Funding (for insured patients) is covered by the regional sickness funds (which have a contract with the Oncology Centre), but the goal is to gain recognition for palliative care within the state budget.
In 1999 palliative care was recognised for the first time in the contracts of Latvia’s 8 regional sickness funds.4 Problems with the Sickness Funds continue, however, for example the fund in Riga (covering 1 million people) collapsed completely for several weeks in 2002 and no cover of any kind was available.
Good co-operation with the Sickness Funds is deemed essential if palliative care in Latvia is to survive. Politicians in the country are said to ignore palliative care (‘saying “it is good” but doing little or nothing’). The general public is said to be largely unaware of palliative care, but 80% are in favour of euthanasia.5 The overall lack of resources is reflected in the low salaries of health care workers, which range between $US 120-200 per month. There is an acute lack of available journals and up to date books about palliative care and the lack of computing facilities is also a problem.
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