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EDITORIALS: Julia Neuberger The NHS as a theological institution BMJ 1999; 319: 1588-1589 [Full text]

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The Whisky Priest

Kevin Pearce   (18 December 1999)

Visit Epidaurus

Patrick Riordan   (29 December 1999)

Churches and garages of health care

Kalman Kafetz   (7 January 2000)

Abundance in religion, scarcity in N.H.S.

Peter Davies   (10 January 2000)

"God Knows He Isn't a Doctor"

Roger M Goss   (7 February 2000)

The Whisky Priest 18 December 1999
Kevin Pearce, GP Harrow Send response to journal: Re: The Whisky Priest	Its all very well congregations losing their faith. Priests have pride too however. Many are fed up trying to provide ever increasing miracles to an avaricious public whilst their church and "god" does not provide them with the resources. The health service IS its staff. Increasingly they see litlle reason to continue to believe in their church.Many priests and servers might prefer to work in a garage where the duties are clearly understood and adequate resources are available to do the job properly.
Visit Epidaurus 29 December 1999
Patrick Riordan, Locum Consultant Llandyfaelog Wales Send response to journal: Re: Visit Epidaurus	Rabbi Neuberger's article thought provoking---however society must also look after the priests of its chosen religions if it expects them to provide succour and relief---Mammon beckons
Churches and garages of health care 7 January 2000
Kalman Kafetz, Consultant Physician Send response to journal: Re: Churches and garages of health care	Rabbi Julia Neuberger's division of health delivery institutions into churches and garages (1) is exemplified by care of the dying. Hospices are churches. People die in them, usually without artificial use of fluids and food, from their diseases to the comfort of their loved ones. Geriatric wards, whatever other descriptions we use, are garages where relatives, encouraged by the press, are as suspicious as doctors are about mechanics. When patients die in a similar manner to those in hospices, accusations are made of covert euthanasia to increase the use of beds. Paediatric units are churches with Great Ormond Street as the holy of holies. This explains the extreme nature of the reaction to Bristol. 1.Neuberger J. The NHS as a theological institution. Bmj 1999;319:1588-9
Abundance in religion, scarcity in N.H.S. 10 January 2000
Peter Davies, G.P. Principal Alison Lea Medical Centre Send response to journal: Re: Abundance in religion, scarcity in N.H.S.	Sir, A minister of religion draws on an abundant and freely and universally available source of love, morality and strength. God (so far as I know in all religions) is not rationed. Ministers do not go around saying,"Sorry folks, today there's only enough of God to go round the people of Leeds. The people in Lancaster will have to wait till we get more supplies in" Indeed my own Christian faith celebrates the abundance of God's riches and contrasts them with the scarcity and poverty of earthly existence. As a doctor in a largely secular organisation I have to deal with the problems of earthly scarcity. The British public may believe that the N.H.S. is the best health service in the world but this is probably because of our limited national perspective and not from a wide knowledge of the wider world. It is worth noting that few countries have chosen to follow our model of health service. Also few rich countries have chosen to invest as little in health as we have. The doctor of today is no priest or minister. To some extent I can offer solace for tired souls but I cannot always promise the best of earthly cures to my patients. The service is rationed at all points. For example, is a seven month wait for M.R.I. scans (this is the current figure in the west of Scotland. I doubt the rest of the country is much better) acceptable to anyone, doctor or patient? And yet as a doctor I have to work within a system where the lack of resources is severely hampering the efforts of all doctors to practice good medicine for our patients. It is certainly leading to delays in investigations and consequent treatments. The lawyers are making a killing from this and thereby making N.H.S.scarcity even worse. In these circumstances even the best practice of the doctor-priests is not going to be as good as it could be. We are not going to be able to deliver the standards that the public want and that we as professionals would like to be able to deliver. The N.H.S. is a sacred cow politically. Any threat to it must be dealt with by finding scapegoats such as underperforming doctors or the forces of conservatism. I believe the time has come for a radical and probably heretical look to be taken at the N.H.S. (e.g.charges at point of use) This in time will lead to a new and hopefully better N.H.S. which will treat patients more quickly and accurately whilst also allowing better conditions for N.H.S. workers. Despite my current frustrations with the service I work in I believe progress is possible. However I hope no-one is so deluded that they believe that any form of medicine can be a religious faith. Even a modernised N.H.S. will be unable to keep us from facing the great questions of religious faith and purpose. Yours sincerely, Peter Davies.
"God Knows He Isn't a Doctor" 7 February 2000
Roger M Goss Send response to journal: Re: "God Knows He Isn't a Doctor"	Dear Sir Faith has undoubtedly enabled many individuals to cope with ill health and face death with comparative equanimity. But I would argue that theological institutions have quite possibly harmed as many people as they have helped. Religious intolerance suffuses the last two thousand years. A church requires its adherents to subscribe to a set of dogma, however irrational or destructive of human autonomy. A first-class garage services its customers' property to their satisfaction. But blind faith in the garage business can result in roads filled with mobile health hazards. Similar mindless faith in the NHS may result in an environment peppered with human ones. After Bristol, and more recently Alder Hey, restoration of consumer confidence is the medical profession's greatest challenge in the new millennium. Happily many doctors recognise the need and are working hard to promote honesty, openness and accountability in the belief that these will re-create public trust in a service staffed predominantly by dedicated and inherently well-intentioned people. From a consumer perspective, extolling the virtues of faith in the NHS as a religious institution may actually run counter to building a new kind of doctor/patient partnership. Mutual respect and a willingness to learn from one another are the foundation of any "first-class service"; not treating doctors like priests or rabbis with a hotline to God. For after all, "God knows he isn't a doctor." Roger M. Goss BMJ Editorial Board member and bona fide PK (1) (1) American expression denoting genuine preacher's kid, in this case a Methodist.