The Revd Dr Michael Wright

Global Reach


Biography: Global Reach


For someone who likes travelling and has an interest in people - their stories and their culture - the opportunity to work with my PhD supervisor on an international project was irresistible. The idea was raised during a discussion between Prof David Clark and Dr Kathy Foley over dinner in the Autumn of 2000 and involved a first-ever review of hospice and palliative care development in the 28 countries of Central and Eastern Europe and Central Asia. Geographically spread and culturally diverse, these countries were in transition following the decline of communism and, with the exception of Poland, had very recent services, the oldest dating from 1990.


As I travelled to countries like Poland and Hungary, Slovenia, Slovakia, Romania and Russia visiting services and seeking data from multiple sources, it quickly became apparent that collaboration with a wide-ranging network of international colleagues was essential to the study’s success. Since then, this ‘community of effort’ became a key feature of our approach and we’ve been touched by the gracious assistance offered to us by supportive individuals in so many parts of the world.


During the report-writing stage of this first study, as we considered the possibilities for future research and took into account the needs of clinicians and policy makers, we came to the conclusion that a place existed for a research-based  international observatory that focused specifically on care at the end of  life.


This concept came to fruition in 2003 when David Clark invited Anthony Greenwood and me to move with him from the University of Sheffield and establish the International Observatory on End of Life Care in the Institute for Health Research at Lancaster University. It was an exciting prospect.


From these early beginnings, the Observatory (  has grown exponentially. By 2009 its major programmes had come to include education and training, patient and carer experience, and service and policy evaluation - in addition to the global development of palliative care and historical analysis. Listed on the website at that time were 29 staff and 12 postgraduate research students.


My interests, however, remained grounded in the spiritual/ hospice history/ global development arena and the fascinating questions that arise. Why hospice, why here, why now? Who are the champions? What draws them to the hospice-palliative care scenario? What does spiritual care look, who gives, how do we know when it’s happening and what are its effects? What aspects of palliative care are generalizable across cultures and what are culture specific? What has palliative care come to mean in the experience of a community? How does it mesh with public health systems? Can levels of development be determined, country by country, throughout the world?


The search for these answers has, during the last nine years, forged pathways to five continents and contributed to more than 60 country reports, published in paper form and also on the Observatory website. They give an intriguing view of a still-young specialty, the barriers to development, and some achievements to date.


From a global perspective, however, a bigger picture emerges: an impression that hospice-palliative care is not just a form of symptom control, for it chimes with primal notions of life and death. There’s a catalytic effect on communities which generates empowerment and builds social capital. Passionate activists confront governments, fired by a commitment to the most vulnerable and an unshakable determination to make a difference. And, underpinning everything, is a common sense of human worth. Although there’s still much to do—and half the countries in the world have no palliative care service yet - the reviewing and recording of this ‘history of today’ provides an illuminating glimpse of human values in the face of mortality.












Hensall Book


Early Days


Dual Role

New Direction

Global Reach