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Chaplains For Military Patients

Volume 41: debated on Tuesday 10 August 1920

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rose to ask the Chancellor of the Duchy of Lancaster how many military patients there are who have been transferred from the War Office to the Ministry of Pensions, and are still under treatment; what arrangements have been made for their spiritual care; how many hospitals devoted to the treatment of these patients require a full-time chaplain; whether these chaplains have been provided and what previous experience they have of hospital work; how many chaplains have been appointed to look after two or more hospitals; in how many cases officiating clergy have been appointed; what arrangements have been made in the Pensions Department in London for the supervision of these chaplains and officiating clergy; and what system of inspection has been set up.

The noble Marquess said: My Lords, I apologise to your Lordships for having put this Question down at so late a period, but the truth is that I have been in communication with the Ministry of Pensions on this subject for many months past, and it was at the request of the Minister himself that I postponed it. The circumstances to which this Question alludes have arisen in this way. When the war was over the military patients under treatment were transferred from the care of the War Office to the care of the Ministry of Pensions. Every sort of precaution was taken with regard to their medical and nursing treatment, but one element was overlooked. It was quite forgotten what was to be done in respect of their spiritual care, and no chaplains were provided under the Ministry of Pensions to correspond with the military chaplains under the War Office.

I need not tell your Lordships how very important the chaplain services are in connection with hospitals. It is more and more certain, according to modern medical and scientific experience, that the sort of help which chaplains can give is of tremendous importance in the cure of military patients, especially in all cases of shell-shock, in which there is a psychological side; the action of a minister of religion is of the greatest importance in the cure of patients suffering in this way. It is true in a lesser degree of patients who are not suffering from shell-shock, but especially true of those who are so suffering. It was, therefore, of vital importance to make this provision, and it was in consequence of a kind communication from the then Minister of Pensions that I ventured to interest myself in this subject. I may say that I have been connected for many years with the Chaplains Department of the War Office, and I therefore understood something of the subject.

When these patients were transferred from military hospitals to the Ministry of Pensions the whole hospital was transferred, and they are still treated in hospitals devoted to them alone. In other cases these patients were in hospitals which were not specially military hospitals, but still under the care of the Government. It is necessary to provide for the spiritual ministrations of the patients in both kinds of hospitals. For that purpose you require a certain number of whole-time chaplains, and I am very anxious to know how many patients there are in these hospitals entirely devoted to military patients, and how many whole-time chaplains have been appointed. In some cases the hospitals are small, and whole-time chaplains can look after more than one such hospital. I want to know how many of these there are.

There are three divisions—the large hospitals which occupy the whole time of a chaplain; small hospitals (more than one of which can be looked after by a whole-time chaplain); and then there are those patients in special hospitals who are looked after by officiating clergymen. I may say that "officiating clergymen," in the technical language of the War Office, is a minister of one denomination or another who is a civilian minister of religion, but who, in consideration of a certain remuneration, looks after military patients. I presume that a similar system is pursued under the Ministry of Pensions. They are all part of the Chaplains Department, and I ask the Government how many of each kind there are?

I want to ask, in addition, what arrangements have been made at Headquarters for the supervision of this Chaplains Department? It is, of course, a very much smaller Department than that which existed under the War Office, but it is and must be a special Department, and there ought to be some central organisation at the Ministry of Pensions for the purpose of running it. Lastly, there ought to be a system of inspection. Your Lordships will realise that in the course of the war a great amount of experience was acquired, I am glad to say, of the proper action of chaplains in cases of this kind, of their duties and of the best method of treatment. An immense amount of knowledge was thus acquired of the particular methods of approaching a very sick man, and the sort of equipment and provision which you require in a large hospital. For instance, you require some small place corresponding to a chapel where the Sacrament can be administered, and among other things you require this special expert treatment of the sick. Therefore a system of inspection is of the greatest value. You want some first-rate expert chaplains at headquarters, whose business it shall be to inspect the chaplains in various parts of the country who are looking after these sick people, both in the hospitals where none but military patients are treated and in the civilian hospitals where only a few beds are occupied by military patients; that is to say, cases where whole-time chaplain's are used, and cases where the officiating clergy are used.

I hope that a regular system of this kind has been set up, and that not only in the inspecting chaplains but in the whole-time chaplains themselves full use has been made of the great experience which has been gained in the war. It would be a thousand pities if this wonderful store of knowledge and experience were wasted. I urge this very much upon your Lordships. I am extremely sorry that it is so late in the session and that the natural fatigue which pursues us all makes it difficult to impress the House, but I am sure for any one who, like myself, has had the great privilege of being connected with these services the vital importance of them cannot be exaggerated.

There is another aspect, and a pathetic aspect, which I would venture to urge upon the Government. After the Armistice was signed there was a curious change in public feeling and practies. Up to that date there was nothing that was not done for the Army, for the soldiers and for the military patients, but the moment the Armistice was signed people's minds were entirely changed, and were turned away, and nobody paid any more attention to this subject. It was a most lamentable result that all these sick people, who had had all sorts of visits and pleasures provided for them, were left to shift for themselves. Nobody went near them or endeavoured to make their lot happier. The whole thing closed down in a moment. Public attention was diverted elsewhere, and these patients were left deserted. At any rate, if a proper system of chaplains is created there will be some mitigation of that state of things, because you would have, wherever military patients are to be found, a minister of religion specially interested in seeing not only after their strictly spiritual care but after the little amenities and recreations which can be afforded them. He could also mobilise local public opinion to help them.

This is not a matter of the Church of England only. I am speaking on behalf of patients of all denominations, and I am urging what I am sure the Government would desire to second, that ministers of all denominations should be provided for this service, whether Roman Catholic, Nonconformist, or Church of England. I hope that the Government. will not think I have said too much, and I confidently rely upon the answer of my noble friend to show that the Minister of Pensions is fully alive to the importance of this subject.

My Lords, it was quite unnecessary for Lord Salisbury to assure the House that the case which he has made out this afternoon was a case irrespective of the Anglican Church. For many months past Lord Salisbury has been in very close communication with the present Minister of Pensions, and indeed with his predecessor as well, with the desire of securing an improved administration of the chaplains branch as regards this remanent of wounded soldiers. As long ago as May of last year it was necessary to inform Lord Salisbury that in view of the small number of institutions concerned it was not considered necessary to set up a chaplains branch as such, but at the same time that the Chaplain-General of the War Office had consented to nominate any full-time chaplain who might be employed, and that in the meantime work would be allotted to officiating clergy.

Let me now deal with the specific question put upon the Paper by Lord Salisbury. In the first place it should be clear that the majority of ex-Service men receiving treatment under the provisions of the Warrants administered by the Ministry of Pensions are accommodated in civil hospitals over which the Ministry of Pensions as such has and can have no control; but I understand that the ex-Service patients participate fully in the arrangements made for the spiritual welfare of the civil patients.

Perhaps. But I will give the figures. There are at present 12,186 patients, including 1,159 serving soldiers, distributed amongst 90 hospitals and institutions under the direct or indirect control of the Ministry, of which over 60 have less than 100 occupied beds. Therefore it will be seen that some of the institutions where sick and wounded men are cared for are extremely small. Mr. Macpherson thoroughly appreciates the necessity of meeting in full the spiritual requirements of the patients; and recognises the wide influence, apart from his purely religious functions, of an efficient chaplain towards the physical recovery of patients, especially those suffering from neurasthenia and kindred complaints.

The spiritual services of ministry hospitals are at present carried out by officiating clergy who are nominated by the superintendent of the hospital from members of the local clergy, and sanction has been obtained for their remuneration on a capitation basis where the number of patients of the particular denomination is fifty or over. Where the number is less than fifty arrangements are made by the superintendent for clergy of the denominations concerned to act in this capacity, though the Ministry has no power to remunerate such officers. The number of appointments up to date is as follows. Twenty -six appointments have been made of paid officiating clergy and twenty of these are clergy of the Church of England. In addition, a large number—upwards of fifty—have agreed to officiate without remuneration. Therefore, at the present moment we have got seventy-five or more chaplains or one chaplain to 165 patients. Assuming the distribution to be tolerably equal, this percentage would be by no means unsatisfactory. As regards the question about supervision, the immediate supervision of the officiating clergy rests with the superintendents of the hospitals concerned.

He may be a civilian or he may be a soldier, but he is under the Ministry of Pensions.

I am not clear that he is an official of the Ministry of Pensions, but he is certainly under the Ministry. If he is an acting soldier he probably would not be called an official of the Ministry of Pensions, though he is under the Ministry. I think that is the case, but I can make quite sure. The immediate supervision of the officiating clergy rests with the superintendents of the hospitals concerned, and these superintendents are responsible to the Commissioner of Medical Services, who is an official of the Ministry of Pensions, and the Regional Director of the region—one of the areas, that is to say, into which the Ministry of Pensions has recently divided the country. The arrangement is part of the general scheme of decentralisation which has been recently set up by the Ministry of Pensions.

No. The superintendent need not be a medical officer, I think. But perhaps Lord Salisbury will allow me to read my brief. There may be in it something more comforting. The arrangement in the regions is part of the general scheme of decentralisation under which the work of the Ministry has been delegated to the Regional Directors of the eleven regions into which the country has been divided. It gives every opportunity for those responsible to be in close touch with local circumstances and requirements. So far, no other system of inspection has been found to be necessary. The superintendents of the various institutions are fully alive to the need of securing the best available opportunities for those clergy, both as regards the spiritual welfare of the patients and the organisation of their recreation.

As to the question of appointing full-time chaplains it is a difficult one and for some time it has been engaging the close attention of the Minister. Mr. Macpherson is of opinion that such a course would be desirable in the case of the very largest hospitals, of which there are fewer than twenty, and possibly also in the case of hospitals which are situated in such remote districts that resident clergy are not readily available. On this matter the Minister of Pensions is now in communication with the Treasury to obtain the necessary financial authority to appoint full-time chaplains in such hospitals as I have indicated. Let me add, in conclusion, that the reports received from the superintendents of hospitals indicate that every effort is being made, and with success, to provide efficient ministration. It is, however, realised that it may be possible to secure improvement in some cases and, as I have just mentioned, the Minister hopes that the present facilities will shortly be supplemented by the appointment of whole-time chaplains.

My Lords, I am very grateful to the noble Marquess for having raised this matter. I need hardly say to any of your Lordships who have followed the history of this subject that we owe a great debt to the noble Marquess for the pains and trouble he has taken in regard to it, not only during the war but since. On behalf both of the Church of England and, I am sure I may say; of many thousands of men in the Army, I want to thank him for the unfailing care and attention he has given to the whole complicated and difficult matter of Army chaplains, and not merely to this particular point, though this is one to which his energy has been most wholesomely directed. I am grateful to the noble Earl for the account he has given for the Government of what is being done, and I agree it is a most difficult question.

It is not merely that, somehow or other, you have got to make arrangements in places where there are a few patients who need somebody who is not a "chance" man, who happens to be an incumbent in the neighbourhood with not too much to do, but that you want the very best type of man you can get. In some of the large hospitals with orthopædic and other departments which bring in a considerable number of these men, because the ordinary work of the hospital lies outside this particular sphere, they have fallen back, for the military part of it, upon—I do not like to say "chance help" in the sense that it is necessarily inefficient or unsuitable, but it is very liable to be so. It is not everywhere that you find the man who has the peculiar gifts wanted in this particular matter. So far as I have been able to follow the rather troublesome transactions and correspondence about it there has been this difficulty—that the Army chaplain, who would naturally be the man most competent to do it, cannot be put in a position in which he is to receive his pay from a source which is not an Army source, and, because of that difficulty about pay, you are in great danger of having the wrong men working in the hospitals.

I am interested to learn that the matter is now under the further consideration of the Treasury and the Ministry of Pensions. I cannot help hoping that the financial matter will be put straight and that the difficulties will be solved by some arrangement in which the War Office will also be concerned. Once you arrange that proper pay is to be given, and that a War Office man may be applied to the work—a man who has served under the War Office and who has the kind of experience required—the difficulty will be largely removed. I do not mean that it is chiefly a matter of pay, but if you employ a local man who has to give some time to this extraordinarily difficult and delicate work, he must be able to find somebody else to do his own work. It is not that he is unwilling to do it, but that he cannot be in two places at once. It may be largely Sunday work and his Sunday work is elsewhere. I am quite sure that the subject is well worth the careful consideration of the Ministry of Pensions, the Treasury and the War Office. It really is important and the consequences are more far-reaching than people suppose. I am grateful to the noble Marquess for bringing the matter up and for the work he has done in connection with it and I am glad it is still receiving the attention of the Treasury, the Ministry of Pensions and, I hope, the War Office.