When the bubble bursts: the future for independent hospitals

The rise of the hospice movement in the last two decades constitutes a significant landmark in modern health care provision, forging a new relationship between the voluntary and statutory sectors. Hospice-type care is now being delivered in a variety of contexts. Among the services existing in early 1993,193 offered in-patient care; there were over 400 home care teams working hospice, hospital or community bases; along with some 200 day care units (either free-standing or attached to a hospice); in addition 216 hospitals had support teams or support nurses. Many more such services are currently being planned around the country Nevertheless, hew hospices have been regarded with scepticism by some health professionals who consider them misguided and insular and concerns have been expressed about the rapid growth of hospices in the absence of adequate revenue finance and personnel to resource them. Yet in-patient hospices in particular seem to have captured the public imagination, mobilising energies and talents within local communities and drawing on considerable levels of volunteer support in ways which create a build-up of pressure for further expansion. A number of important sociological and policy issues therefore flow from these developments within the hospice movement