The demographics of living and dying continue to evolve rapidly even in high-income countries.  The social and health systems delivering care continue to be challenged as these changes manifest themselves. 

We will not have the community or professional workforces to provide care for many people who have life-limiting illnesses in the future. How we plan for and respond to these challenges is, arguably, the biggest issue facing palliative care services internationally.  

The challenge is in education (of friends, families, and health professionals), research (health services research defining the very best models of care especially in the context of emerging technologies) and systems delivery. 

Only an intersectoral approach is going to deliver the quality of care that the community has come to expect.  This will involve social services, health services, treasury, and our social security systems. This will still be in the context of the funding for palliative care having to compete against every other part of health for its core funding.  

The decisions that we make now will have far reaching effects into the care that generations ahead will experience. Careful evaluation of the optimal models of care and the outcomes we, as a community want to achieve, are urgent and necessary conversations.