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A large part of the state palliative care policy is not fully implemented and many tertiary care hospitals, even in the government sector, don’t offer palliative care. This is happening when many more people are recognizing the need for palliative care for those with other chronic diseases, something Kerala emulated much earlier. “Though most patients we get are cancer patients, this is slowly changing as other departments are also referring patients with serious health related suffering,” said Dr Chitra V, Pain and Palliative medicine, Amrita Institute of Medical Sciences, Kochi.