Hospices should open their doors to marginalised people

They already epitomise the best of local community health services. Now it is time for hospices to seek out those on the fringes of their communities, says Steve Jamieson

At the beginning of the hospice movement it was made quite clear that the patients who occupied the beds were, for the most part, those living with end stage carcinoma.

Once hospices became mainstream rather than exceptional the call went out for them to open their doors to people with a range of conditions such as heart failure, motor neurone disease and other neurological illnesses. It took one or two hospices to start the ball rolling by admitting patients who did not have cancer. Others quickly followed, embracing an enhanced level of inclusivity.

Hospices are the epitome of the best of local community health services. They are supported by local people and are often fortunate to receive significant funding via wills, bequests and legacies.

Expert loving care

Perhaps we have reached the time when it is right for hospices - which have the reputation of moving with the times and adjusting to different needs - to take one more giant step into their communities and seek out more ‘alternative’ people who need expert loving care and attention.

People on the fringes of society who are living with severe disease and disability could be considered for hospice care. We also have an increasing number of elderly people serving long sentences in prisons who would benefit from hospice standard care. The same is true of homeless people living in hostels throughout the country.

The provision of excellent nursing care is not equal. It is often available for those lucky people who understand the complex system and are in a strong position to receive what they need and want. In other words, 'he who shouts loudest gets it'. For those whose lives have been one of hardship, deprivation and insecurity, access to excellent care continues to be a lottery. 

Hospices are in a wonderful position to open their doors, widen their approach to those who receive their expert services and reach out to those people who, as a result of bad luck, find themselves at the end of their time on earth to be living on the outer fringes of society.

Steve Jamieson is chief executive of the Hospice of St Francis Berkhamsted