Dark days for the Lighthouse

Barring the arrival of a knight on a white charger, the London Lighthouse is doomed to close as Europe's largest centre of care for people living with HIV and AIDS.

Some of its work will continue, but not in the purpose-built centre opened by Princess Margaret 10 years ago and visited regularly by Princess Diana in the last five years of her life.

The decision to sell the building coincided with the announcement that the Diana Memorial Fund is giving pounds1m each to six charities with which she was closely associated at the time of her death.

The six include the already well-endowed Royal Marsden specialist cancer hospital and the Great Ormond Street Hospital for Children.

The Lighthouse, which came perilously close to closing completely, is one of 100 charities that might get up to pounds65,000 from the fund later this year.

Its predicament is the result of the success of combination drug therapies. Most of the NHS AIDS budget is going on the new treatments.

Kensington, Chelsea and Westminster health authority is reducing its funding of Lighthouse services by pounds1.7m next year, a cut of 58 per cent. Months of negotiations have produced an agreement that it will fund the residential unit until September with an interest-free loan of around pounds700,000.

The only way the Lighthouse will be able to repay the loan is by selling its building and moving day-care, home-care and other services.

It is a devastating prospect for Andrew Henderson, one of the group which began the project in the mid-1980s in response to the inadequacy of health and social services' formal response to the spread of HIV.

He was then social services director for Kensington and Chelsea council, and was aware of the need for something different being recognised through the home-help service.

The group wanted a kind of hospice where people with AIDS could spend their last days in an accepting and supportive atmosphere.

There was a great deal of local hostility. The council was faced with the biggest petition it had ever received - 3,000 people from the Notting Hill area said 'no'.

But the opposition was turned round at a public meeting, principally by contributions from two local women.

A German Jewish refugee spoke movingly of how the area had always welcomed people in trouble or faced with oppression. It had welcomed her, a foreigner. Should it not now do at least as well for its own, she asked.

And local Labour politician Ann Holmes firmly dealt with uninformed fears about the social behaviour of service users.

A second petition supporting the project arrived at the town hall signed by 3,500 people. Within a short period, more than pounds4m was raised to buy and convert a disused school. Actor Ian

McKellen raised pounds400,000 from a one-man show.

Since then, the Lighthouse has pioneered services that have been copied around the world. But two meetings in the past few weeks with public health minister Tessa Jowell have failed to save the building.

Mr Henderson told her that to allow the residential facility to be lost 'is not only extremely wasteful but very unwise as qualifications to the success of combination therapies become more and more evident'.

However, HA public health director Sally Hargreaves believes the relapses among HIV patients using combination therapies in the US are not likely to be repeated here.

She points out that most US patients, unlike those in Britain, previously used the AZT drug and developed resistance to it.

The Lighthouse has seen the crunch coming for some time. Executive director Susie Parsons has overseen two years of 'restructuring' which have cost pounds800,000 mainly on redundancies, and left the Lighthouse with no cash reserves.

She says she is relieved that many services will continue.

But she adds: 'I feel personally extremely sad and angry that we are in the position of having to sell the building and close the residential service because I know from service users that there is still a need for the service.'

Kensington Chelsea and Westminster HA will continue to buy residential services, but from other providers because, Dr Hargreaves says, they are cheaper.

Ms Parsons claims the price of residential services has already been reduced, and a bigger cut was on offer.

'They could have had a 40 per cent reduction,' she says. 'We have been working to bring our price down and succeeding in that. You can't do it in one jump. It would have been a very competitive price indeed.' The HA 'did not accept we were able to do that', admits Ms Parsons.

The building is likely to be converted into an old people's home. It is expected to raise around pounds3m, putting it out of reach of most statutory authorities, and is expected to be bought by a private firm.