'If you want spiritual help, die only between nine and five'
LONDON LETTER:Chaplains fear patients of faith could go to their deaths alone because of hospital cutbacks, writes MARK HENNESSY
EVERY DAY, Carol English, who works with the College of Health Care Chaplains in London, receives calls from worried chaplains attached to English hospital who fear that accelerating National Health Service cutbacks will see them being made redundant, leaving patients of religious faith facing operations or death without the opportunity of spiritual comfort.
Some have already been let go by the Imperial College Healthcare NHS Trust in London and the Maidstone and Tunbridge Wells NHS Trust, while others have had their hours cut dramatically.
The chaplains, who are mostly drawn from the Anglican, Catholic, or other Christian faiths, are “a soft target”, said English, for NHS managers trying to save money, even though the savings made are trifling.
The consequences, however, are not. Under the strict rules that govern the NHS, chaplains fulfil duties that cannot be easily handled by local parish-based priests and clerics. “Already, the cutbacks in the out-of-hours services mean that you should not die out of hours if you want spiritual help. Die only between nine and five,” English said.
Because of data protection and other rules, the chaplains are the only ones who can be given information about patients – their faith, if any, and, whether they want to see a religious pastor.
“Local priests could only be called in by the families of the patients concerned. They wouldn’t be given any information about anyone else in the hospital,” she said.
Last year, the NHS said it aimed to “respond with humanity and kindness to each person’s pain, distress, anxiety or need. We search for the things we can do, however small, to give comfort and relieve suffering. We find time for those we serve and work alongside.”
In some biting comments, Archbishop Vincent Nichols, head of the Catholic Church in England and Wales, said the NHS declaration held “splendid sentiments, suitable as a mission statement for any Lourdes pilgrimage. Often they are fulfilled in NHS hospitals, for which so many are very grateful. But sometimes they are not, as some will know from personal experience.”
Too often, the NHS reduces the sick and the dying to “a bundle of genes and actions”, he said. “There is a hidden violence in so many of our systems, even those of care, because their operational mode is reductionist. If we reduce death to a clinical event and manage it through a series of standard procedures then we do not deal with death well, either clinically or humanly.”
Last month, Welsh minister for health Edwina Hart issued a blunt instruction to the NHS there that it must provide spiritual and religious care consistently to those who need it and have places in every hospital where people of faith can pray.
“Many people, religious or not, need support in their life, especially in times of crisis or when they are extremely vulnerable.
“It would be easy to assume that people with religious belief leave their faith at the door when they enter hospital . . . but we know that the opposite is often true. I want the NHS in Wales to be aware of and care for the diverse spiritual, cultural and religious needs of all the people,” she said, adding that such comfort could actually reduce the NHS’s costs, not increase them.
However, not everyone agrees. The National Secular Society believes that religion should play a much smaller part in hospitals, and that it should not certainly not be funded by the taxpayer. Chaplains have “put up a spirited fight defending their corner”, said NSS president Terry Sanderson, but few people realised that they were being paid for by the state. “Many people simply assumed that they were clergy working for the churches but based in hospitals. That’s what we think it should be.”
The NSS found that the NHS spends £32 million annually on chaplains’ salaries and pensions, though the secularist lobby group believed the total tally would exceed £40 million.
An official figure from the department of health is not available, but there have been few public quibbles about Sanderson’s estimate.
For example, the Barking, Havering and Redbridge Hospitals NHS Trust pays £160,000 for the three chaplains it has on its books, along with one part-timer, while the Central Manchester and Manchester Children’s University Hospitals NHS Trust pays just over £250,000 to fund its five full-time chaplains, and one part-timer.
“The average cost to the
health service of a chaplain is £57,000 per annum. I’m sure if patients were asked where they wanted their money spent – two and a half nurses or more than four cleaners rather than one cleric – it is clear that nearly all would opt for the nursing or cleaning staff,” said Sanderson.
Change is coming, though. Already, NHS chaplains have received letters asking them if they would be prepared to retire, take time off, or go on part-time hours, while chaplains who are over 65 – as many of those who are Anglican or Catholic are – have “no chance” of being kept on, even though many of them want to stay, said Carol English.