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Health-care chaplaincy: Ministry that is vital but unsung

14 October 2022

James Newcome looks at the contribution that health-care chaplaincy makes to the Church’s mission


CHAPLAINCY is an ambiguous vocation in many ways,” the director of the Church of England’s Mission and Public Affairs Division, Canon Malcolm Brown, said in a sermon at the funeral of a friend who had served as a chaplain for much of his life. Most chaplains would agree with that assessment.

There are also a huge number of chaplains — as we discovered in Cumbria some time ago, when we established annual chaplaincy gatherings and a “Chaplain to the Chaplains”. In Cumbria alone, we have about 100, many of whom are volunteers.

Chaplains serve hospitals, prisons, the police, fire and ambulance services, schools and universities, auction marts, local councils, the armed forces, the King. . . And so the list goes on, with even the bishop included. But the work that they do is often little understood, and those who are clergy are sometimes forgotten, or ignored, when clerical gatherings are being organised. One chaplain even told me that he had been asked by a colleague what had prompted him “to leave the mission of the Church”.

Dr Brown identified that there are three basic features of chaplaincy, of which the first is: “taking the Church to people who can’t get there themselves”. That certainly applies to people in hospital or hospice beds — just as it did, for instance, to workers on oil rigs in the North Sea, for whom the Church of Norway provided an extensive network of chaplains.

From a religious point of view, taking communion to individuals in hospital, praying with patients, relatives, and staff, and providing services in hospital chapels are part of the service of taking the Church into the community. But it goes well beyond these things. Many of the conversations that chaplains have might be described as “spiritual” rather than specifically “religious” — and those are the ones that are often appreciated most.


IN the NHS, chaplains are not there to proselytise. But they are there to engage with deep issues about life and death which concern everyone — and, as they engage, to reflect the love of God to, and for, every single person, regardless of that person’s beliefs.

Chaplains have a ministry that extends far beyond the boundaries of the Church, reaching parts of human society with which the Church often has little contact. What applies in hospitals is increasingly now also true in health centres, with the development of GP chaplaincy, pioneered so effectively in Birmingham.

Second, chaplaincy exists as a bridge between the Church and the world, discovering what John Wesley called “the prevenient grace of God” in his world, and letting the Church know what has been found.

As an ordinand, I remember going to Sheffield for what was then called a “pastoral-studies unit”. We were looking at industrial chaplaincy in the steelworks and coal mines, both of which still existed then. The chaplains there were quite clear that this was an important aspect of their work.

God is already present and at work in hospitals; so, if mission does indeed mean “seeing what God is doing, and joining in”, then chaplains are very much on the front line. This involves a complex balancing act that not everyone can manage or understand. Some people get stuck, as it were, in the Church. For others, the “world” takes over to such an extent that the Church seems more like a rather embarrassing encumbrance.

This nuanced approach makes it difficult for health-care chaplains to see much fruit from their ministry. Although evidence suggests that people with a spiritual helper recover more quickly than those without one, this isn’t always obvious, and is certainly not easy to quantify.


A THIRD feature of chaplaincy is being alongside those who bear heavy responsibilities and are working hard for the common good. In the NHS, that includes managers, doctors, nurses, administrative staff, and the many others who serve patients and their families in a wide variety of ways. This involves praying for them and offering pastoral support, especially with current rates of exhaustion and burnout.

It also involves engaging with the huge challenges that our National Health Service currently faces. Workforce issues, including recruitment, training, pay, morale, and retention, rank high among those challenges.

Then there is the question of integration — in particular, with social care. Chaplains will be watching closely as the new integrated-care partnerships and boards become established, knowing that, without better integration, both the NHS and social care will be severely affected. Chaplains will also be encouraging longer-term thinking and planning than has often been seen in the past. In the process, they will be wrestling with ongoing issues of funding.


THE Government’s recent mini-Budget has sparked further controversy about funding for the NHS, as well as social care. As chaplains know well, such debates often ignore some of the hidden factors that contribute to an ever-increasing bill. these include lifestyle issues — notably obesity — and decisions about which drugs should be available on the NHS, especially those that are hugely expensive but may only briefly defer the patient’s death.

Health-care chaplains need the wider Church’s support. Not all chaplains can be experts in medical ethics but, from organ donation to assisted dying, these are some of the difficult moral and theological questions that confront them on a regular basis, and about which they are more than likely to be asked for advice or counsel.

Health-care chaplaincy is of crucial importance to many people in some of their most vulnerable times of life, especially at the end of life, as the pandemic has illustrated profoundly. And yet there has been a steady erosion of Anglican chaplains over the past ten years.

NHS chaplains have been victims, in part, of financial pressures. When cuts have to be made, chaplaincy provides a soft target. But they have also fallen foul of a default secular mindset that treats all religion as problematic, and assumes that questions of religious difference can be resolved only by ensuring that if one faith is involved, all must be. It is sometimes argued that parish clergy or other religious representatives should provide what is required.

Manifesting one’s religion is a human right, however, and the NHS has a responsibility for providing adequate religious, spiritual, and pastoral care.

Given the long waiting lists for operations, overcrowded A&E departments, and the need for widespread reform in the world of primary care, the employment of chaplains may look like a secondary concern. But this quiet, unsung ministry is part of the backbone of the NHS, and its lasting value is out of all proportion to its fairly minimal cost.


The Rt Revd James Newcome is the Bishop of Carlisle and the Lead Bishop for Health and Social Care in the House of Lords.

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