Israel. IAPC membership includes leading figures in palliative care, who encourage professional and public education about the concepts of palliative care and promote the development of services. Membership, which is currently around 800, is open to all health professionals, volunteers and interested lay people that identify with its philosophy.

Initially chaired by Dr Ilene Ora Cibulski the IAPC produced a bi annual Hebrew/English newsletter ‘Support’ until her retirement in 2000.⁶⁵ Since 2001, the IAPC has been chaired by Mali Szlaifer, who is dedicated to continuing to develop training and networking for its members and for palliative care services around the country. IAPC has an elected Board of Directors that aims to represent all the professions involved in palliative care and from a range of different services. The work of IAPC includes:

• Convening annual conferences, regular meetings and study days, seminars, and training programmes for health professionals; including physicians, nurses, social workers and also for trained volunteers, all of whom are actively working in the palliative care services.⁶⁶
• Involving members in teaching on the professional palliative care programmes in Israel. Promoting clinical and academic research by its members and the dissemination of findings within the association.
• Campaigning via conferences, publications and the media to have palliative care included in the NHI legislation; and to advocate for the rights of terminally ill patients with palliative care included in the NHI.
• Supporting local projects that are developing and expanding services throughout the public sector.
• To seek to define palliative care and develop standards of quality and adequate service provision.
• Collating data on existing services, with the aim of publishing a guide to services for use by health professionals and the public.⁶⁷

The association puts an emphasis on the importance of collaboration between health professionals from different disciplines with the aim of encouraging maximum support for patients and families. IAPC is a collective member of the European Association for Palliative Care (EAPC).

Israel Cancer Association (ICA)
Established in 1952, as a not for profit non government organisation, the Israel Cancer Association is dedicated to the education and development of services for professionals working in the field of oncology and to promote treatment, support and services for cancer patients and their families. The ICA has a long term aim to ‘reduce the mortality and morbidity rates of cancer.’⁶⁸ Since 1983, with the opening of the first hospice (Tel Hashomer) which was funded collaboratively by the ICA, MoH and HMO Kupat Holim Clalit, the association has also addressed the need to support and fund the development of palliative care in Israel. The association is now the largest national source of non government funding of palliative care services.
The ICA works both independently and in collaboration with HMOs and the MoH, to fund service provision, work placements and posts (physicians and nurses) education, training and research. Since the early 1980s Aliza Yaffe, ICA Head Nurse has, with other professional colleagues, promoted the concept and development of specialist oncology nurses, which now includes offering additional palliative care training, by providing grants for training and posts. The concept of the specialist oncology nurse was initiated in part by recognising and responding to the needs of health services and in part by those health services realising the benefits of having specialist nurses, as Aliza Yaffe explains:

‘The manager of the health service in that specific section, came each year to Israel Cancer Society and said we would like to have an oncology community nurse. I did lots of lobbying for a while, and that nurse, her job would be this and that as needed, [for example] specifically in Arab communities she will take care of, let’s say, more elderly people. The Cancer Society (ICA) gives a grant of half-time for a registered oncology nurse for three to five years. Afterwards, they [the community health service] will absorb that job.’⁶⁹

Those oncology nurses working in community health centres who have completed palliative care training can now offer nursing care at the end of life, alongside their work with cancer patients during and after treatment. The ICA manages a website which provides information about promotion of cancer prevention, raising public awareness for example, about smoking. ICA also runs media campaigns, produces multi-lingual leaflets and publications about cancer prevention, early detection and available cancer related services. The association has a telephone helpline providing public information.⁷⁰

Israel Palliative Medical Society (IPMS)
This organisation, established in 1996, is a branch of the Israel Medical Association. and chaired by hospice physician Michaela Bercovitch. Election to the board of directors is restricted to physicians but general membership is open to other health professionals including nurses, physiotherapists and social workers. The aim of the IPMS is to represent physicians and other health professionals involved in palliative medicine and to promote palliative medical services, education and research: there are plans to develop a training fellowship.⁷¹ The IPMS, together with the other national organisations, is actively working towards the recognition of palliative medicine as a specialty by the Ministry of Health and the development of national clinical guidelines in palliative care.

The society, with its own publication, the Journal for Palliative Medicine, encourages meetings, seminars and participation in national and international conferences, and links with national and international palliative medicine organisations. The IPMS is a collective member of the European Association for Palliative Care (EAPC).⁷²

There are two international organisations: European Association for Palliative Care (EAPC) and the European Medical Oncology Society (ESMO) both of whom support and provide educational links for palliative care professionals in Israel, involving professionals in conferences, networking, and dissemination of publications.⁷³