Worcestershire Acute NHS Trust is setting a regrettable precedent by withdrawing two thirds of the funding for the chaplaincy service this year, with the intention of ending all funding next year. No doubt other cash strapped NHS Trusts are watching developments closely.
The chaplaincy service consisted of three full time Anglican chaplains between the three hospitals of Kidderminster, Redditch and Worcestershire Royal. There are a further 4 part time visiting chaplains. All the Catholic chaplains are part time and based in local parishes and there is evidence that their parishioners were well cared for by the “on call” priest. Other faiths also have visiting clergy for their own communities. It is futile to suggest that medical and nursing staff can meet patient's spiritual needs. Indeed the staff themselves may require spiritual support from time to time.
Of course when there is financial stringency all departments may be called on to make savings. The chaplaincy service, in line with other services, found the 15% savings suggested for all departments, but in the event all the resident chaplains are to be made redundant and the service reduced to a shadow of what it used to be. It is the only department to be virtually axed in the present financial crisis. As for replacing them with unpaid volunteers, this cannot be permitted under employment law as it could result in counter claims of unfair dismissal.
The decision was made in the confidential part of a Board meeting and no minutes are available for scrutiny. The Board did allow representations from the Bishop of Worcester but the decision was effectively irrevocable. At a public AGM of the Board, members of the public including eucharistic ministers and former patients, spoke against the decision and the Archbishop of Birmingham was represented by a full time Catholic chaplain. A UNISON representative spoke in support of individual chaplains but the nurse member of the Board claimed that there were fewer requests for chaplains and the medical representative said that none of the medical staff considered a chaplain essential. This was in spite of the fact that medical staff had not been formally asked their views, but seems to be based on some private conversations in which doctors had been asked to consider priorities. Not surprisingly they put clinical staff first.
After criticism in the press, County Council and from MP s the Board has belatedly agreed to talks to consider a way forward though they are thought to be looking for only a visiting pastoral approach. There is no disguising the strong impression that they are giving that spiritual care is not a call on NHS resources and presumably has little place in healing. They seem to be surprised and somewhat embarrassed to find that the public do not altogether agree and many have written in to say so. Archbishop Nichols` letter was favoured with a stock circular from the Chief Executive prefaced “Dear Sir or Madame” and he was not amused! After all the maladroit action which is beginning to have political repercussions, there remains the needs of the majority, who whilst Christian, are not normally members of any worshipping community. They comprise 70% of the full time chaplain's work and their spiritual needs have been served heretofore by visible hospital chaplains, and their co workers.
Dr Jones began by inviting the audience to introduce themselves and in addition to nurses and doctors present were cancer survivors, patients, former nurses and a priest with chaplaincy duties. Dr Jones herself has a background in nursing with 13 years experience in ITU. She describes herself as an “undenominational Christian”.
She began by saying that the euthanasia debate, as conducted in the media did not correspond with clinical realities. She went on to outline the present law which accepted the concept of futile treatment or treatment which would not alter the ultimate outcome being withdrawn or withheld. It also accepted the principle of double effect whereby, it was lawful to treat symptoms though an unintended outcome may be the shortening of life. Courts were extremely reluctant to become involved other than to give a declaration on the lawfulness of a particular course of action. In fact, very few doctors had been prosecuted for homicide except in rare cases such as that of Dr Harold Shipman. Most doctors who found themselves prosecuted for causing death, were charged with manslaughter. The Assisted Dying Bill introduced by Lord Joffe was a departure from the present homicide law because it actually legalising intentional killing. It had led to deep concern amongst lawyers because it contradicted the current law proscribing deliberate and intentional killing.
The Christian Medical Fellowship had heard that a new and amended Assisted Dying Bill for the Terminally Ill was being prepared for debate later this year. It differed from Lord Joffe`s Bill in that death was to be anticipated within 3 months as opposed to 6, and that doctors with a conscientious objection would not be required to refer to other doctors with no such objection. A “cooling off period,” and a witnessed written request would be required. Retrospective monitoring would be put in place though she thought this prove ineffective as the main witness would be dead. At the same time amendments, and later statutory instruments, were being prepared to extend the Bill during its passage through Parliament or in the event that it reach the Statute Book. The Bill is intended to give a small group of highly autonomous people what they wanted .
She felt that physician assisted suicide was “the worse of all options,” as it would lead to discrimination against vulnerable and helpless people who may feel themselves to be a burden. There were considerable problems with prognosis, especially of degenerative conditions, and that the lowest point in many peoples lives was after the diagnosis of terminal illness rather than as death approaches.
She concluded by reference to scripture where Jonah, Job and other servants of God had begged for death. This had always been denied them and they continued to witness to Him.
In the forthcoming debate Christians will need to make their voices heard.
Dr Tony Cole
Master