LETTERS : Don't write off the terminally ill

From Ms Jean Gaffin Sir: You report Professor Sir David Weatherall's concern that people who are terminally ill should receive appropriate care (" `Unkind' doctors given bitter pill", 23 December).

It was this concern that led Dame Cicely Saunders to open St Christopher's Hospice just over 25 years ago and now fuels the growth of the modern hospice movement.

Specialist palliative care services include in-patient beds, day-care and home-care. Through a wide range of educational initiatives, these services, whether based in the National Health Service or the voluntary sector, are spreading the palliative-care

approach to doctors and nurses working in primary care, hospital and nursing home settings.

The Hospice Information Service estimate that almost two-thirds of patients dying of cancer are seen by home-care nurses and that in 1991 28,000 of the 160,000 cancer deaths occurred in hospices.

Through fund raising and volunteering, a generous public provides more than £100m per annum to support the voluntary services.

But if we are all to have the quality of care that Sir David calls for, more resources will be needed. Then we might be seen to be valuing all patients and giving priority to quality of life issues rather than, as too often now, writing off those who no longer benefit from active treatment.

Yours faithfully, Jean Gaffin Executive Director National Council for Hospice and Specialist Palliative Care Services London, W1

30 December