The need for palliative care is increasing as the world population ages. According to studies, such care is required for more than 61 million patients and their families worldwide.

In Greece, the relevant healthcare provisions are considered fragmentary, both in terms of the range of services provided, as well as in regard to state funding.

Greece is one of the countries where specialised palliative care services are deemed inadequate and are mostly provided by NGOs to outpatients, or at home, and to a limited range in relation to the country’s population.

The number of patients in need of palliative care in our country exceeds 135,000 persons annually and is set to increase in the coming decades. Given the fact that there are currently only three such providers in the country, the capability of offering palliative care services is considered to be extremely limited and far from the standards that apply in most European countries.

The proposals of the Greek Patients Association:

     Development of the appropriate institutional and legal framework for the establishment and operation of palliative care services in the country, including the regulatory framework for the availability of drugs.

     Establishment and operation of the necessary facilities throughout the country, according to the standard specifications.

     Creation of a pool of healthcare professionals, who will be well-trained in matters of palliative care, in order to offer their services to patients who need them.

     Promoting research to improve the design, implementation and evaluation of services.

     Raising awareness among families, caregivers and across society regarding the importance of providing efficient palliative care services, and ensuring effective cooperation between the stakeholders, under the coordination of the Ministry of Health.

The empowerment of the patients constitutes one of the main conditions for the betterment of healthcare quality. It is both a prerequisite and a result of a health system that implements policies focused on, and guided by, the recipient of healthcare services and their experience.

Patients’ empowerment is defined in many ways, depending on the context and goals. A comprehensive definition is: “the process that helps people gain control of their lives and increases their ability to take initiatives and act on issues which themselves perceive as important”. Empowerment aspects include health literacy, co-decision making and self-management.

Patients with chronic conditions are often referred to as important resources of the healthcare system, but remain unused. It is a proven fact that patient-centred healthcare models achieve better quality of care and contribute to system efficiency. However, the concept and process for patient empowerment remains underdeveloped in Greece.

The proposals of the Greek Patients Association:

     Implementation of actions to promote health literacy of patients and citizens in general.

     Development of patient’s associations skills in order for them to represent health care recipients and assert their rights more effectively.

     Use of internet and new technologies for the dissemination of information that will contribute to patient empowerment.

     Participation of patient representatives in health policy decision – making process.

Access to comprehensive and quality healthcare services is important for health promotion and sustenance, prevention and management of diseases, the reduction of disabilities and mortality rates, and the achievement of healthcare equality for every citizen.

Universal access means to ensure that everyone has access to quality health services wherever and whenever they need them, without financial burden. This includes a full range of necessary healthcare services throughout one’s life, from health promotion to prevention, treatment, rehabilitation and palliative care, always based on a strong primary healthcare.

The proposals of the Greek Patients Association:

     Transparent, inclusive, modernised health governance, through efficient and effective public system administration.

     Development of a high- quality primary healthcare network throughout the country.

     Investments in healthcare and other social infrastructure that will contribute to the mitigation of regional disparities.

     Improving quality, enhancing safety and streamlining hospital care.

     Utilisation of innovative technologies to ensure access to healthcare services.

     Digital modernization of the healthcare system and promotion of information technology and e-services.

     Measures to improve the sensible use of drugs and diagnostic tests.

Efforts to modernise public psychiatric care and mental health care, over the years, have led to gradual reforms and individual system improvements. From the asylum psychiatry with the institutional, enclosed facilities, cut off from society, we gradually progress to a different overall approach of the mentally ill, to a social- and community-oriented psychiatry and psychosocial Rehabilitation.

The national reality in the field of mental health faces numerous and complex challenges. Furthermore, integrated interventions are required, in order to meet the existing and emerging needs for mental health services, which will ensure equal access, prevent social exclusion and support the social and financial integration of people with mental health problems.

The proposals of the Greek Patients Association:

     Reinforcement of mental health units, complete the deinstitutionalization process and make beds available for acute psychiatric cases in general hospitals.

     Creation of geriatric units and care facilities for patients with dementia.

     Accelerate the operation of medically supervised injecting rooms.

     Development of guidelines for handling acute cases, and the treatment and care of patients under involuntary hospitalisation, pursuant to article 69 and their treatment follow- ups.

     Establishment of audit and patients’ rights protection committees in every mental health unit, with the participation of members of Mental Health Associations.

     Creation of emergency services in general hospitals, with specialised personnel, to ensure de-escalation in critical cases.

     Implementation of the current legislation regarding involuntary hospitalisation and all the deadlines set by Law 2071/12, and now also in accordance with Articles 12, 14, 15, 16, 17, 22, 25, and 28 of the Convention on the Rights of Persons with Disabilities.

     Individualised assessment of the apparently mentally ill patient’s ability to make their own medical decisions, pursuant to Article 12 of the Convention on the Rights of Persons with Disabilities.

     Training of all health and mental health professionals regarding the human rights of people with mental health issues, according to the provisions of the Convention on the Rights of Persons with Disabilities and the relevant WHO guidelines (WHO Quality Rights), in collaboration with Mental Health Associations.

     Provision of personalised information to all patients with mental health problems about all their human rights, including the right to appeal against an involuntary hospitalisation ruling, and in collaboration with Mental Health Associations.

     Facilitate the supported decision-making of patients and their communication with patient advocates, during the course of their treatment, now under the scope of Article 12 of the Convention on the Rights of Persons with Disabilities and through Mental Health Associations.

     Ensuring effective access to the justice system, without prejudice, with an effective monitoring mechanism and by ensuring effective access to legal services and the provision of free legal aid to all involuntarily treated patients, according to Article 13 of the Convention on the Rights of Persons with Disabilities.

     Regulating the mandatory transport of apparently mentally ill patients by specially designated EKAV vehicles and the subsequent training of these vehicles’ crews for the safe transport of the apparently mentally ill, with appropriate respect for their dignity and personality.

     Training Hellenic Police officers about suicidal cases and the provision of emergency psychiatric intervention, in collaboration with the Mental Health Associations.

     Reinforcement of Mobile Mental Health Units located in remote areas, away from the urban centres.

     Establishment of house calls and crisis intervention to be performed by multidisciplinary community groups throughout the country.

     Creation of housing facilities in all regional units and support of autonomous and semi-autonomous living facilities by EOPYΥ.

     Creation of social inclusion and vocational rehabilitation facilities in every regional unit with the cooperation of Mental Health Associations.

     Development of guidelines concerning the treatment of acute cases, the method of treatment and care of patients treated under article 67 involuntary treatment status, and the follow-up treatment.