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Thursday, February 23, 2017
Feature: In search of Catholic health
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¬†The following article by Francis Davies, is Director of the Centre for Faith In Society at the Von Hugel Institute, is based on a talk to the Bristol Guild of Catholic Doctors hosted by Bishop Declan Lang The keynote speakers were Archbishop Peter Smith and Fr Jim McManus. To Praise, To Bless, To Preach ≠ In search of Catholic health for our times To hover in that twilight between waking and sleeping, consciousness and oblivion where there is seemingly no pain any longer may be a space for which many would long. The other week though I met a senior hospital Consultant who has made a demanding pilgrimage from such a place: His marriage was collapsing. He'd started to drink. Then he'd added anaesthetics to the cocktail to help him get through. Tough ops. Hard calls. Long hours. Despairing relatives at the bedside. And emptiness at home. One Sunday he'd been left in charge of the kids. He was due to cook the Sunday lunch. Somewhere deep down though, through the stoned haze, he knew that if he lit a match to ignite the gas cooker the children would be caught in an explosion. He couldn't manage it . He didn't. His wife came home to find him ≠ literally ≠ ironing the chicken for lunch and convinced that this would work. Today he is absolutely sure that we all need an "ironing the chicken" moment. The point is that if we want to praise , to bless and to preach in a fresh way in the place where we work ≠ and especially in the health and social care sector - we need to be grounded. This means being true to ourselves and being better heard. As Christians though it is not for us to cut simply to an unrooted mantra of "what works" or "cost centredness" important though they are. Nor is it good enough to go all dewey eyed and romantic confusing the reality of our lives with warm theological aspirations ≠ philosophical ought to bes. If God could spill the blood of his own son for us then, exhausted though we often find ourselves, we ought to be able to do a bit better than that. What does this mean? Well, the first thing to say is that there can be a form of dehumanisation that goes with "being practical". For example, "I have this astounding new way of delivering post-operative care but Ive got to be practicalthe professions will kill me if I introduced it" or, " I know that we are taking short cuts but Ive got be practical about the budget risks". Perhaps tougher still " I came on shift. I was the only nurse there. She was half way through a termination. How could I not care for her". This is the coal face of health ethics that needs deep, robust and tender reflection not to mention support. The second thing is this kind of theological romanticism. An eminent theologian recently described "the NHS as a powerful parable of the Good Samaritan". I tried this out on an Asian Doctor friend of mine and he laughed, sceptically commenting "absolutely correct..First, the Good Samaritan was a private sector solution. Second it took a foreign Doctor to sort out the absence of local carers and the organisational bloody mess". In a hospital HR department they scoffed even more enthusiastically at the suggestion saying "but Agenda For Change was a licence for unbridled greed and the doing down of some of our newly arrived, especially Fillipina, staff". Christianity at its best is a reasonable religion. As Christians we can reasonably be expected to respond to the new times in which we live and work in at least two ways. First, as I have said, we need to be true to ourselves. It should not be for us to offer "hope" without roots, metaphors of comfort without evidence. without having walked through the fire of crucifixion ourselves can we ever truly mean to suggest the hope of resurrection? Lacking something akin to a calvary moment - ironing the chicken - how meaningful is the empty tomb we offer that might console our patients and clients? To re-enact the liberation of the third day at Mass is at the heart of Christianity and yet "being practical" tells us that we have to bury this very essence of human flourishing in something strangely called our "private lives" or the "religious bit of our week". Being romantic buries it another way by encouraging us not to deal in what is real. Mind and body, heart and soul, tired and committed, health workers serve with conviction. It is not the Christian way to offer only partial solidarity. We need not speak of faith every day to undo the modern heresy that sub-divides our humanity. We do however need to recognise it to develop deeper reflection, increasingly virtuous habits and a true connection with our patients and clients. Part of this will include a rich "spirituality" and this in turn is a confusing word. Misused words must be attended to. We hear much around the NHS about a "spirituality" for patients stripped of community, bodiliness, memory, reason let alone faith. In Christianity the idea of a religious specialisation called "spirituality" is a relatively recent one and we need to robustly test the extent to which our new specialisation has been captured ≠ commodified ≠ by an account of life that is so fixed in radical individualism, and unrooted in joy, as to he hardly human at all. This will mean being hard headed and not going weak at the knees like love struck teenagers when words with meanings which we have constructed are being stolen for other purposes. But this is where we need some social analysis and hard research evidence also. In the UK the remnant of our major Catholic hospitals were closed by a working party established by Cardinal Heenan. We do have a few left , along with many social care institutions, but neither here nor in mainstream health services have we invested much in developing our understanding and leadership. Unlike in some other countries we do not have a natural constituency from which could leap striking voices able to articulate a far reaching vision of a Catholic health presence either in our own works or in the NHS. This has powerfully limited Christians in at least two ways: First, policy advisors employed by the Church have tried to fit their intensely limited experience of the NHS and wider health and social care sector, into their experience of other areas of public policy. They have consequently tended towards a parliamentary focus with a few civil service add ons. The trouble is that even the NHS on its own is totally unlike any other policy field because of the sheer quantities of cash involved - £90 billion at a recent count. Billion pound budgets nestle in decentralised regions, thousands of staff directly impacted by area decisions, hundreds of patients faced by local impacts and all run by a central department split between London and Leeds with PCT catchment areas that are by no means co-terminous with Diocesan boundaries. This complexity provokes some of the sweeping theological generalisation that I have touched upon but it has also distracted us from gathering up information about our own people and our own options at a time of immense change: It breaks my heart to hear anecdotal evidence from Catholic hospital chaplains that more than a third of Fillipina nurses in the NHS, who arrive well, are being returned home with mental health difficulties. It frustrates me that we have no meaningful figures to quantify the Christian presence in health and social care . It would not surprise me if it mirrored the pattern in the voluntary sector where Christians are statistically over-represented in charity leadership. And what of the faith based contribution to hospital volunteering and visiting and local social care support? We know in prisons the Churches are the backbone of such endeavours and it would not be astonishing if that were the case in health also. We urgently need research to unpack these issues or else policy inexperience risks being blended with theological guesses to put our Bishops at risk and our public positions on health in the dock of credibility. Would this be just another research report? No, it would be a platform from which we can learn again who we truly are and plan to be truly heard. It would also be real ammunition in the ongoing defence of our right to provide funded Chaplaincy. What is more is that in this combination of fresh theological questioning and focused empirical research, alongside a richer understanding of health, we may also come to recognise a new opportunity that is upon us in the coming months. The Secretary of State for Health has announced that from April 2007 she will create a significant venture fund to pump prime the creation of new social enterprises in the health sector. PCT's have additionally been charged with making this form of "independent sector" provider a key feature of the new NHS settlement and they now have a new DOH Social Enterprise Unit to help them in this task. Could we not give legs to our values by founding new social enterprise hospitals ? Might we provide institutional embodiment for our theological passion by supporting Christian doctors, nurses and social care workers that want to take part of the NHS ≠ such as Community Services in a particular county ≠ and establish them as bodies with deep motivation, flexibility of client encounter and inspirational practice? Could the Bishops call on Christian health workers to put their deeds where their complaints have been? Globally there are three Catholic hospitals and more than 5 social care organisations for each Bishop. This is a moment in the UK when our ideas could have similar consequences ≠ albeit more demanding ones than just waving theological wishful thinking in the air and launching another publication and conference round. Such a call though needs a fresh inspiration, a new leadership. In a recent book Fr Timothy Radcliffe recounts the Talmudic legend of Nachson Ben Amidinadabab(sp). The Israalites fled to the banks of the Red Sea only to find themselves caught between the oncoming Egyptians and the depths of the ocean. In this version Moses was flummoxed, pacing with uncertainty from pillar to post. As he did so a young lad , Nachson, took a tentative first step out into the water. The waves leapt to the side clearing a path through which God's chosen people could flee. All these years later we could be forgiven for thinking that the version of this event which has Moses as the hero was just another example of senior management taking the credit for frontline innovation and risk taking. More profoundly we can own that it is in taking the first step that inspirational leadership is formed. The present time may be one of crucifixion. We may still long for a realm of comfort that eludes us. We may be at the point of not having even begun consider the dawn that comes from ironing chickens. But if we are to praise, to bless to preach in new ways, to make whole what has been broken in health and give birth to fresh talk, care and institutions we must take the first step. This is the authority given to us by baptism. It is the passion of our faith. It could inspire a Catholic dimension to health in our times. Because crucifixion has never been more than only three days from the empty tomb. Francis Davis is Director of the Centre for Faith In Society at the Von Hugel Institute, Cambridge and Chair of SCA Health and Social Care - an Observer/DTI social enterprise of the year
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