My opposition to hospitals Chaplains is not part of a knee-jerk reaction to all things religious. I support the right of everyone to have their own religion. The State should allow everyone to hold their beliefs without the fear of persecution and without undue interference. Religious individuals have nothing to fear from my secular opinions. All I ask for is freedom from your religion.
For everyone to be free to hold or not hold a religious belief, the State must be separate from religion. The State must be separate from the Church, the Temple, the Synagogue and the Mosque. If any religious person thinks that their religion deserves to be linked to the State, then that person wishes to limit the freedom of others.
The National Health Service is a State organisation, but the NHS is not free from religion. The NHS employs religious leaders as Hospital Chaplains and I think that this is inappropriate. From my second paragraph it should be clear that my opposition against Chaplains is not based on a dislike of religion. My opposition is not based on atheistic ideas. My opposition to chaplains would be equally justified even if I were a member of a religious group. The problem with the role of the Chaplain is that it incorporates religion into a State organisation, and in doing so, the freedom of others is diminished.
The majority of Chaplains who are paid for by the NHS are Christian. However, two weeks ago I spotted a rare job advert for a Hindu Chaplain. Today the NHS job website has five Chaplain posts available, each exclusively for Christians. The salaries for these five jobs start at £21,176 and go up to £40,157 for a Senior Chaplain on the Isle of Wight.
It is worth noticing that the Chaplain is the only job in the entire NHS which discriminates upon the grounds of faith. You can only apply for the role of the Hindu Chaplain if you are a Hindu. You can only apply for the lucrative role on the Isle of White if you are ordained. This is a closed shop. This is the provision of NHS employment based upon your ability to believe that Jesus was born of a virgin, walked on water and died for your salvation. I do not want people of religious faith to be discriminated against, but nor do I want public sector jobs to be allocated upon one’s credulity for scripture.
Discrimination of employment is one thing, but what upsets me is the effect that Chaplaincy has upon patients. I am sure that some Christian patients derive comfort and solace from Christian Chaplains. However, the NHS is meant to provide services for all patients so we need to need to consider the effect of Chaplains on non-believers too. The Church might not be used to considering the feelings of members of other faiths or of heathens who have no faith. From the view of the Church, non-believers are either destined for an eternity in hell, or else they are suitable targets for evangelism:
Non-Christians are deceivers and antichrists. John 2. 7
God destroys non-believers. Jude 1. 5
Whoever believes will be saved, but whoever does not believe will be condemned. Mark 16. 16
I recognise that the Bible also has compassionate passages. But it is undeniable that both the Old and New Testament can be cruel and intolerant. Chaplains, like all good Christians, are able to cherry-pick the loving parts of the Bible and brush aside the nasty parts. But, even if they do this convincingly, I do not think that their role in the NHS is justified. I will return to this point shortly but first I want to briefly address the meaning of “healthcare”.
When patients are critically unwell the first priority is to stabilize their condition. Clinicians must make the correct diagnosis and then provide appropriate treatment for the patient. This represents the “physical” aspect of healthcare. Some people criticise doctors for viewing the patient like a broken machine that just needs fixing. The reality is that the human body is analogous to a complicated machine. The lungs are elaborate bellows, the heart is a superb pump and the kidneys act like intricate filters. In an emergency situation all patients want a doctor who understands the body and knows how to fix it.
As healthcare has improved we recognise that there is more to medicine than merely fixing broken bodies. We recognise that people are more than just machines. Patients have psychological needs and social needs that also need addressing. For example, some patients suffer from depression or loneliness. Some patients are terminally unwell so it would be inappropriate to relentlessly try to “fix” them. Sometimes the best medicine is compassion, empathy and symptom control. This is termed “Psycho-Social” healthcare.
Advocates of chaplaincy try to define health in even broader terms. They claim that health is four-dimensional: Physical, Psychological, Social, and Spiritual. I am not completely opposed to a 4D approach of healthcare. However, we must remember that “spiritual” is not the same as “religious”. Click here for more about this. I am not certain of what constitutes a spiritual ailment. Would a belief in the “wrong” god be a spiritual illness? Can there be any objectivity in Spiritual Health? I think that that most of the examples that Chaplains give of “Spiritual Health” are not really the remit of the NHS, or otherwise, their claims are really just a convoluted distortion of what is already included in the Psycho-Social model of health. There is a difference between a physician and a priest. If you want medical treatment you can attend the NHS. If you want to know more about Jesus you attend a Church. Denying the distinction is just detrimental to both professions.
Chaplains endlessly claim that they provide a service for all patients, not just those of their own faith. On the Today programme Reverend Hodge made this point. So let’s examine this claim and in doing so we’ll notice how Chaplains keep morphing their role. So for the moment let’s forget that both Testaments of the Bible display intolerance to non-Christians. Let’s assume that the presence of a dog-collar and Bible does not evoke a sense intimidation or resurrect childhood memories of abuse.
Let’s imagine that the Chaplain really can provide a service to non-Christian patients. This is feasible. The chaplains could spend time simply listening to the patient. Many patients cherish the opportunity to speak to an attentive listener. The Chaplain could provide a sense of perspective without necessarily involving faith, and they could assist the patient in developing a positive outlook without mentioning Jesus. The Chaplain could consol grieving relatives and help with funeral arrangements without mentioning an afterlife. In fact it would be quite possible for the Chaplain not mention religion at all and still be of great benefit to the patient.
I would suggest, therefore, that the benefit that patients derive from the chaplain could be delivered by a non-religious person. The NHS could fund a “Patient Support Service” that is delivered without any religious affiliation. This service could be staffed by appropriately trained counsellors irrespective of their own faith. Applicants for the job would be selected based on their compassion and empathy rather than their knowledge of the gospel. This would be a service which could truly benefit all NHS patients irrespective of faith. This would be a service that I, and most secularists, would support.
But sadly, whenever this option is suggested, advocates for Chaplaincy claim that religious Chaplains have extra skills which “ordinary” compassionate people lack. “Chaplains, you see, have an understanding of god which is crucial to their role”.
Really? So then how can the Chaplains provide a service to non-religious patients, if a crucial aspect of their job is indeed religion? It seems to me that Chaplains are trying to argue both sides of the argument. They claim their role is open to all patients, but when a secular alternative is suggested, they claim that religion is a key part of their role.
The NHS spends £29 million on Chaplains every year. This is £29 million pounds that could be spent in better ways. Rather than employ a Senior Chaplain, a hospital could fund more healthcare assistants (£13,903) or doctors (£22,412). The Chaplaincy budget could be spent on more dialysis machines and more hospital beds. Or, that money could be spent funding a Patient Support Service without religious overtones. We could spend NHS money on all NHS patients.
I do not wish to banish religious leaders from the hospital. Local Vicars, Imams and Gurus should be encouraged to visit the hospital if patients request to see them. However, the NHS should not pay their salary. If I was a religious leader I would see it as my duty to visit the sick in my local hospital. Why would religious leaders object to this?
In summary, we all have our own beliefs and everyone is entitled to have a faith. In order for all of us to be able to enjoy the freedom to hold beliefs there needs to a separation of religion from the State. The NHS is a State organisation so its services should be equally available to all patients regardless of faith. Chaplains claim that religious differences are not a barrier to their work. However, they object to the idea of a non-religious Patient Support Service on the grounds that religion is crucial to their role. The Chaplaincy consumes valuable NHS resources which could be better spent on improving healthcare for everyone.
Where do we go from here? How can we improve things in a pragmatic way? I do not think that it is realistic for the NHS to lose all of its Chaplains overnight. I think that Chaplains should adopt the same approach to faith that every other hospital worker currently has. Each Chaplain will be entitled to their belief, but this belief should not be expressed to patients unless they specifically ask for it. Chaplains should no-longer be overtly religious as this is off-putting to patients of other faiths. The dog-collar should abandoned and there should be no need to carry a Bible. All new appointments should be open to everyone, not just members of one particular religion because it is discriminatory for NHS jobs to be based upon faith. The Chaplaincy can gradually morph into a Patient Support Service where the focus is on the patient rather than the faith.
If you agree or disagree with my opinion I would really like to hear from you. I’m convinced that an open debate on these delicate issues results in the best outcome.
If you disagree with my opinion perhaps you could give some consideration to the following questions:
- Which religious faiths should the NHS fund? Should we have Catholic and Protestant Chaplains? Sunni and Shia? Orthodox and Reformed? Hindu? Sikh? Rastafarian? Buddhist? Scientologist? Mormon? How do you decide which beliefs deserve their own Chaplain? How about philosophical beleifs? Would it not be better if patient support was provided without having to divide people up depending upon their faith? I think all humans are capable of experiencing fear, pain and anxiety whilst in hospital. Can we not provide a service which in inclusive and embraces diversity?
- Is it possible that religious leaders inadvertently put undue pressure on patients? Imagine that a Jehovah’s Witness is considering accepting a life-saving blood transfusion (a decision which is frowned upon by the faith). Would a visit from a Jehovah’s Witness religious Chaplain be beneficial in this situation?
- Does offering prayer to patients risk undermining medical practice? If prayer is claimed to work then perhaps taking medication seems less necessary?
- Does religion pose a particular threat to psychiatric patients who suffer from schizophrenia? The Bible gives religious explanations to the experience of hearing voices and seeing visions and this might be misinterpreted by the patient.
- If doctors are too busy to spend time with patients then shouldn’t we have more doctors rather than rely upon religious Chaplains?