Like many innovators, Richard had an unstoppable energy and determination. When as a medical student, he witnessed a ‘bad death’, he was subsequently inspired by a lecture given by Dr (Dame) Cicely Saunders. He knew at that point that ‘care of the dying’ was the work he wanted to do once qualified.
Dame Cicely had just left St Joseph’s Hospice in East London, (a nursing order established by the Irish Sisters of Charity) and opened St Christopher’s Hospice in South London, which meant that St Joseph’s was short of a doctor. Thus, Richard began training under Dame Cicely’s guidance at St Christopher’s, while also working part-time at St Joseph’s. Having also previously had experience as a general practitioner (GP) of visiting people in their own homes, he gradually started visiting patients who were well enough to be discharged from the hospice back to their homes. As the work increased, he was helped by one of the nuns from St Joseph’s.
By 1974 some of the local GPs were directly referring patients to Richard to be seen at home, and the St Joseph’s Hospice Home Care Service became established. It covered five London boroughs – more than a million population – and Richard ultimately obtained funding for a district nurse from each borough, to work with him as part of the team. Having been similarly inspired by Dame Cicely, after reading some of her articles in the nursing press, I was fortunate to be one of those nurses to join the team, and to work with him for 6 years – by far the most innovative and motivating of my 35-year nursing career.
The residents of the east end of London in those days were relatively poor, and often only inadequate domiciliary medical, nurse and social work services were available. So, for example, if you visited a patient who had been incontinent and needed physical attention, you couldn’t ignore those needs, and just say you were there to assess their symptoms. This evolved into a much more ‘hands on’ service, including at times by the doctors, or even social workers on the team and not just the nurses. Our model was generally quite different from that provided by St Christopher’s Hospice home care team, Macmillan nurses, and the many fledging services spreading, in those early years, around the country and around the world.
It was a 24/7 service, with each of us being ‘on call’ two nights a week, including Richard, who additionally, especially in the early years before the team enlarged and acquired more doctors, frequently had cope with one of us calling him on any night for advice over the phone. We had pagers, but no mobile phones or satnavs in those days, so it was frequently challenging say, at 3am on a cold, wet night to find your way to the right entrance of a particular 10 or 20 storey social/council housing block, while also hoping the lift was working! The nurses were in uniform, and carried bags containing prescribed medication, yet, unlike today, there was never any fear of being attacked. So while the work was intense and demanding, our energy flowed, from the inspired and unrelenting leadership from Richard, and the satisfaction of being able to help and be alongside these patients and families through their most difficult and distressing times, enabling many more patients who wanted to die in their own beds, to do so.
In 1984 Richard and his family moved from London to Hereford, where he injected his same drive and enthusiasm into his work and became the first medical director of St Michael’s Hospice. A few years later, his work again took him back to caring for people within their own communities as he developed the Hospice of the Marches, which later became Hospice of the Valleys – covering various part of Wales. Wherever he was working, he offered the same unstinting service to meet the needs of dying people and their families, and the same inspirational ‘can do’ drive and energy to those with whom he worked.
During these years, he continued lecturing and visiting abroad, and became particularly involved with an orphanage in Zimbabwe, subsequently adopting and bringing to the UK three young orphans, raising money to pay for their education and supporting them every way he could.
Richard never stopped trying to help others, and along with other palliative care pioneers, he leaves a legacy of having inspired and encouraged others to establish new services across the globe. He also has personally touched the lives of many families, who will always be grateful for the service he willingly gave them, as well as the professionals (including myself) whose lives were changed for the better, by knowing or working with him.
These words by his daughters at his funeral are a perfect description of him.
“Richard was an extraordinary person. It would not be truthful to say he was an easy person all the time or that everybody liked him. But those who understood that the world needs pioneers and high achievers and so made allowances for his eccentricities, saw that his heart and intentions were unselfish and genuine.”
Harriet Copperman OBE, SRN
London UK.
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