'The hospice is for the whole of the Highlands'
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EVEN after 30 years, it's easy to see why Cecilia Bottomley and Flora Mackay made such a powerful impact when they joined forces to start the Highland Hospice campaign.
The chemistry between them was just right, and it still is today: Cecilia feisty and outspoken, Flora more quietly persuasive yet equally unwavering in her commitment.
Together they became an unstoppable double act, refusing to take no for an answer as they set about creating a hospice for the Highlands. Their stubbornness, single-mindedness and relentless determination saw them win the hearts and minds of the community and overcome some initial resistance from elements within the medical establishment.
The service they set in motion all those years ago has been of incalculable benefit to thousands of patients and their families, yet the ladies themselves are disarmingly modest as they look back on their contribution. "Flora and I were just two wifies who passionately believed there was a need for a hospice," is how Cecilia puts it.
In the early 1980s they were working as nurses at Culduthel Hospital in Inverness – "an old-fashioned building", according to Flora, but a place where "a lot of fantastic nursing" went on.
Cecilia and Flora could see they were part of a system that was trying to do its best for people with incurable illnesses but struggling because of limited resources. Their aim was to help patients and their families by providing a more welcoming, less institutionalised environment, one that could offer a range of specialist services.
"There wasn't a lot of treatment or counselling support then," Cecilia explains. "I found it really emotional because families were coming from outside Inverness, from quite a distance, to see their loved ones, being told this news and then having to go back home to cope with it there."
This strikes a chord with Flora. "And they had to stick to the designated visiting hours," she points out. "You'd been given very bad news, you were trundling back in a bus or on a train, or driving a car, all you've had with your loved one was an hour, and you'd been whipped out along with all the other visitors.
"Imagine being given bad news and driving, for example, back up to Wick. How could you concentrate knowing that your loved one has only got maybe days, maybe months?"
Flora is still affected by the vivid memory of one cancer patient, a young mother who was in an open surgical ward. Too sick to eat when the food trolley came round, the woman expressed one simple wish: for her own duvet from home rather than hospital sheets and blankets. But the "powers that be" wouldn't allow it.
"I thought, 'This is just dreadful. Why can't we have a hospice?'"
Cecilia has similarly upsetting experiences to look back on. "Flora and I thought, from day one, that your life at the beginning and the end should be dignified. We wanted to have a place of rest where families could spend time with them, and not be put into a mortuary. People want to have those last moments with loved ones in a dignified place."
Flora, who later worked in a general surgical ward at the Royal Northern Infirmary, remembers it as a time when cancer was barely spoken about, even though "the amount of cancer-related illnesses was pretty huge".
The first step was to initiate a debate about setting up a hospice. It may seem surprising now, but early reaction was not wholly positive. Flora says: "I've got a quotation from one doctor who said, 'Do you think that we're not capable of looking after patients who are terminally ill?'"
However, crucial backing came from Cecilia's GP, Dr Sam Marshall. He was part of the community group that started Moray Firth Radio. A radio appeal, and a public meeting at Inverness Voluntary Organisations Group (IVOG), got the ball rolling.
"People had been waiting in the background, hoping that somebody would do something, and Flora and I came along," says Cecilia.
There was a wave of support from people the length and breadth of the Highlands.
"As soon as we did the appeal people from all over the Highlands wanted to donate stuff, wanted to give money, wanted to give their time," Cecilia recalls.
"The generosity of people, including businesses, was amazing."
In 1983, after a packed public meeting in the Kingsmills Hotel, a committee was formed. Members included Dr Marshall, local solicitor Douglas Graham, consultant physician Finlay Kerr, retired consultant Walter Borthwick and the entertainer Jimmy Logan, whom Cecilia had contacted while he was starring at Eden Court Theatre.
"We couldn't have done it without these amazing men and they really have to be acknowledged," she says. "It was a huge feat."
Road trips took place throughout the region to generate further support and to raise awareness of the whole hospice concept. Cecilia explains: "People thought a hospice was where you went to die. We wanted to take the stigma out of that, because hospice care is people coming in for respite and pain control, and their family to get support, and they go back into the community.
"I feel very passionately about it. We were saying, 'This is a hospice that is for the community, it's going to be hospice care right through the Highlands,' and that had never been done.
"People were going away and not getting the support they needed, their families were at home, and the expertise wasn't there. That's why we ended up saying this is a people's hospice, because without the people of the Highlands the hospice couldn't have existed. The hospice is for the whole of the Highlands."
Flora remembers how "we ate, slept, dreamt the Highland Hospice" for five years before Ness House in Inverness became available as a base.
Highland Health Board helped the committee identify the building – overlooking the river, just along from Eden Court – and a room was set aside in the infirmary to serve as a fundraising hub for the hospice.
"From day one the health board was really generous," Cecilia says. "They were under restrictions too but they were 100 per cent for us."
While Ness House was still being renovated, the committee took the bold step of buying the neighbouring private house, Netley Lodge, when it came on the market. It began life as a day centre in 1987, with the inpatient unit opening the following year.
At last the Highlands had a hospice of its own, and as well as caring for patients it took on a training role with the opening of an education unit. "People from outwith the Highlands were coming to conferences, people were coming to lecture for the local GPs... amazing for this wee hospice," Cecilia says.
"All that was beneficial to the health board and to the community."
Flora is still struck by the difference that was made to patient care. "They were sitting there in a hospital ward, nine times out of 10 in agony," she says, thinking back to the days before the hospice became a reality.
"There were no specialists and the families couldn't cope with them at home because they didn't have the pain relief. So to have this facility then was just great – fantastic.
"And it couldn't be in a better place. It's scenic, you're by the river, and if you've had a horrific couple of hours you can come out of the hospice and have a lovely walk. And if you're particularly religious you've got the cathedral there."
Cecilia adds: "We pushed that it wasn't a place to die, it was a place of hope. Of course people die in hospices – that's the final bit. But they're coming in and out of the day centre, or the GPs and nurses are dealing with them out in their ?communities, so they're living full lives. It's not all doom and gloom."
Almost three decades on, the passion remains undimmed. Cecilia and Flora are still very much involved with Highland Hospice and are hugely impressed with the way provision has been expanded to serve communities across the region.
In addition to the 10-bed inpatient unit at Ness House there are day hospice services in Inverness, Portree, Dornoch, Thurso and Fort William, and outreach bereavement support for family and friends throughout the patient's illness and into bereavement.
Around 40 per cent of the £3.9 million required each year to keep services going comes from the NHS. The hospice needs to raise the rest. The fundraising team runs a busy programme of events, supports fundraisers in communities across the region, and also has 11 charity shops throughout the Highlands.
"I think the uniqueness of Highland Hospice is because people are coming from all over," Cecilia says. "It is a community hospice. You can query whatever you want. You can say I don't like this or I don't like that, and that's the whole ethos – it's an open book for everyone to see where the money is going and who's doing what.
"We were asked a long time ago, why did people come on board so quickly and why has it continued? All of us at some stage in our lives are touched by cancer – friends, family, loved ones. I think that's the thing."
Flora, who now does Marie Curie nursing as well as working in the intensive care unit at Raigmore, points out: "It's actually quite satisfying to hear families saying they've had great comfort, great relief and support from the hospice."
Reflecting on all that has been accomplished, what is it that gives them the greatest sense of pride? Flora hesitates for a moment and says: "The fact that we achieved it in a short time. Okay, it took five years before you could open the doors, but the fact that it is still up and running."
Cecilia replies: "To see how it has progressed, because of the staff that we've had, the directors, the doctors... I think it's mind-boggling, it really is.
"People are volunteering in the day centre, they're out there in the shops, they're out there fundraising – it's unbelievable the support they are giving. And families who have had the support of the hospice continue to support it.
"I really am overwhelmed by the generosity of the volunteers and the people of the Highlands because we couldn't have started it, and we couldn't have continued it, without them. It was overwhelming, and it still is. People are so generous."
Ann Alcorn, from Muir of Ord, is the latest £500 winner in our Hospice Lucky Numbers prize draw.
