The Cafe 2

The SR update, 'The health board would rather punish the hospice than save it' (SR, 16 February) rang some bells in Cowal. A very similar episode to the St Margaret's Hospice story has happened in Dunoon. There has been huge public support for Cowal Hospice (housed at NHS Highland's Dunoon General Hospital) over the last 10 years. Much of this support has been financial.
      NHS Highland has hatched a plan, announced in a full-page advert in the Dunoon Observer on 7 January, to 'move away from the stand alone in-patient hospice unit'. Everyone locally is aghast. A much-cherished local facility is officially closed.
     The four-bed hospice unit has been run by Cowal Hospice Trust which consists of local volunteers including (in a personal capacity) the leader of Argyll and Bute Council, Dick Walsh. The shock of the local populace has been muted by the fact that effectively over the last year the hospice has been run down and closed for much of the time. Staffing problems were most often cited as the official reason. Those with a more inquiring disposition suspect other reasons.
     The local paper has got up a campaign – Hands off our Hospice posters are everywhere. A petition was raised quickly and attracted over 3,000 signatures (out of a total Cowal population of 20,000). Belatedly but significantly, local GPs have come out publicly against the closure, as have local clergy.
     NHS Highland is indeed widely seen as the bogeyman here – it clearly has its own agendas which do not involve sharing facilities and management responsibility with a voluntary trust. Its decision to close this facility, dressing it up as 'community care', could be regarded as unilateral, but the comparison with St Margaret's ends there. Cowal Hospice Trust appears to have been outmanoeuvred by the big NHS beast and seems to be complicit in the demise of its own facility. The Dunoon Observer full-page statement was signed up to by trust chairman Philip Pitmann and member Dick Walsh.
     NHS boards in their bureaucratic wisdom don't appear to fit in with independent hospices, calling into question how the sick and dying are to be cared for. There seems to be a deeper problem of ethos: beliefs about caring at the point where all medical science has failed. It's uncomfortable for the NHS and so hospices are 'difficult'. While this may be authoritarianism of the worst kind, local volunteers do have a responsibility.
     Much of the ire of locals about this decision is about this callous loss of a local facility. But also, since numerous funeral collections and fundraising efforts have been made, the trust is sitting on a large sum of money from public contributions.
     Cowal Hospice Trust accounts to 31 March 2010 show funds in hand of £250,000, much of which has been raised through public generosity. So what,it seems pertinent to ask, is going on? The public has contributed to a charity which runs a local service that most people want. The charity has adequate money to run its part of the operation for three years. But the hospice is closed.

Derek Rodger