Hard times

BMJ 1995; 310 doi: (Published 25 March 1995) Cite this as: BMJ 1995;310:809
  1. Judith Hollis-Triantafillou

    Our KAPI centre is in trouble and, as so often seems to be the case these days, the root problem is a financial one. We are a community based, open care centre for older people, supplying health, social, and recreational services to our members, and, although one of over 250 such centres throughout the country, we do have some special characteristics that make our situation somewhat different from the others.

    Firstly, we were and continue to be regarded as one of the prototype KAPI centres that were piloted in the late 1970s and acted as a model on which the whole network was based. Secondly, while local authorities administer all other KAPIs, our governing body is the Volunteers' Association, which as far back as the 1950s established a small centre called “Granny and Grandad's corner,” run entirely by volunteers and serving the pressing needs of elderly people in a poor suburb of Athens with a rapidly growing population consisting largely of Greek refugees from Asia Minor. The acknowledgment of the importance of this service with the grant of government financial aid in the late 1970s enabled the project to expand and employ professional staff, but the unique spirit of volunteerism pervading the centre from its initiation has meant that the staff, in recognition and support of this contribution, have accepted lower salaries than their local authority employed colleagues. At the same time our more independent status has made us less subject to political whims and manipulations over the years, and we have been able to enjoy developing our services in close cooperation with the members and the volunteers and even to “export” our ideas to other interested countries.

    However, increasing financial strictures have led to cracks appearing in the smooth surface of our cooperative venture, revealing underlying flaws that we had been only vaguely aware of but now have to deal with before the whole project collapses. One by one we have trimmed services to fit a decreasing budget, and the extremely popular recreational programme has been kept going only by the fundraising activities of the members themselves. In December, with not a drachma in the till and an ancient drainage system completely blocked, an approach was made to the members' committee to use for the repairs some of the funds raised for a three day trip to the Pelopponese. This request was refused, with accusations of economic mismanagement and a demand for making public a detailed financial statement for 1994. Shock, outrage, and hurt feelings from the Volunteers' Association (“After all we've done for them!”); a declaration of their rights from the members (“We raised the money and can decide what's to be done with it”); the staff in the middle trying unsuccessfully not to take sides.

    When the dust has settled maybe we can survive by putting into practice some hard learned facts: that volunteer services must be run professionally; that staff must be actively involved in management; and that members have responsibilities as well as rights.—JUDITH HOLLIS-TRIANTAFILLOU, general practitioner, Athens, Greece

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