A Victim Of Its Own Success

The charity Marie Curie Cancer Care operates a community hospice in a large old building in Harestone Drive, Caterham. This is often referred to simply as Harestone.

Harestone is unlike other Marie Curie hospices in that it runs a day care centre and is the base for a Community Supportive Care Service, a Specialist Palliative Care Team and dozens of volunteers.  Clinical Nurse Specialists give help and advice which would otherwise need a visit from a doctor.

The day care service provides a place for people suffering with serious illnesses to have a day away from home - somewhere they will be looked after, can meet other people, have a hot meal and try various therapies.  The social side is very important in raising morale but contrary to some reports the day care service provides much more than just a chat over a cup of coffee. Qualified staff carry out medical reviews, they set up infusions for cancer treatments and administer blood transfusions - all services which would otherwise involve a trip to hospital. Day care acts as a community clinic.

The specialist teams offer a range of services like bereavement counselling, alternative therapies, rapid medical response, financial advice, and expert palliative care. Physiotherapists help people maintain their mobility and independence. There is a team which provides spiritual care, visits patients in hospital and when the time comes will help with funeral arrangements. This is all available to the local community as well as visitors to day care.

Twelve years ago Marie Curie decided that Harestone should be used to experiment with the concept of a 'bed-less hospice'.  By making a complete palliative care service available to people in their own homes the number of hospice beds could be reduced to cater for just those few cases where clinical need or domestic circumstances made home-based care impractical.

Three years ago this service had reached the point where the ward at Harestone could be closed and the few remaining in-patients transferred to beds at the nearby North Downs Hospital.  Development of the methods and people continued so that by the end of November 2008 everything was in place for the bed-less hospice to become a reality: the last four beds at North Downs were closed, any future in-patients would use other hospices at Crawley or Sydenham and the ward nurses would be used to help patients in the community.

Then on the 27th November, just as the new community service was about to go live, came the news that Marie Curie Cancer Care had decided to close down the hospice, the day care service and specialist teams, and that all staff would face redundancy.

Harestone became a victim of its own success.  By providing maximum care in people's homes, and thus reducing the need for hospice beds, it had achieved exactly what the board had asked of it.  And yet while Glasgow gets £millions for beds in a new hospice, the Marie Curie board point to the planned underuse of beds at Harestone as an excuse to close it down.