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NHS: Hospital Chaplaincy

Volume 685: debated on Monday 23 October 2006

asked Her Majesty’s Government:

In light of the actions of the Worcestershire Acute Hospitals National Health Service Trust, what steps they are proposing to take to ensure adherence to the Department of Health’s guidelines on hospital chaplaincy.

My Lords, the Department of Health remains supportive of the guidance issued to NHS trusts in November 2003 about patients’ access to spiritual care, irrespective of their faith or beliefs. NHS trusts are responsible for delivering that care in a way that meets the diverse needs of their patients. How they do so is a matter for local decision, particularly as these arrangements now vary considerably. It is not for Ministers to intervene in these local matters.

My Lords, I thank the Minister for his reply, though in our locality there is difficulty in believing that the trust, which has been condemned for this decision by virtually every democratic body in the area, is really responsive to local opinion. Is the Minister prepared to look at the mounting evidence that the trust’s decisions are motivated not, as claimed, by the need to get the books to balance but by a more ideological position on chaplaincy that actively subverts the guidelines of the Department of Health? If he finds that evidence—I am happy to supply it to him—compelling, would he then feel it appropriate for the Government to intervene in defence of the holistic concepts that lie at the heart of the health service?

My Lords, the evidence available to me is somewhat different from that available to the right reverend Prelate. The trust has a substantial funding gap that it has to make good by some £8 million this year and £16 million next year. It has to lose 675 posts, only three of which relate to chaplaincy. From the evidence that I have been given, the trust has good reasons for its decisions. One must bear in mind that the loss of three chaplaincy posts would be the equivalent of losing about four nurses.

My Lords, does my noble friend accept that support for the campaign launched by the right reverend Prelate goes way beyond the Church of England and includes many local community groups and the Amicus trade union? Does he not also accept that it would be most unfortunate if the hospital chaplaincy generally, outside Worcestershire, were seen as a soft target by health service trusts anxious to save money?

My Lords, I do not think that there is any evidence whatever of that, but if the right reverend Prelate wishes to give me such evidence I will certainly look at it. I have seen no evidence that there is some conspiracy to do down the chaplaincy throughout the NHS. The Worcestershire trust is trying to deal with some outstanding financial deficits, which it has to do. All of us want the NHS to balance its books properly; the trust is taking the appropriate action, and Ministers owe it to the trust to support those actions.

My Lords, does the Minister accept that people have spiritual needs and that chaplaincy is an important part of their healthcare because otherwise they might become much more distressed and not benefit from the treatment that they receive? Would the Minister consider another way of dealing with chaplaincies, through other organisations or bodies? If such groups were prepared to support chaplaincies, would the department be prepared to encourage them to continue?

My Lords, the noble Baroness is right. She puts her finger on the point that there are many ways to provide such spiritual care. We supported that, as Ministers and as a department, through the 2003 guidance, but we have to leave local people to arrive at local decisions on the best way of providing that spiritual care.

My Lords, does the Minister accept that, if there are cuts to chaplaincy services, there may be some difficulty meeting the guidelines set out, for example, in the Liverpool Care Pathway and the end-of-life care strategy that the cancer tsar, Professor Mike Richards, is preparing? Does he further accept that the Government have said that NHS organisations should make provision for those services? It is important to know the extent to which the Government are monitoring whether the arrangements are properly in place and that they will be maintained.

My Lords, I cannot think of another way of saying how much we stand by the 2003 guidance. We acknowledge those needs and have always made clear that it was guidance, not a performance management system. I thought that both Benches opposite were in favour of the Government giving local people more independence to make their own decisions.

My Lords, is the Minister aware that the attributes of hospital chaplains are unique—those of not just the Anglican or Catholic faiths but all other faiths—and that their attachment to a hospital is of enormous benefit to the patients who need them? As chairman of a hospital that has an active and vital chaplaincy that encompasses all faiths, I hope that the Minister will make clear his support for maintaining the hospital chaplaincy.

My Lords, I am aware of what the noble Baroness has said, and I have indicated our support for the guidance. I have looked at the Church of England website, which shows that the number of full-time stipendiary clergy fell from just over 11,000 in 1990 to some 8,700 in 2005. Reductions in their services were going on outside the NHS.