Rev. Dr. Steve Nolan on professional protectionism

Chaplaincy in the United Kingdom: Religious Care or Spiritual Care?

The history of United Kingdom (UK) chaplaincy goes back beyond the founding of the National Health Service (NHS). In the early post war period, chaplaincy was dominated by male Anglican priests, but slowly, as things changed socio-culturally so things changed within chaplaincy: there are now many more women, Free Church and non-Christian chaplains than there were 1948 and professional representation is now provided by a professional body, the College of Health Care Chaplains (CHCC).

With the socio-cultural changes and the weakening of the wider Church’s role, there has come a weakening of the Church’s role within the NHS – which, in my view, has both good and bad aspects. It seems inconceivable that sixty years ago anyone would have questioned the place of chaplaincy, let alone have suggested it be withdrawn; the professional body has an important part to play in establishing, or re-establishing chaplaincy’s place within the NHS.

My own view is that we are limited by being too closely allied with religious care or, to be more accurate, by the common perception that spiritual care equals religious care. This perception is clearly apparent in a Times article, ‘Hospital chaplains and the power of positive thinking’ – published June 6, 2008 the subtitle ran: ‘A fightback has begun over NHS cuts in religious ministry’! (www.timesonline.co.uk/tol/comment/faith/article4083128.ece)

I notice an anomaly at the heart of the way chaplaincy is currently positioned. On the one hand, in order to secure a chaplaincy post I need to provide some evidence that I am recognized/accredited by some religious organization, be that Christian, Jewish, Muslim, or whatever. However, once I am in post, the recognition/accreditation that qualifies me for post serves to disqualify me from ministering to sections of the constituency I am paid to serve: as a Christian (and a Protestant Christian at that), I can serve the religious needs of fellow (Protestant) Christian patients, but not patients who are Jewish, Muslim, etc. – or for that matter Catholic Christians.

So, I want to say that the main focus of my work is spiritual care, because this allows me to work with patients of any religious persuasion; it strengthens my value to the organization and justifies my salary cheque. However, I also want to continue to insist that those who can join me in this work must, like me, be recognized by a faith community. (I’m personalizing this, not because I want to represent my personal views, but because I want to express the contradiction in which I feel I am caught, personally and professionally.)

The difficulty I think we have as a profession (at least as I experience it in the UK) is that, although we emphasize (rightly) that our work is the work of ‘spiritual care’, the way we police the boundaries of our profession – insisting on religious affiliation – means that we are strengthening the misconception that we operate primarily as religious officiants, addressing primarily religious needs. Of course, we are not; and few who deliver our service would want to claim such, and few who experience the service we offer would express such. But my sense is that our professional protectionism fixes us in the psyche of service providers and managers as offering religious solutions to religious problems. (I think, to be fair, that in part this suits the service providers and managers, because religion is far easier to categorize, quantify and understand than spirituality – which, it seems to me, even those of us in the business have difficulty explaining succinctly!)

I think, as chaplains, at least in the UK, we are contributing to our own difficulties. If, by our protectionism, we are casting ourselves in the mold of religious practitioners, then it’s perhaps understandable that, when budgets are squeezed, service providers and managers might think it is legitimate to cut chaplaincy posts and bring in local clergy (of whatever faith tradition) to fill the gaps in religious care. What we need to do, it seems to me, is be much clearer about what we offer – spiritual care – why it is important and why we are qualified to offer it – not simply because we are trained in the practices of a religious tradition, but because our training and experience in spiritual development (albeit within and informed by certain, specific religious traditions) equips us to be with others who are going through a period of intense spiritual crisis.

Of course, this approach challenges an overly simplistic sacramental approach to spiritual care – the value of which, I think, is in any case limited – and it faces its own challenge with respect to how it might be marketed to service providers and managers. But I think we as a profession need to face this challenge, which is, in part, to be more honest and transparent; in part, to give up the expectations of past privilege and to stand or fall on the integrity of our practice.

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