http://news.bbc.co.uk/1/hi/health/7988476.stm
It is estimated that hospital trusts spend £32m on hospital chaplains. Could the money be better spent?
In my view, patients who want 'spiritual guidance' in hospital should be entitled to it but that does not mean the taxpayer should fund it. Taxpayers don't fund churches.
Last edited by Mulder; 8th April 2009 at 08:29 AM.
People in hospital may not be able to attend church - that is where I would see the difference in regards to what should come from tax.
I don't know if the money could be better spent because I don't know how people feel who are religious or what effect those feelings may have on their recovery, or how chaplains impact on any such effects.
What I do know is that when I pay tax I pay it to a collective so I try not to view how it's spent in terms of whether I personally will benefit - I'm not suggesting that's what you're doing in raising the question, more explaining why I would anser with 'I don't know'.
If I did think about it personally, right now I feel very grateful for our NHS, warts an' all. As a family I reckon we currently owe all the tax payers a buck or two. One dressing my hubby has on his finger they told him cost £150! The mind boggles at what all his care would have cost.
"Cost" is debatable here. The actual cost is probably a few pence, but it becomes £150 once endless layers of management and subcontractors get their cut. When I had some private treatment at an NHS hospital a couple of years ago, they proudly advertised how profits were deliberately high to fund NHS treatment (fund NHS bureaucracy, more like). The itemised bill I received included £35 for a single hypodermic needle and a similar amount for about 5 minutes' use of a (re-usable) instrument for looking inside of me (and I'm not talking about anything high-tech here). The surgeon explained that she would try to use as few instruments as possible, since every one she unpacked from its sterile shrink wrap would result in another £50-£100 on my bill.Originally Posted by Floppit
The thing is, the cost would be high regardless. The wages of a doctor alone as there was one on hand hour in, hour out for days, 3 CT scans, 2 MRIs, 4 days of critical care, a whole rescussitation team, 2 emergancy ambulance trips (not counting the one down south!), an opthamology team loading all there equipment into an ambulance to treat him where he was rather than move him, + said treatment and ongoing opthamology consultant, a 'plastics' team to save his finger end, more exrays than I can count, 4 echo heart scans, 2 (at least) cardiograms, almost a week of heart monitor equipment plus attending staff to read said equpiment, 2 months hospital care and all the things I can't remember or don't even know about.
Don't you think it would be rather churlish of me to consider us hard done by right now? As I said above it would only be relevant IF I was to consider tax from an individualistic and personal viewpoint.
The dedication - and cost - of the doctors etc., is not in question, either in your case or in my relatively trivial treatment. What I object to is that while the doctors, nurses etc., are dedicating their lives to saving ours, they have to think about some "internal market" process whereby their choice to, say, use the proper dressing for your husband's finger, is costing them £150 off their budget, and therefore, ultimately, taking away £150 worth of treatment from other patients. I hope it never occurred to anyone to skimp on the dressing because of the cost - I don't expect it did to the doctors, but I'm not so sure about the managers above them - but my point is that they should not even have to consider this.
£32million, large number! Difficult to put into context, lets try.
The cost of cancer drugs for a year for 1,000 patients.
The cost of 10 MRI suites.
The cost of putting a population the size of Cambridge on statins for a year.
The cost of running an Air Ambulance for 15 years.
In fact hospital chaplains account for 0.036% of the NHS's £90 billion budget. A drop in the bucket.
Or to put it another way £50p per year from each and every one of us.
So really axing chaplains wouldn't make a huge difference. However there is a principle at stake. As an atheist I will never have need of their services so why should I pay anything even 50p for other people's spiritual needs?
However similar arguments can be made for other NHS services. I don't need an MRI so why should I pay for others, I don't need cancer drugs so why should I pay for others. In those instances it's all about pooling risk. I might one day need those things. But as a man I'll never need certain other treatments. We can beat about the bush for a while here but really if we accept socialised healthcare (and I recognise that not all do) then we must accept that we'll be paying for services most of us will never need.
So then we come on to need. Is that the difference between a hospital chaplaincy and a maternity ward. I will never directly make use of a maternity ward. There are others who can be certain not to even get an indirect benefit from it. However the difference is that the need for maternity wards by those who do make use of the service is far more real and measurable than the so called need for the religiously inclined to receive spiritual care. As atheists we see no reliable evidence that saying the last rights makes any pragmatic difference to the outcome. Maternity wards save lives.
It appears to us to be, if not a huge expense then a frivolous expense. If these people are victims of the oldest longest running con trick in human existence then they should be the ones to bear the costs not the rest of us. Or is this the same argument that says smokers should get lung cancer treatment on the NHS?
All the same I don't want to see hospital chaplains axed. There are many other NHS services which focus on the perceived quality of care rather than direct need. If our investigations into alternative medicine have shown us anything it is that such perceived quality of care can have a profound effect even in the absence of any actual medicine. There are many people who have questions about what they're going through that a doctor is not qualified to answer. Neither for that matter is a chaplain, but the sort of non-answers that they give appear to provide some comfort to those who ask these sort of questions.
I have a personal experience with the hospital chaplaincy service, even as a dyed in the wool, active-belief-that-god-doesn't-exist atheist. Our first son was a full term stillbirth. I won't dwell on the details but I can't emphasise enough that it was the single most traumatic experience of my life. The hospital chaplain visited us and politely enquired if we wanted him. We were surrounded by family some of whom had a religious bent and so for their sake we allowed him to say a little prayer. Since baby had been carried to term the law requires a funeral. The chaplain offered to take care of all that for us. This was all organised and paid for by the hospital. I'm unsure if this cost is included in the £32 million quoted, probably not, but the hospital chaplain did conduct the service. I must confess that I was aggrieved at the way he conducted a purely Christian service after assuring me that he could include a humanist element for my side of the family. However I don't see the answer as axing chaplains. They are supposed to be able to cater for all belief systems and I'm sure that with the proper training and co-operation with humanist groups my belief system can be more effectively incorporated into the service chaplains provide.
After the funeral we had the services of a bereavement midwife: sympathy, advice practical and emotional support. It was a real benefit to us but as I compare that to what a chaplain offers to those with religion I can't claim much greater pragmatic need.
Don't axe the chaplaincy service; improve it so that it better caters for those of use with differing philosophies.
Last edited by Matt; 8th April 2009 at 10:10 AM.
I agree that chaplains are probably the least of our problems regarding NHS wastage. I'd start with getting rid of 90% of the management and the internal market. I think the NSS point is that religious services should be provided by the charity of people who follow those religions - in other words, another case for disestablishment. I would hate to think, though, of Floppit's husband not getting the best finger bandage because the budget for it had been spent on a Catholic priest to give the last rites to the person who died in the same ward. This is the sort of decision the internal market forces people to make.
I have sympathy with that argument. If it works, use it.
As a matter of curiosity, how much does the NHS spend on counsellors to provide some comfort to the non-religious? Or animals - since experience shows that having a dog or some other pet to stroke makes a measurable difference to the wellbeing of some patients?
I wouldn't know. What I do know is that we had about 100 times as much face time with the berievement midwife (a trained counsellor) than with the chaplain. That said I'm given to understand that berievement midwives fall under the auspices of the our NHS postcode lottery and speaking to others arround the country who've had similar experiences, many are left high and dry. I feel that she was well worth her salary.
Doubtless the chaplains would claim that they offer their services to all, irrespective of belief, and that they help with training staff in respect of berevement and loss, further that they provide support for staff as well as patients.
However, it does seem that this is an example of discrimination. If you are not a christian tough luck because that's what is on offer. The more logical approach is to determine the counselling/support needs of the staff and patients and then to find the most cost-effective way of providing this. I suspect that 'purchasing' services from the church as required would work out cheaper. Further, as the chaplains are effectively advertising for the conversion of 'souls' at the point when people are at their most vulnerable, perhaps there is an ethical dimension to giving one group free reign.
Perhaps one could offer the 'opportunity' to the group most willing to pay - then one might actually make some money from the practice!
I'm not sure how true that is. Last time I was in an NHS ward I overheard the man in the bed opposite being asked whether he was religious, saying they could arrange a chaplain. When he said he was Jewish he was offered a rabbi instead, but he explained he was secular Jewish so it wasn't necessary. I suppose this might be because it was in a part of North London with a significant Jewish population, so it might not apply to all hospitals. Whether or not the rabbi would be paid by the NHS, I don't know.
It's interesting that I was not offered any spiritual support, even though I don't recall declaring myself to be an atheist. Perhaps it doesn't apply to people admitted via A&E.
It is alleged that my Uncle Bernard’s last words were uttered when he saw a priest enter his NHS ward and shouted “f#ck off you f#cking parasite!” at him before lapsing into a terminal coma. I’d have to suggest that even though he was an atheist he got his money’s worth out of that particular hospital chaplain?
I think it's really a question of equality and/or privilege.
Are religious people getting a service here, paid for by everyone, that isn't open to others (even if it's only because they don't believe the religious stuff)?
If psychological comfort is to be provided (and why not?) then it should at least be equally available to all and equally relevant to all.
I can only offer a personal insight to this, but when I had a family member in hospital who was recovering from a near-fatal illness, we had a chaplain keep popping into the room asking if she could do anything to help. I actually found it quite offensive. When someone is seriously ill and in hospital for a long time then the whole family suffer - the mental anguish is particularly unpleasant - and support would be most welcome; but I couldn't (nor anyone else in my family) accept some faith-head's input at such a traumatic time.
Surely this sort of help or service can be offered without the need for religion so everyone at least has equal and context-free access to it.
So I would say that if there's some professional counselling or support available then it should be on an equal, non-privileged basis; and if faith heads want their representatives there to offer support also then fair enough - but as the NSS say, they should fund it themselves.
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