What's the point of chaplains in hospitals?
This was the profound question posed by one of the porters outside the chaplaincy office yesterday not realising that I could hear every word from inside, and could recognise his voice. If I hadn't been on the phone at the time I might have invited him in for a chat about his reservations on the role of chaplains in hospitals... I assume that is what he was referring to... Either that or the efficacy of our Health Minister Edwin Poots and his colleagues, and I'm not going to make any public comment on them here!
It's not just porters who are asking that question however... The Humanist and Secular societies and their fellow travellers have understandably been asking it in various forms for some time. There was also a recent Freedom of Information Request concerning the amount of money spent on chaplains throughout the NHS in Northern Ireland by by MLA Conall McDevitt, which prompted a lot of comment in the house on the hill and in the media (before they started debating their own pay rise). But yesterday my morning as a chaplain got off to a great start with Dr. Edward Presswood, who was billed as a doctor of acute medicine based in North London, was on Radio 4's Today programme arguing that religious chaplaincy has no place in the NHS... or at least that there should be no paid chaplaincy... off the back of his lecture to Central London Humanists the previous night entitled "Bring Back Bed 13" which was supposedly a look at science, superstition and healthcare. Now not only have I never encountered the lack of a bed (or ward 13) in all my experience in Northern Ireland, but the tone of his argument was condescending and, frankly, showed a complete ignorance of the real nature of hospital chaplaincy. They wheeled out Rev. Debbie Hodge, chief officer of the Multi Faith Group for Healthcare Chaplaincy, to debate with him. This seems to be standard practice on the Today programme these days, particularly where issues of faith are involved... It's like the Jeremy Kyle Show with letters after its name, throwing combatants into the public arena for a bit of blood-letting, to entertain, if not educate or edify the audience. The same happened recently with the Richard Dawkins/Giles Fraser debate over whether Britain was a "Christian country". But thankfully in both cases the Christian participants did not play the game and sink to the patronising tone of their opponents, nor with Giles Fraser, did he capitalise on the open net presented when Dicky Dawkins couldn't recite the full name of Darwin's magnum opus.
One of Dr. Presswood's key statements was that he (generously) didn't want to ban chaplains from hospitals... he just didn't want "the taxpayer" to have to foot the bill. Instead, he argued (and this is a persistent National Secular Society position), the church, which is a hugely wealthy organisation, should pay for their own chaplains. There is a major problem with such an argument, however, and that is, in an unregulated free-for all, who gets the right to appoint chaplains? Is it only the established churches in England and Scotland? This of course is ridiculous given the range of Christian denominations, not to mention the other faiths, and would be even more complex in disestablished Northern Ireland. There would be hidden costs in trying to regulate this and unforeseen consequences of the complexity... and were chaplaincy to be totally banished there is good reason to believe that many duties carried out by chaplains would have to be fulfilled by other professionals, including psychological/psychiatric professionals, at a later point at much higher cost.
My colleague Derek Johnston has done a thorough job of refuting previous challenges by secularists, so I'm not going to cover the same ground here. However, in these days were cost-effectiveness is all, we within chaplaincy do need to take a good hard look at ourselves... and to that end let me suggest 5 simple ideas that might make a significant difference:
1) Abandon Denominational Chaplaincy: In this I agree with Dr. Presswood, but not as a cost-cutting measure, rather as a better model of operation. If denominations want "representation" within the system then let them pay for it, but the core Hospital Chaplaincy team should be there not as representatives of their denominations, but as professional healthcare Chaplains. Where there are religious needs that can only be provided by a cleric of a particular denomination/faith then if there is no such person on the team, that should be facilitated by the chaplains via the patient's own priest/pastor or a local priest/pastor retained for such emergencies, either on a paid or voluntary basis.
2) Develop Specialist Chaplaincy Teams: Instead of chaplains representing different denominations covering the whole hospital in a patchy way on the basis of patient lists broken up denominationally, the chaplains should world in a specialist area/s, eg. midwifery, childcare, care for the elderly, psychiatry, general medicine, intensive care, palliative care, bereavement. This would allow more consistent care not only for patients but for families and staff too.
3) Develop Local Chaplaincy Support Groups: As well as the sort of support we currently have, including volunteers to bring patients to church services on Sunday, this could also include volunteer chaplains and visitors, fundraising teams, prayer support, and practical help for special events eg. carol services etc.
4) Develop more Appropriate Management and Support Structures: To my knowledge Belfast Trust is the only NI Trust with a fulltime Chaplain Coordinator, and these should be basic to chaplaincy provision. The management of Chaplaincy varies from hospital to hospital, even within trusts: with some it falls under Nursing, in our own trust it is under Patient Experience. In an ideal world I would have it as part of a wider "Psycho-Social directorate", but no-one asks me.
5) Develop Distinct Vocational Training Courses: In recent years, locally, we have been blessed (and I use that word advisedly) by a revamped and reinvigorated Northern Ireland Healthcare Chaplains Association, providing Continuing Professional Development courses and the Certificate of Pastoral Education. However, this is still piecemeal and only open to people once they actually become chaplains. What is needed is a distinct vocational pathway, equipping people with the professional skills they require for a modern healthcare environment. Some of the courses required could be delivered in association with ministerial training courses, as many of the skills (eg. listening, counselling, bereavement care) are shared with parish ministry, but seeing it as a distinct discipline will help give chaplaincy the respect it needs in the eyes of other healthcare professionals, and also, perhaps help individuals more finely hone their sense of call. Also, being realistic, if we are to abandon a denominational model of chaplaincy denominations can no longer be expected to pick up the tab for training those who will be chaplains (another of the hidden cost).
Currently, partly as a function of economics and partly (I believe) as a function of ideological vandalism, the NHS is going through the biggest upheaval of its 65 year existence. Chaplaincy cannot escape this. These are simply my suggestions as to how I would like to see it change and they may never be taken seriously by anyone. However, the larger churches in Northern Ireland currently have a privileged position within the NHS here, and we need to use that position creatively and generously to help shape a form of chaplaincy, which while it may not address the concerns of Dr. Presswood or my expressive porter, may go some way to addressing the genuine spiritual needs of future generations of NHS patients.
ps. Sorry for the delay in this post. Was supposed to be online this morning, but again it disappeared into the ether... I think someone is intercepting these posts... For what possible reason I cannot imagine...