This year’s focus for the development of palliative care in China is post-graduate education in palliative care. Chinese clinicians identified the EAPC Recommendations for the Development of Postgraduate Education as the model to follow. The medical recommendations were developed by Professor Frank Elsner and the EAPC taskforce on medical education.
Prof Elsner has already initiated palliative care training in Beijing and Prof Payne plans to involve 2 colleagues who speak Mandarin in the efforts to develop a generalist palliative medicine training course. Ideally, this course would be presented by Chinese trainers based on the EAPC framework adapted to the Chinese context.
Prof Payne originally became involved with the Cancer Rehabilitation and Palliative Care Committee in 2009 through Professor Yu, one of the leaders of the committee. Prof Yu is a medical oncologist, described by Prof Payne as a dynamic woman, full of energy and committed to the development of palliative care in China.
Prof Payne commented that many people she met at the conference read English publications about palliative care although they may find it difficult to communicate in English. Prof Yu read about the Budapest commitments launched at the EAPC conference in Budapest in 2007 and approached Prof Payne when she was vice-president of the European Association for Palliative Care. Prof Payne and a group of Chinese oncologists held a series of meetings to develop a consensus about adapting the Budapest Commitments to the Chinese context. These have been published in an article with Dr Qi Mei as lead author on the Wuhan Commitments documenting the aspirational statements for the development of Chinese Cancer Palliative Care.
Prof Payne observed that palliative care in China is very much hospital-based, although there are a few hospices in the communities; and also that palliative care has a cancer focus in China. She visited a Cancer Hospital in Wuhan at the request of nurses from the hospital, and found it very busy with pressure in terms of space.
Cancer patients in the rural areas have to travel to the cities for treatment and cancer is often diagnosed late with prevention, screening and early diagnosis receiving less attention. Prof Payne comments that many people including doctors are smokers, that there is no restriction to being permitted to smoke in public spaces and there are high rates of lung cancer in China.
Many patients also consult traditional Chinese medicine practitioners and take traditional medicines together with their oncology treatment. Medical students study modules in traditional Chinese medicine as part of their undergraduate training.