Building the big society

IT is difficult to think of a better example of David Cameron's "big society" in action than the hospice movement. With, on average, only a third of their costs being met by the Government, hospices aredependent on public goodwill not only for their funding but also for the services provided by more than 100,000 volunteers who help out across the country.

The hospice movement has helped to transform the quality of palliative care received by the terminally ill, yet its lack of public funding means that it remains all too vulnerable to the vagaries of the

economy. When more and more people are feeling the financial squeeze, as at present, there is always the danger that charitable giving will suffer and, with Government cuts in the pipeline as well, hospices face a twofold threat.

This is why hospice managers across the region are warning of job losses and reduced services and holding up the example of St Luke's Hospice, in Sheffield, which is blaming the impact of the recession and increased operational costs for scrapping a planned move to larger premises and cutting its number of beds.

It is heartening that the Government has wasted little time in undertaking a review of palliative care, with Ministers promising more patients the opportunity to spend their last days in their own homes and insisting that a per-patient funding system will be introduced for all those who provide pain relief for the terminally ill. Yet, when compared with the reality of the present system, with hospices

struggling to maintain even their present level of services, such words seem little more than a pious wish-list.

Mr Cameron has yet to explain how the Government will provide the incentives to make his "big society" a reality. One thing, however, is certain. If charities and volunteers are to take more of a role in the provision of public services, the hospice movement has provided a shining example of what can be achieved if the support structures are in place. And the Government has to ensure that they are.