ABSTRACT
The above quota tion is taken from a recent UK report which emphas izes improving existing end of life care ser vices and creating al tern atives to them. It is used here to emphas ize an im port ant message: present stand ards of care in the UK do not meet the social needs of patients and com munit ies. A pub lic health approach, also known as health promoting palli at ive care, highlights the need for palli at ive care ser vices to promote and facilitate com mun ity engagement and for state inter ven tion within a social model of health. Health promoting palli at ive care is a growing social movement throughout the world. In the challenging envir on ment of the UK, there are some encouraging de velopments. This chapter de scribes the background and rationale for health promoting palli at ive care, including key demographic, epidemiological and social trends, and it also provides examples of pol icy and practice de velopments. Health promoting palli at ive care draws upon the prin ciples of social justice, equity and ‘health for all’ from the new pub lic health. Such prin ciples are beginning to be applied in the UK. The late twentieth century de velopment of hospice and palli at ive care in the UK and the world wide de velopment of health promoting palli at ive care have brought some pos it ive de velopments. For example, fewer people now die in phys ical pain and the UK recently came first in an inter na tional league table for end of life care (Economist Intelligence Unit 2010). At the same time, we also need to recog nize that from the turn of the century specialization and profes sionalization has brought something of an expert takeover of death and dying in ways that have both dehumanized and removed them from every day ex peri ence and consciousness. As this volume indicates, health promoting palli at ive care offers a way forward. This chapter could not have been written without the help and support received from so many committed people and for this I am very grateful.
