Not to be St C’s-focused about it, there are two other honours that mention palliative care, MBEs, in the Queen’s birthday honours list:

Dr Constance Ada Mary LLEWELLYN-MORGAN

Chair of Trustees, Ty Bryngwyn Hospice,
Llanelli. For services to Palliative Care in
Carmarthenshire.

Professor Edwin John PUGH

Consultant in Palliative Medicine, North
Tees and Hartlepool NHS Foundation Trust.
For services to Medicine.

Who gets honours then and is it appropriate? Leaving aside the remnants of empire in the British system, all countries honour people who make a particular contribution Legion d’Honneur in France and congressional medals in the US, presumably following their own cultural criteria. For the UK, here is of course a committee that advises about who should get one, and anyone can put someone up for an honour, but my ercxperience of the voluntary sector suggests that many organisations plan this rather carefully to assure their recognition. Some people reject one or ask not to be put up of course. Senior civil servants also get a good whack, more or less routinely: you can tell who blotted their copybook or did a specially acceptable job by looking at the levelof what they got.

Even so, should it be quite so bound up in political and policy considerations? The head teacher who became a dame would have been less likely before Labour decided a while ago to honour contributions to teaching at the grassroots. Should it be entwined with political decision-making?  And, looking at a field such as palliative care, or social work, one wonders who keeps an overview. Since charitable activity is an important part of a field such as palliative care, people seem to receive honours for chartiable activity which in a way is a bit of a extra to their professional role: does that mean that palliative care gets a higher proportion than other health and social care specialties? If so, it might be because charities think about these things mroe carefully as a strategy in the fund-raising, reputational game.

Of course, one asks the same question abot royal patrons; again this is a routine part of the British charitable system, and other countries have their equivalents. but have we really looked at how far we want royalty entwined with charity?