Pain, loss of dignity, and early death: the Francis report
confirms a mountain of anecdotal evidence of neglect, bordering on
cruelty, in our hospitals. Like other recent reports into
dysfunctional aspects of public life, this one comes up with
predictable recommendations for more scrutiny. Meanwhile,
commentators blame a lack of cash, policy, leadership, and morale
for what has gone wrong.
But human institutions need more than mechanical checklists to
work as they should. Dishonesty and a lack of care may be
encouraged by bad systems, but they are also defects of character.
The problem is the widespread belief that morality is a matter of
personal choice. We choose our values as though from a supermarket.
In doing so, we assume that our public life is separate from
Our responsibility while at work is to fit into the system,
earning our living while protecting our position: see no evil; hear
no evil. Our private lives are where we look for fulfilment. Hence
the culture where responsibility is a game of pass-the-parcel: it
moves up and down the chain of command, but never sticks
An ancient tradition of virtue, which goes back to Aristotle,
suggests that this separation of public and private is
fundamentally wrong. Character is not formed in a vacuum. Virtue is
not a matter of personal choice. The self you are at work is as
much your real self as the one you are at home. Honesty, integrity,
and compassion are not just personal choices that mirror your
private aspirations. Rather, they are habits of mind and heart,
which rub off on people when they are together in a common
This is something that is recognised by the armed services,
where leadership, loyalty, and personal responsibility still count
for something. It is what the Church means when it speaks not just
of training clergy, but of forming them.
If we want caring nurses, forthright doctors, honest bankers,
and even vigilant food-manufacturers, someone needs to agree what
they are for, and to work out how values translate into behaviour.
Let the patients in; let the customers in: let us all be part of
Otherwise, our institutions will always go bad on us, running
themselves in their own interest, blind to the needs they serve.
Until the rift between private and public is healed, we will
continue to leave undone those things which we ought to have done.
And there will be no health in us.
The Revd Angela Tilby is the Diocesan Canon of Christ
Church, Oxford, and the Continuing Ministerial Development Adviser
for the diocese of Oxford.