Hospital chaplaincy units show bias towards Christianity

Letter - response to BMJ letter [BMJ 2004;329:626 11 September]
Re: Hospital chaplaincy units show bias towards Christianity

In response to the letter of 11 September on the so-called ‘bias’ of
hospital chaplaincy departments towards Christianity, I should like to
share some thoughts. I have recently finished a research project entitled
Listening to the voices of faith: the provision of spiritual and religious
care for the six main faith groups in Sheffield. The benefactor whose
estate financed my project, Dorothy Dixon-Barrow, was devoted to the cause
of equality of health services across the different ethnic communities in
Sheffield. The project was funded as a contribution to that cause. The
project had two distinct parts: a national overview of ‘multi-faith’
provision and local research by means of a questionnaire and interviews. I
wanted to see what the national provision of ‘multi-faith’ facilities and
staffing were so that this could be a benchmark against which Sheffield
could be measured.

During the project I conducted a national written survey which was
completed by 132 out of 176 Acute Hospital Trusts in England and Wales.
This represents a 75% response rate. Historically the provision of
spiritual care in hospitals has traditionally been the province of the
Christian hospital chaplaincy. As the UK has become more mixed –
racially, culturally and in matters of faith – it has become more
necessary to provide such care in a way which reflects the beliefs of the
growing number of members of what might be described – in the British
context – as minority religions. I would not describe the present
situation as ‘biased’ towards Christianity – it is a fact that the
Christian Chaplaincy provision and model of working has satisfied the
country’s spiritual and religious needs for years but of course it no
longer does. So adaptation and change is needed – ‘bias’ suggests a
deliberate approach which I don’t think is an accurate description.

There is a widespread acceptance of the need not to neglect the needs
of patients belonging to minority faiths. The NHS itself accepts this in
the DoH 2003 report as does the original Patients’ Charter 1991. A
further document Caring for the Spirit: a strategy for the chaplaincy and
spiritual healthcare workforce [SYWDC 2003] produced by South Yorkshire
NHS Workforce Development Confederation actually spells out how
improvements can be made to give equity of provision and this document has
been sent all Chief Executives. There is commitment from many Chaplains
to work towards redressing the present imbalance in provision but there
often are huge problems in persuading Trusts to provide facilities and to
pay for minority faith chaplains. The persistence of a few Chaplains does
result in change but the problem is that there is no consistency. So
provision up and down the country for Muslims and/or other faiths is
uneven and patchy. There is no correlation between the demographics of a
particular geographical area and the provision of multi-faith facilities
and staffing in the local hospital.

A further problem exists which is that the “minority faiths do not
have a formal tradition of ‘chaplaincy’ nor do they have personnel who
function as an approximate equivalent to a chaplain” [Gilliat-Ray 2001].
It takes time to educate and encourage faith communities that there is a
task for them to do and that it is their voices which now need to be
heard. Only in partnership with different faith communities can the
situation be addressed and this is already happening. My survey has
revealed that Chaplains regularly have contact with religious groups in
their areas. Out of the 132 responding hospitals the total number of
groups contacted were 534. The largest number of groups was Muslim and
Christian with the rest being evenly split between Hindu, Jewish, Sikh,
Buddhist and others.

In conclusion, the NHS needs to match its aspiration with commitment.
Christian Chaplains are at the forefront of pressing for change but there
needs to be a greater partnership with other faiths to help the NHS
deliver what it promises.

Helen Blackburn

Chaplain, Sheffield Teaching Hospitals NHS Foundation Trust

References

Blackburn, H., Listening to the voices of faith: the provision of
spiritual and religious care for the six main faith groups in Sheffield.
2004. (Available in PDF format via www.sheffieldfirstforhealth.net with
link to Dorothy Dixon-Barrow Award)

Gillat-Ray, S., 2001. Sociological Perspectives on the Pastoral Care
of Minority Faiths in Hospital. In Spirituality in Health Care Contexts.
H. Orchard, ed. Jessica Kingsley Publishers. p137

SYWDC. 2003. Caring for the Spirit: a strategy for the chaplaincy and
spiritual healthcare workforce.

Competing interests:
None declared

I feel I might have something to contribute to the replies to the
letter from Sheikh et al.

I worked for over 5 years (happily)in the coronary care unit of the
Manchester Royal Infirmary, until 2001, as a nursing auxiliary. The centre
of Manchester serves a wide variety of communities.

Every sunday for 5 years without fail (to my recollection) I asked
every patient if they wished a visit from a member of the chaplaincy.
Manchester Royal has a selection of chaplains from different faiths.I can
say that in 5 years I can recollect only 1(one) non christian asking to
see one of the chaplains. This was memorable becuse it was so exceptional.

The christian patients frquently replied yes. The Roman catholics
more frequent than Church of England.

I presume the reason for this is that christians require the presence
of a chaplain to fulfill the duties of a christian.

Do other faiths have the same requirement?

If other faiths do not have that requirement do they require a
chaplain of the same faith to fulfill their needs?

My own experience, despite being anecdotal,would make me doubt the
validity of Sheikh et al's criticism of access to chaplaincy staff.
This is for two reasons.

1/ If patients do not wish to have access to chaplaincy staff of
their own faith (or any other) how are they disadvantaged?

2/ Chaplaincy staff (of any description)would never turn down a
request to comfort or console or just visit a patient or relatives.

The role of Chaplain goes far beyond that of religous duties. If an
individual requires a chaplain for reasons other than a religous duty
surely this does not have to be from somebody of the same faith.

Perhaps a questionnaire to patients asking what they require from a
chaplaincy might clarify if they are disadvantaged by not having somebody
of the same faith to attend.

My last point is to strongly disagree with the statement that non
christians are disadvantaged by the quality of chaplaincy care. I felt
this was a slur to the chaplaincy care provided every day up and down the
country.

The quality of care was not assessed by Sheikh et al's questionnaire
and therefore should not have been commented on.

I felt it implied that members of the chaplaincy would not care for
non christians to the same degree as christians. I feel that this should
be challenged. Anybody who sees a chaplaincy in action would know this not
to be true.

To clear up any doubts about conflicting interests I am a non
christian.
Kind regards

Competing interests:
None declared

Sir

Is there a law which prohibits clergy of any faith requesting
authorisation for, then making, announced hospital visits to benefit any
patient who wishes to accept such a visit from them?

If not, where's the problem?

I note that the missionaries Susheel Oommen John cites made great
efforts, and still do, to reach the faithful - do the authors not find
that route just as acceptable?

Regards

John H.

Competing interests:
None declared