Osakidetza has unveiled HaurSare, a new pediatric palliative care network designed to offer comprehensive support to children and their families. This service will ensure medical and emotional care, both in the hospital and at home, during severe illnesses and at the end-of-life stage, with 24/7 availability. The Minister of Health, Alberto Martínez, emphasized that “the home becomes a central space for care” through this network, addressing a crucial need for many families.
The core of this network will be the case manager nurse for complex chronic conditions and pediatric palliative care. This specialist will lead the management of the most complex cases, provide home care, and act as a link between the hospital, Primary Care, the family, the school, and social services. Iratxe Salcedo, head of Pediatrics at Osakidetza, stated that “the deployment of the specialist pediatric nurse in the Euskadi network is a historic milestone.” In its initial phase, HaurSare will have 16 professionals, making Euskadi the first region in Spain with specialist pediatric nurses in Primary Care. Additionally, teams will be reinforced with a psychologist per territory, as emotional support is fundamental throughout the entire process.
“"When a child becomes seriously ill, we don't just treat a disease. We accompany a family, sustain a life, and defend dignity. In Euskadi, caring is not an option, it is a public responsibility."
According to data provided by Martínez, minors with complex chronic pathologies represent 6.8% of the pediatric population, and approximately 90 out of every 10,000 children under 19 require pediatric palliative care. These patients account for 20% of pediatric hospitalizations, more than half of stays in pediatric ICUs, and eight out of ten pediatric hospital deaths. Twenty percent of them are oncology patients, but it also includes children with congenital diseases or other life-limiting or life-threatening pathologies, as well as accident victims with severe sequelae. Behind these figures lies a common reality: families needing continuous support, quick responses, and care adapted to each situation.
The implementation of HaurSare will be progressive, with the incorporation of professionals, provision of material resources, structured training, and staggered activation of continuous care until full 24/7 coverage is achieved “in the coming months.” Multidisciplinary teams will be established in the four reference hospitals: Araba, Cruces, Basurto, and Donostia. It is estimated that between 200 and 300 children and adolescents per year could benefit from this home care. The project also includes a three-level training itinerary and is committed to innovation, research, and socio-health coordination, aligning with European initiatives such as Hope4Kids.
Although Martínez has affirmed that HaurSare “is born as a direct response to the commitment acquired in the Basque Health Pact,” its creation follows a previous controversy. in June 2025, Dr. Jesús Sánchez Etxaniz, a leading figure in pediatric palliative care at Cruces Hospital, reported being reprimanded for providing home care to a four-year-old terminally ill girl outside his working hours and using a hospital vehicle. This situation caused “anger and disappointment” in the doctor, who requested sick leave, and sparked a strong controversy with the support of the Spanish Association of Pediatrics. Mobilized families submitted more than 21,600 signatures to the Department of Health, denouncing that “death does not understand schedules” and the need to resort to general emergencies in critical moments. HaurSare aims to resolve these deficiencies, ensuring comprehensive and continuous care.
