A new palliative care study tour, led by David Oliviere, is heading to the beautiful neighbouring countries of Hungary and Romania. This uniquely structured tour provides in-depth insight into each country’s palliative care history and challenges, while providing a broader overview of this region. Gain insight into how the distinctive spiritual identities and rich cultural heritage of Hungary and Romania have shaped attitudes towards life, death and caregiving.
Both countries began developing palliative care in the early 1990s, following the collapse of communist regimes. In both cases, the concept of palliative care was essentially unknown to the public, to medics, and to policymakers, and the initial impetus came from civil society rather than government.
In Hungary, the first hospice team started in 1991. At that time, the majority of patients died in hospitals alone, with poor symptom control and limited communication with healthcare professionals.
Romania followed a very similar trajectory, with no specific training in place for medical staff to attend to terminally ill patients diagnosed with incurable illnesses.
Romania’s story, however, is inseparable from a single institution, Hospice Casa Sperantei, located along a lake in Bucharest, lined by graceful willow trees. Casa Sperantei has been pioneering palliative care development in Romania since 1992, developing specialist palliative care services in home-based settings, inpatient units, day care centres, and hospital support teams, while providing national and international education programs for professionals.
The organisation partnered with the UK-based Hospices of Hope and grew into a regional centre of excellence. The Princess Diana Centre for Palliative Medicine (a residential training centre) opened in 1997, followed in 2002 by the first inpatient unit. Mobile teams serving poor rural populations in Brasov County were pioneered in 2011, and a new Bucharest facility opened in 2014. In 2019 a centre for children and families affected by life-limiting conditions opened in Adunatii Copaceni, near Bucharest, becoming fully functional in 2021.
Romania moved relatively early on medical recognition: a palliative care subspecialty for doctors was recognised in 2000, and a multidisciplinary master’s degree program has been available at Transilvania University of Brasov since 2010, when the first palliative care academic position was established.
Despite this progress, Romania still faces serious gaps, with paediatric care a particularly acute situation. In 2019 only 1.5% of terminally ill patients received any sort of palliative care, and more than 50% of adults and children diagnosed with cancer in Romania experience unrelieved pain each year. Currently, services are primarily focused on inpatient units, while home care and outpatient services remain largely dependent on charitable organisation or private services.
Hungary’s path shares the NGO-origin story but then diverged toward state involvement. The Hungarian Hospice Foundation (HHF), established in 1991, was the first hospice team in Hungary, tasked with informing the public, healthcare professionals and the government about palliative care through public forums and educational courses.
It took over a decade for a legislative breakthrough, springboarded by a 2001 media campaign. In 2004 the Ministry of Health defined palliative care and the requirements for operation, effectively making palliative care legal in Hungary. That same year, a two-year National Health Insurance Fund demonstration project on financing home and hospital palliative care was launched, during which the number of groups providing palliative care and the number of patients receiving it doubled.
A distinctive feature of Hungary is that patients and families pay nothing; home and inpatient hospice care are reimbursed by the National Insurance Fund. This universal, free-at-point-of-care model contrasts with Romania’s greater dependence on charitable financing. From 2014, physicians in Hungary can take a one-year course to qualify for a license in palliative medicine, and palliative care is taught in medical and nursing undergraduate and postgraduate education.
Hungary’s most persistent structural weakness is the shortage of dedicated inpatient beds, even as home hospice care is relatively well developed. One innovative development has been the “Pécs model” — the Palliative Care Consult Service (PCCS) at the University of Pécs Clinical Centre, which was the first initiative in Hungary to provide palliative care for patients admitted to hospital and manages patient pathways after discharge. It started in 2014 with 300–400 patient visits per year.
This tour examines the interesting parallels and differences between the palliative care journey of Romania and Hungary, looking at how palliative care services are delivered across the neighbouring countries. Participants will learn how Romania has built impressive institutional infrastructure through civil society and international partnerships, particularly around training and inpatient care, and achieved early medical recognition of palliative medicine. However, it remains acutely under-resourced in terms of patient coverage, with home and community care almost entirely dependent on charitable organisations rather than the state.
In contrast, Hungary achieved earlier and more systematic integration into the state healthcare and insurance framework, which has made care genuinely free for patients and home hospice relatively accessible. Its persistent weakness is the shortage of dedicated inpatient beds and the fact that cultural stigma around death still leads to late referrals.
Both countries illustrate a broader Eastern European pattern: rapid pioneer-phase development driven by NGOs in the 1990s, followed by slow and incomplete government integration.
The itinerary will include visits to the Magyar Hospice, Pécs Medical School and its palliative care service, as well as the renowned Hospice Casa Speranței. Participants will meet with the rural palliative care team in the town of Făgăraș and visit Bucharest Hope Hospice, the most modern facility of its kind in the country, including a meeting with one of the pioneers of Romanian palliative care.
It is also a wonderful opportunity to experience the region’s spectacular, unspoilt countryside, medieval villages, rich culture and history and magnificent towns and cities, including elegant Budapest on the Danube. Enjoy excellent local food and wine and immerse yourself in the eclectic ethnic mix that continues to shape the character—and care traditions—of these two remarkable countries.
The Palliative Care in Hungary and Romania study tour, led by David Oliviere and run by Jon Baines Tours, takes place from 13–23 September 2026.
Call 0207 223 5618, email info@jonbainestours.com or visit www.jonbainestours.com/palliative to book or find out more.
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