Abstract
For palliative care, the past decade has been a time of change and growth. In 1985 there were fewer than 100 hospices in Britain; now there are over 200. There are now 400 home care teams compared with fewer than 50 in 1985, and the specialty of palliative care medicine is well established.1 The next few years are likely to be more difficult. Research by Addington-Hall and McCarthy has shown that there is still much to be done.2 Their survey of the carers of 2074 patients who died of cancer in 20 districts showed that 88% of patients were reported to have been in pain, 66% were said to have found the pain extremely distressing, and 61% were said to have experienced it in the last week of life. Higginson has projected an increased need for specialist palliative care from patients with non-cancer diagnoses.3 This might increase numbers of patients by at least 50%. There will be pressure …

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