Where are the hospice funds?

Cancer diagnosis leads to poverty and unemployment

More and more cancer patients are surviving and want to continue working.

(Bild: thinkstockphotos.com)

A cancer diagnosis at a younger age - 40 percent of patients are between 15 and 65 years old - increasingly leads to poverty and unemployment. In addition, it is currently unclear where the 108 million euros for hospice and palliative care that have been distributed to the federal states since 2022 have gone.

The presentation of the current Austrian Cancer Report 2024 in Vienna by Krebshilfe is a tough one: after figures on the social situation of affected patients were linked for the first time, it emerged that a large number are unable to return to work or can only do so partially, even though they would like to. This is not only accompanied by financial losses up to the poverty line, but the course of the disease is also negatively affected by the psychosocial hardship and sometimes entire families suffer. Added to this is the burden on the health and social system.

Example: A self-employed hairdresser aged 52 who can no longer cut her hair after suffering nerve damage to her fingers as a result of chemotherapy and can no longer get a job, but is also unable to complete a new apprenticeship. In any case, there are few or no job opportunities for her on the labor market.

Or the young single mother with an advanced stage of cancer who loses her job and wants nothing more than to enable her two sons to graduate from high school.

Life saved, job gone
8500 people are diagnosed with cancer every year while still working. This may not sound like a lot, but after just 10 years it adds up to 85,000 people affected. As treatment options continue to improve, long-term survival rates are also increasing. Around 60 percent of patients now recover and are able to continue working. From this perspective alone, protection against dismissal during the illness makes sense.

"The likelihood of remaining employed or returning to work after a cancer diagnosis is heavily dependent on the age of the patient. In particular, cancer patients aged 50 and over are much more likely to retire within two years than people without cancer. This is the result of an analysis for which we combined and evaluated data from the National Cancer Registry with labour market data for the first time," said Dr. Monika Hackl, Head of the Austrian National Cancer Registry at Statistics Austria at a press conference in Vienna.

Ensuring optimal patient care
 This sounds obvious, but has never been surveyed in detail before! Cancer Aid President Prof. Dr. Paul Sevelda is therefore calling on the new federal government to guarantee the best possible care for cancer patients and to cushion the psychosocial effects. Not only from a human and medical point of view, but also from an economic one.

For the first time, existing data on the subject of cancer and employment was linked.

(Bild: Krone KREATIV/stock.adobe)

Main demands:

• Inclusion of psycho-oncological care in standard funding
• Effective protection against dismissal for cancer patients on sick leave
• Mandatory part-time reintegration for employers
• Expansion of oncological rehabilitation services
• Rapid use of available funds for the expansion of palliative and hospice care
• Implementation of "cancer nurses" by the hospital operators
• Structured collection of cancer-related data 

Fear of survival
Sevelda continues: "Every day in the cancer aid advice centers, we experience how enormous the challenges are for those affected and their relatives, including not only the understandable fear for their lives, but increasingly also worries about their job and financial burdens caused by the disease. Since the introduction of the emergency aid fund, for example, it has been necessary to provide financial support to around 4,000 cancer patients who have fallen on hard times through no fault of their own. Austrian Cancer Aid has had to spend around four million euros on this. The money all comes from donations, otherwise this would not be possible."

Cancer patients are increasingly worried about their jobs and financial burdens.

Univ.Prof. Dr. 

Bild: privat, Krone KREATIV

What is particularly shocking is the lack of information sharing across the country with regard to the Hospice and Palliative Care Fund Act, which was passed by the National Council and Federal Council in March 2022 to ensure the nationwide expansion and development of specialized and high-quality hospice and palliative care. The fund was endowed with 108 million euros. In accordance with this law, earmarked grants were distributed to the federal states.

Non-transparent use of funds for hospice and palliative care
The presidents of Austrian Cancer Aid, the Austrian Palliative Society and the Austrian Society for Haematology and Medical Oncology sent a request to all provincial health councils in April 2024 (the letter is available to the editorial team) to find out where these funds ended up.

The result: six federal states responded vaguely, Vienna, Salzburg and Styria did not respond at all. According to the Cancer Report, the information reported back does not allow any conclusions to be drawn about the exact use of the funds. Once again, Krebshilfe is appealing for transparency. Nevertheless, a continuous expansion of the corresponding care is evident.

Even if the topic of end-of-life care is not a particularly attractive one, it concerns us all. Not only in the event of illness. "Hospice and palliative care is more than just medical care - it is a sign of human solidarity and an indispensable part of our society. In the last phase of life, every person needs not only medical help, but above all human closeness, comfort and dignity. We must work together to ensure this," says Prof. DDr. Eva K. Masel, board member of the Austrian Palliative Society (OPG) and Austrian Cancer Aid.