Health chaplaincies should be funded by religious groups, say secularists

By staff writers
April 8, 2009

Chaplaincy and spiritual care in the National Health Service should be funded by churches and religious organiations instead of by the taxpayer, says the National Secular Society.

The NSS claims that chaplaincy services are costing the NHS more than £32 million. It says this would pay for around another 1,300 nurses or over 2,500 cleaning staff.

Using the Freedom of Information Act, the Society undertook its own research into the cost of chaplaincy services after the government said it did not keep centralised figures on such spending.

“The headline figure only takes into account the salaries of the chaplains. It doesn’t take account of National Insurance contributions, pension payments, administration costs, office accommodation, training, the upkeep of chapels and prayer rooms,” said Terry Sanderson, president of the National Secular Society. “We can conservatively add another 20% to the headline figure taking it up to £40 million.”

The NSS has now sent the report to the Health Minister, Alan Johnson, calling on him to review chaplaincy services with a view to ending taxpayer funding for them.

Mr Sanderson said: “We are not asking for an end to chaplaincy services, but we are asking that the taxpayer not be made responsible for them. In these times of financial stringency, hospitals are going to have to think very carefully about how they spend their budgets. Hospital chaplains are not on most people’s list of essential services in a health care setting.”

He added: “For some people – we suspect a very few – chaplains serve a useful purpose. But most people would prefer the tens of millions spent of clerics to be spent instead on nurses, doctors, cleaners and equipment."

Mr Sanderson said that if the churches and religious bodies considered these services vital, they should be prepared to fund them themselves.

“Most people who go into a hospital come from the local area,” said the NSS president, “and it would be better if their own vicar, priest, rabbi or imam came to see them if they felt in need of religious support. This could be done as part of the clergy’s regular duties – it should not fall as a burden on the NHS.”

Mr Sanderson said he was asking the Health Minister to conduct more thorough research into what extent these services were actually used by patients and how appreciated they were. “We get plenty of mail from people who feel they have been pestered not only by chaplains, but by religiously-motivated nurses,” he said.

The All-Party Parliamentary Group for Chaplaincy in the NHS, which has around 40 MPs in membership, says that spiritual care - which is not necessarily religious - can be a vital part of overall health care. The same point is argued by NHS Trusts and the Department of Health.

Chaplains are not compulsory in the NHS, as they are in prisons, the armed forces and higher education.

Health chaplaincies have already suffered dramatic falls in funding. Research carried out in 2007 indicated that chaplaincy care since 2005 has been cut by 54,217 hours per annum.

In the same year, the union-backed College of Health Care Chaplains warned that up to 40 per cent of the 850 hospital chaplaincy posts in England were at risk.

Thousands of dying patients and bereaved relatives will lose out on vital support, it said at the time.

The Rev Dr Chris Swift, then president of the CCHC, commented on the 2007 research: "NHS managers ... view the chaplains as ‘a soft target. But the NHS is not in financial difficulties because of spending on chaplaincy. Managers need to make lasting improvements to other services – not raid chaplaincy in order to cover up their lack of progress elsewhere."

He added: "Chaplaincy is a flagship service in delivering care that meets the diverse needs of patients in modern Britain. It is available to all and personal to each. Our society has always valued the care of the vulnerable and that includes those approaching the end of life. I ask the Government to show its commitment to the chaplaincy guidance already issued by the Department of Health."

This morning the Unite Union dismissed the National Secular Society's comments as "based on erroneous and simplistic assumptions".

A Church of England spokesperson responded by saying: "Spiritual health care has long been acknowledged, by both medical practitioners and the churches, to be an intrinsic part of caring for people in hospital. NHS Trusts pay for chaplaincies because they see them as part of their duty of care to patients, not because the churches force them to."

Speaking on the BBC Radio 4 Today programme on 8 April 2009, NSS's Terry Sanderson said that his organisation's call for churches and religious bodies to fund NHS chaplaincy was not calling for an end to such provision, "far from it".

However, in 2007 the National Secular Society stated "these chaplains are parasites", and it adds today: "Clergy should only be in hospital by request. A hospital should not be a happy hunting ground for religious proselytisers, whether they are chaplains or other hospital staff.”

NHS guidelines published in 2003 for managers and staff meeting the religious, spiritual and pastoral needs of patients rule out "an evangelistic role" in the provision of such services.

The NSS has described work done by chaplains as a waste of money and "of dubious value to all but a few". But it opposes assessment of the spiritual needs of patients, describing one such plan in Southampton as an "intrusion".

Some hospital chaplains, including a few humanist ones, work on a voluntary basis. The British Humanist Association (BHA) has promoted the pastoral and spiritual care for non-religious people in the health system, arguing that the NHS should support care for all rather than funding for specifically religious provision.

Simon Barrow, co-director of the religion and society think-tank Ekklesia, commented: “Spiritual and pastoral care is an important part of health, healing and care for the dying. You can’t reduce health care to needles and dustpans. But that isn’t the same as saying that the NHS should pay for exclusively denominational chaplains. An inclusive approach is needed.

"It’s an area where there are opportunities for creative partnership between decently-funded hospitals and trusts, voluntary groups, faith bodies and those with a pastoral concern for the non-religious too. A forward-thinking review and reliable data, both qualitative and quantitative, is called for.

"However, we question the idea that spiritual care in the NHS should be provided and funded exclusively by the religious. That assumes that the two are simply synonymous - whereas for many, they are not. People in need should not be made dependent on charity."

He added: “As far as Christians are concerned, the spiritual care of the sick and the provision of resources to do this, remains a basic obligation of the church community. They cannot rely on the general taxpayer to foot the bill for this. The role of the church for those in its specific care and that of the NHS in supporting patients from a variety of backgrounds may also be different. But they can work together.”

The Unite union told Ekklesia today that the assumptions behind the NSS's proposal would leave ancillary services in the NHS vulnerable and underfunded, with people reliant on volunteers rather than paid professionals, including chaplains.

A Department of Health spokesperson said it was "committed to the principle of ensuring that NHS patients have access to the spiritual care that they want, whatever faith or belief system they follow".

He added: "Chaplains do an extremely demanding job, often in difficult circumstances, and their skill and dedication is highly valued by patients, relatives and staff within the health service."

In practice, there are a variety of arrangements for providing chaplaincy services, and the question of who pays for what is raised in different quarters.

Peter Kearney, speaking on behalf of the Catholic Church in Scotland, said: "[Our view is that] Religious and spiritual carers should not be employed by the NHS nor funded by the NHS. Priests will not become employees of Health Boards nor receive any payments for duties which are part of their pastoral ministry."

But an equalities specialist in the care field commented to Ekklesia: "I have problems with the National Secular Society's apparent assumption that if people in a hospital setting want anything other than clinical support, they should be reliant on faith communities being able to raise the funds to provide it."

She added: "In that case, someone whose child has just died, who has been told they have cancer or who has lost their job through mental illness and is seeking to make sense of their identity in new circumstances should presumably just 'pull themselves together'. Other staff in hospitals are usually under-trained and often far too busy to deal with such needs."

Also on Ekklesia: 'Why health chaplains are vital', by Professor Stephen G. Wright -

Although the views expressed in this article do not necessarily represent the views of Ekklesia, the article may reflect Ekklesia's values. If you use Ekklesia's news briefings please consider making a donation to sponsor Ekklesia's work here.