Tuesday, December 16, 2008

Positivity - glass half-full or half-empty?

We were recently approached by a seasoned Buddhist who is inspired to build a Buddhist Hospice here in the United Kingdom - a place where a dying Buddhist could be fully supported in their practice as they neared the end of their life, a modern, well-appointed place where holistic care could be given to the highest standards by Buddhist attendants.

This is a noble aspiration, and it was put to us with unusual fervour and enthusiasm, notwithstanding the challenges inherent in such an undertaking. The person who made the proposal didn't know about our own existence when he first conceived the hospice idea, and only learned about the Trust via a third party, which led to his telephoning us.

My first-off response was to greet the proposal, saying that I would personally lend whatever resources I could to such a venture and, further, that the Buddhist Hospice Trust would do whatever lay in its power to help. I thereby surprised myself at my own positivity.

I think my response was called forth by the positivity of my counterpart, the one who made the proposal; but also that it came from a general attitude of positivity that I have cultivated this year, although I can't say how I've done it. I've meditated on positivity a few times, and - of course - positivity (and cooperation) were advertised as themes for the year on the website, and in planning the conferences that didn't happen. One can only wonder - but there it is - a glass half full of readiness to help, open-mindedness, and belief in miracles!

At the Mandala meeting we met up with the man who wants to run with the hospice idea and see it through to fruition, in company with like-minded others as a project to unite all traditions, generating the fund-raising and voluntary-service capacity needed, and within a open time-frame. This fellow's enthusiasm is infectious, and there's no doubting his determination to realise his dream, his ability to entrain others, or his experience of the British Buddhist scene (whatever that might comprise).

We had an interesting discussion. I'm not at all an expert on hospice work, and I did suggest to him that he might better consult people who are about what's involved in developing a hospice service from scratch. My views on hospice work are, it must be said, at least idiosyncratic; but one does not have to be a specialist to know that hospices in general are 'retrenching' financially and in other respects, that end-of-life care is changing, so that it is likely in future that more people will die 'at home' than in a hospital or hospice bed. This doesn't of itself imply that a Buddhist hospice can't be achieved, nor that it oughtn't to be: let what will be announce itself, and who knows what may happen.

What I was able to point to, from my own experience of care-provision (in nursing and residential care environments, as well as in hospitals), is the high cost of care. It is not so much in capital costs that hospice care comes dear, but in recurrent costs - the monthy bills, as the following "back-of-an envelope" calculations may show. These are my own raw figures, and they may only be rough approximations, but - as far as I can honestly say - they are realistic, and give some idea of what might be involved.

The figures offered are based on a notional hospice offering four in-patient beds for terminally ill or dying people requiring end-of-life care, including palliative care (pain- and symptom-relief, specialised nursing, and on-call medical support). The figures represent estimated monthly outlay, based on a twelve calendar month year.

Rates/Council tax £ 200
Utilities (Gas. electricity, water, sewage) £ 800
Insurances £ 120
Maintenance of fabric/repairs £ 100
Technical equipment (hire/replacement) £ 160
Food/drink (based on 4 patients and eight
staff) £ 300
Cleaning materials and consumables (e.g.
paper towels, toilet rolls, gloves etc) £ 160
Stationery/stamps/office sundries £ 80
Telephone/Internet £ 60
Nursing staff (based on 6 Whole-Time
Equivalents [WTE] for 24 hour cover x 7 day week and employer's NI) £7,200
Care Assistants (based on 6 WTE at national
minumum wage including employer's NI) £4200
Administrator/clerk-receptionist/payroll staff 1 WTE £ 900
Housekeeping staff (cleaner/laundrywoman) 1 WTE £ 750
Cook/Kitchen Assistant 0.5 WTE £ 400

Total £15,430

You may agree this is a lot of money to find monthly, and could call for a professional Fund Raiser, probably full-time. Let's say (if we include her necessary expenses and the resources of publicity she would need to do her crucial work) another £1,400 a month. That adds up to a rounded-off total of £200,000 annual recurrent running costs.

Food for thought, but my cup's still half full, and I'm up for further debate and analysis on the matter. Are you?

1 comment:

Sand pit said...

It would be fantastic. Fingers crossed!