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The NHS and the Church of England

Politicians are more than anxious over negative public opinion on the National Health Service, falling over backwards to say that the NHS is “safe in our hands.” Meanwhile, the Church of England (C of E) is concerned about losing “market-share,” especially over conducting funerals. One way of linking these two extremely large British institutions is in terms of life-style choices. Or, better still, over lifestyle and death-style choices. What have the NHS and the C of E in common over lifestyle? Just how do a people’s lifestyle link to this phrase—”death-style?” Are they closely linked or kept at respectful distances? These “styles” embrace key issues in our life involving grief, cemetery or woodland burial, cremation, and choice of who to take funerals. But one thing always leads to another and soon we have sporting, celebrity, political and royal deaths on our hands as well as afterlife beliefs of many sorts. Meanwhile, the media and social media flash opinions everywhere. Underneath all this lies a kind of power flow into and out of the British “establishment,” military and police, popular opinion and celebrity. Despite dense information many are unaware of the forces driving unfamiliar parts of British life with the Brexit vote flood-lighting the ignorance some have of other people’s views on the world.

So, what matters? It is my conviction that matters of life, health, sickness, well-being and death are what matter. They are universal, but shape up as British because of the National Health Service and, I think, because of the heritage and present influence of the Church of England. And let that church also stand as a short-hand for other religious groups. Tolerance, fair-play, and free speech are more familiar candidates for “traditional values” but the health factor drives our life concerns. How or where are these values united, nurtured and practiced, or ignored and trashed? Where do we “see” fair-play in terms of health-well being? While the obvious place to discuss this would be parliament and politics, an extensive loss of confidence and trust leads me back to NHS and the C of E. These two institutions, amongst the largest in the country, resemble invisible Trident submarines or starkly visible air-craft carriers that “carry” the cultural value of force through deterrence. “Carrier institutions” are vital for a people’s well-being. Justice under the law is a treasured prize in today’s power-ridden and often power-corrupted era. If trust is lost in these, trouble awaits. And sometimes trust is shaken and of dubious status.

Queen_Elizabeth_Hospital_Birmingham,_Edgbaston,_Birmingham,_England-7March2011
Queen Elizabeth Hospital Birmingham, the largest single site NHS hospital in the United Kingdom. Photo by Tony Hisgett. CC BY 2.0 via Wikimedia commons.

Where then can the abstract values of a complex society be carried, carried-out, and be seen to do so? I think the Church of England helped do this for centuries and still, to some extent, does so in thousands of UK contexts. But I also think that the NHS is taking up the slack, especially over the fundamental human concerns of health, well-being, and death. At a time when people’s ideas focus more on this life than on an afterlife, these issues come to the fore. If we speak of salvation at all, and it is the core message of Christianity, many see it as a good life here and now, and a good death here and now. And it is the NHS that is best placed to capture the desire for health and well-being, as well as providing a frame and context for dying and death.

But, what are values? They are, I think, ideas pervaded by emotion. Moreover, if and when some values go further and help shape our identity they become “beliefs.” These may be religious, spiritual, secular, scientific, philosophical, political, naturalistic or any shape or form. And beliefs matter because our identity and sense of who we are matters. Historically, the NHS started as an idea but has swelled into a value and even into a belief as our emotions of fear and hope are lodged in it.

In an age anxious over old-old age and the fear of disruptive sickness, the NHS has emerged as caregiver “from the cradle to the grave.” Because life really matters, Britons have developed a real commitment to the National Health Service as the framework and safety-net for personal and family life. The NHS helps make Britain a safe and less risk-ridden society than it was before the Second World War. The rise of the Welfare State helped make industrialized Britain a far safer place for workers and their families alike. Treatment at the point of need no longer depends upon wealth. The system that emerged includes pre-natal classes, maternity provision, child-healthcare, accident and emergency care, health monitoring of ageing groups, and end of life care. These capture “cradle to grave” expectations. But once expectations are born they take on a life of their own. “Accident and Emergency” is not an idea, it is more like a symbol packed with emotion, more like a value or even a belief than a mere political idea.

This helps us see the force of arguments over which and whether drugs should be provided by the State to extend a person’s life by some months or years. Should medication be allotted to some groups at the expense of treatment for others? Should lifestyle drugs be free? And what about death-style drugs? This is where deep issues arise and prompt Medical Ethics. The question of Euthanasia and assisted dying are, notably, more important than ever before. It is not wonder that multiple collisions arise over “ethics”: but are they “religious” or “medical” ethics. It is fascinating that the closing decades of the twentieth century are often described as increasingly “secular”at the same time as many institutions set up their own “ethics committees.” Ethics committees seem to be one marker of decline of public religious influence.

So, what of the Church of England? Despite some bad cases and sleepy eras it has, for centuries, cared in its own way and with its sense of Christian Ethics for people from the cradle to the grave—from Christening to Cremation. The rites of infant baptism, confirmation, marriage, and funeral ceremonies, as well as such periodic festivities as Christmas, Easter, and Harvest Festivals, all played high-profile parts in British life. Royal and celebrity marriages and funerals, along with death in tragedies, have all been played out through Abbeys and Cathedrals as well as local parish churches across the country. Decline in active church attendance and the decreasing role of clergy in funerals can be easily discussed in terms of secularization but I want to think more in terms of options of care and of the core cultural values that drive a society. Through extended debates on women’s ordination, the Church has even been a carrier for women’s rights.

Today, the C of E, with other churches and religious groups, is still there even if serving a decreasingly engaged population. It is understandable that bishops and clergy would like to extend their pastoral activity into baptisms, weddings and funerals; it is also very understandable why politicians shout through the media that the NHS is “safe in their hands” – for that phrase really means “you are safe in our hands.” Once upon a time the idea of “salvation” included the idea of health and ultimate heavenly well-being: just now it roosts upon our owner-occupier housetops, and is much desired by the homeless.

Featured image credit: Photo by AvidlyAbide. CC BY 2.0 via Flickr.

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