The CEO of Marie Curie is defending the charity sector’s position in providing end-of-life care. He is arguing for the ‘Big Society':
“Make far greater use of society in healthcare. Welcome volunteers to help deliver care in every setting in the public sector. We do in the voluntary sector and it works and it is high quality”.
The problem I have, as a GP, is in the persistent exclusivity of private (and here I include charitable) healthcare providers. Alas, each of the local hospices has it’s own, long, referral forms: each of the charitable nursing organisations has it’s own set of what they will and will not do for patients. I don’t see charitable providers being as accountable as the NHS. Some may even be doing harm – meaning that the NHS does not go ahead and develop it’s own coherent care because charitable providers offer to do some pieces of it, which then don’t ever get established properly in the NHS. There is also a great deal of duplication between what district nurses do. Charities should not be beyond criticism. There is no obligation for any charity to take a patient on. This means that fragmented care is the norm, as is phoning around multiple providers, trying to arrange overnight care for dying patients at home. It’s hardly the best we can do for our dying.