Junior doctors and the National Health Service: responses to Canon Tilby
From the Bishop of Crediton
Sir, — Canon Angela Tilby (Comment, 22 January) writes that she is baffled by the junior doctors’ dispute; and she seems to be.
How junior doctors respond to the new contract negotiations is not the whole story; nor are they the only group working in the NHS.
After more than 30 years as part of the NHS, I am realistic about its strengths and weaknesses, but the NHS has changed, and it has increased its efficiency despite Canon Tilby’s suggestion.
The Commonwealth Fund, in a report published in 2014, ranked the UK first, of 11 countries, including France, Germany, and the United States, over all, being strongest in efficiency, quality, and access. Robotics in surgery, genomics in cancer care, and progressions with caring for people with dementia are just three examples of ways in which the NHS has changed. While there may be some areas that are resistant to change, and areas that do require continued improvement, the NHS is not “hopelessly resistant”, as Canon Tilby suggests.
To suggest that executives overspend so that they can claim the NHS in underfunded belittles those who work relentlessly to provide high-quality care.
People are living longer, with more complex conditions; costs are increasing while funding remains flat; and people’s expectations are increasing, as is the number of obese people. Society has difficult decisions to make. We should not be misled into believing that the problem is as simple as the “self-interest of doctors” or “a culture of aggressive entitlement in the NHS” (if there is one).
I would encourage Canon Tilby and other readers to become involved in their local NHS through the mechanisms that are now available; I know that it would be welcomed.
SARAH E. MULLALLY
Non-Executive Director of
Salisbury NHS Foundation
Trust; former Chief Nursing
Officer for England
32 The Avenue
Tiverton EX16 4HW
From Dr K. Byatt
Sir, — Canon Tilby’s column of 22 January surprised, disappointed, and appalled me in equal measure. She has misrepresented a complex, multi-dimensional political challenge superficially. Perhaps she hasn’t spoken to many doctors about the facts, has relied on superficial (and at times misleading) media leaks, reports, and caricatures, or just doesn’t understand the issues.
Generalisations, without any supporting data, are scattered through the piece. For example, I am not sure why she characterised the junior doctors’ march as coming in part from “a nostalgia for Trotskyite activism”. It was merely a physical representation of shared indignation by thousands of intelligent, largely apolitical, extremely concerned young professionals — exactly the sort of shared indignation that fuelled the recent anti-war and earlier anti-poll tax demonstrations.
Also, doctors have not said that it is all about safety. They have shown concern that, for many of them, they are not happy with the cutting of their overall pay apparently, at the same time as the “social working hours” payable at base rate are increased so that 7 a.m. to 7 p.m., Monday to Friday, becomes 7 a.m. to 10 p.m., Monday to Saturday. The implication that they, too, want their “mouths stuffed with gold” is ludicrous.
The characterisation of the junior doctors’ strike as simple “self-interest” is facile, inflammatory, and inaccurate. If being concerned to have working arrangements that are not likely to impair their ability safely to look after their patients represents self-interest, then I am all for it. I would have thought that someone familiar with the increasing pressure on Anglican clergy to manage increasingly large combined parishes, and outwith the European working-time regulations at that, might have been a little more sympathetic and understanding.
If (as I believe) the problem is, indeed, insufficient money for what the taxpayer and the politicians want us to deliver, then it is not self-interest to say so. It is our professional responsibility, and explicitly required of us by the General Medical Council, and the NHS statutory “Duty of Candour”, to do just that. If the Secretary of State issues unofficial sound-bites that contain inaccuracies or misleading information, what should hard-pressed and undervalued professionals do?
I have been very impressed by the careful consideration, intelligent analysis, deep moral searching, and good-humoured, courteous representation (in the media, online, and on the streets) of my younger colleagues. We have an impressive cohort of developing professionals, with whom I am proud to associate myself.
I am more than happy to provide on request more detail to support my assertions. A letter cannot do the complex matter justice.
Wye Valley NHS Trust
Union Walk, Hereford HR4 7QN
The Primates, science, and sexual orientation
From the Revd Dr David Gosling
Sir, — The Revd Dr David de Pomerai’s letter (22 January) underlines the urgent need for a scientific understanding of the basis of human sexuality which was totally lacking in the prelates’ recent Lambeth decisions. But I am not totally convinced by his arguments, and I believe that some of his points need stronger emphasis.
It is important to emphasise that there are different causative factors in the homosexual disposition, but at least some of them are known to relate to the pre-natal period. This removes all grounds for blame or sin and the consequent discrimination that characterises so much religious thinking about this issue.
Homophobic Christians are therefore obliged to attempt to justify their attitudes by a selective and anachronistic interpretation of scripture which ignores both Jesus’s claim to replace parts of tradition with his own teaching (“but I say unto you”) and the ambiguities in St Paul’s views on the subject. This kind of fundamentalism will be eradicated only with better education and a stronger emphasis on science at secondary level in schools.
Dr de Pomerai draws attention to an online review about homosexuality between identical twins as evidence for disagreement within the scientific community on fundamental scientific issues. But if, as he suggests, the study is not peer-reviewed, then may we not disregard it altogether? — in which case it is hardly evidence of disagreement.
DAVID L. GOSLING
Clare Hall, Cambridge CB3 9AL
From Dr Henk Carpentier Alting
Sir, — In the discussion about “science and pseudo-science on sex and sexuality”, we need to distinguish between what the sciences can and cannot do.
The sciences are good at showing us how things are, such as the biochemical structure and related causal processes of living systems. The sciences also tell us much about how things causally came to be. Some are quite good at predicting what will be. On the other hand, the sciences are not good at telling us what ought to be.
Take an example of a person handicapped by some underlying genetic fault. The relevant sciences may know a great deal about the physical-genetic causes of this person’s condition. Now suppose we say: “this is the tragedy of human fallenness.”
“Fallenness” is not a scientific but a religious notion; it is not about what is, but what ought (not) to be. It lies in the context of our relation to God’s purpose and his redemptive work, which is not part of any science.
A Christian world-view has much to say about the sciences. The point is that the “is-ought” distinction allows us to grasp that how things in fact are is not how they ought to be. That in turn allows us to assist or resist change judged by what ought to be.
The sciences then have a role in helping us understand what is and how best to move towards what ought to be. We might even say that the “is-ought” distinction is part of the image of God who spoke creation as “good”. That again is neither a scientific hypothesis, theory nor an evidence-based and experimentally verified conclusion.
The sciences may yet tell us much more in terms of genetics, psychology, environment, and culture. Even so, how reproduction works is one thing, whether polygamy ought to be is another. Similarly, how sexual orientation and behaviour ought to be is not determined by any science. We should not wrench scientific knowledge out of its proper domain, thereby turning it into pseudo-science to prop up arguments that come from elsewhere.
HENK CARPENTIER ALTING
30 Buckingham Road West
Stockport SK4 4BA
From the Revd Jonathan Frais
Sir, — Thank you for your coverage of this month’s gathering of the Primates in Canterbury. On the timeline of the week, another moment worthy of mention is when Archbishop Foley Beach of the Anglican Church of North America set out first moves for reconciliation with the Episcopal Church in the United States: call off their lawsuits; make restitution for millions for dollars taken from people in property and buildings; and restore to deposed clergy their full pensions. For some, it adjusted their perception of “local issues” in North America.
The Rectory, 11 Coverdale Avenue
Bexhill, East Sussex TN39 4TY
Anglicans’ communion with the Old Catholics
From the Bishop of Cashel, Ferns & Ossory
Sir, — It was enlightening and, indeed, encouraging to read of the Revd John Wall’s experiences (Diary, 18/25 December) of the healthy state of Anglicanism in Utrecht and nearby Amersfoort in the Netherlands.
The picture might have been fuller and even more encouraging had he also described the worship and witness of Old Catholics in those places. For almost a century, Anglicans and Old Catholics have been in full communion, and their Archbishop presides over the historic see of Utrecht and resides in Amersfoort.
While Anglicans and Old Catholics have certain differing emphases in the areas of language and culture, they emphatically belong together in seeking to offer a common witness amid the many challenges of modern Europe. Any picture of Anglican church life in the Netherlands which neglects to incorporate the reality and possibilities of our deep and special relationships with the Old Catholics of the Union of Utrecht is bound to be an incomplete one.
I would encourage all Anglican travellers from these islands to seize the opportunity, when in appropriate locations, to experience not only familiar Anglican worship, but also the atmosphere of worship of our Old Catholic friends. Visitors need not feel intimidated by inadequacies of language; they will receive a most warm welcome, above all at the eucharist.
MICHAEL CASHEL FERNS & OSSORY
Anglican Co-Chair, Anglican Old
Bishop’s House, Troysgate
Kilkenny, Republic of Ireland
The Bishop Bell affair
From the Revd Professor James H. Grayson
Sir, — The Diocesan Secretary of Chichester, Gabrielle Higgins (News and Letters, 15 January) is mistaken in her assertion that critics of the actions of the diocese in the case of the late Bishop George Bell were arguing that he should be above suspicion. I know of no one who has made that argument.
The questions that were raised have to do with the complete secrecy surrounding the announcement. There was no intimation that Bishop Bell was under investigation; only a guilty verdict was announced — and a defenceless person’s reputation was trashed. The questions that everyone does want answered are (1) what has he been accused of? (2) when and for how long did the alleged abuse take place? and (3) was it with more than one person?
Failure to answer these questions forthrightly might lead some people to suspect that there was a gagging clause involved in the settlement. As there are only allegations, as the current Bishop of Chichester has said, the accuser should be referred to as the alleged victim or alleged survivor. One final issue, a matter of transparency, is how much compensation the alleged victim was paid.
JAMES H. GRAYSON
25 Whitfield Road
From Mr Roy Sully
Sir, — The Chichester Diocesan Secretary claims to believe that “There is no doubt that George Bell achieved many great things during his lifetime, for which he is rightly honoured and which continue to be remembered” (News, 15 January).
Why, then, is the diocese attempting to erase his memory by renaming its guest house, which had previously been known as George Bell House? It was presumably named after Bishop Bell in recognition of the many great things he achieved during his lifetime. Those achievements still stand and the house should continue to remember them through Bishop Bell’s name.
36 Coborn Street
London E3 2AB
The Kaunda era
From Canon Michael Bullock OGS
Sir, — Like David Eldridge (Letters, 15 January), I worked in Zambia during Kenneth Kaunda’s presidency, in my case as a USPG missionary from 1979 to 1986. I cannot agree that the writings produced by or for Mr Kaunda make any serious contribution to Christian humanism.
Mr Kaunda’s regime was highly authoritarian and intolerant of dissent; some political opponents were detained. He did not discourage a cult of personality, and presided over a one-party state in which more than lip service was paid to “scientific socialism”. Elections were held in which he was the sole candidate. His mismanagement of the economy was arguably wilful.
I am not in a position to assess Mr Kaunda’s much publicised Christian faith, commended by churchpeople two generations ago; I believe he should now be given a more critical assessment.
22 Georgian Court
Spalding PE11 2QT