Faith and secularism in health services

Presented by Professor Grace Davie, Emeritus Professor of Sociology at Exeter University.

Dr. Margaret Chan and Archbishop Rowan Williams met at the World Health Organization in January 2012

Dr. Margaret Chan and Archbishop Rowan Williams met at the World Health Organization in January 2012

What are appropriate boundaries? How do we define and implement ‘spiritual’ and ‘religious’ care? How can health services mediate religious interests in multi-faith environments?


Spiritual and religious context in the UK.

The church needs to have credibility in how it engages with secular services in a secular country. Christianity remains deeply embedded in the culture of this country, for example the shape of the year and the week. Public holidays are based around Christian festivals.

Until very recently the religious structure in the UK and throughout Europe was of a parish in which you lived, where everyone belonged and received care. This is why the industrial revolution was so damaging in Europe, compared to the US which never had the parish system: US churches are  congregational and not territorial. The Church of England remains a public utility. Like the NHS it is there (for funerals and marriages) at the point of need without charge.

There is a growing market in religion, with people making a choice as to which religion to follow rather than inherited religion. So there are TWO MODELS running at once, parish geography based and market, choice based. This can cause tension and conflicts. The congregations that are growing are in cathedrals and in charismatic churches.

There are parallels between changes in healthcare and in churches; multiple options, any willing provider can give healthcare. The market is intruding on public utilities. ‘Spiritual’ as currently used is a market based, choice based concept. Chosen religion or spiritualties are not necessarily purely private; seriously made choices do have a public impact.

We are in danger of muddling up two kinds of pluralism. There is pluralism that means the arrival of new traditions with new communities where the religion is arriving whole and active. The second use of the term pluralism is around the fragmentation of a tradition where people assemble their own spirituality from bits from other traditions. There is also a need to cater for those who are not Christian and require particular care

The recent secular reactions by the new atheists (Dawkins, Hitchens et al.)  are not so much  a reaction to the personal faith of individuals, but to the reemergence of faith in public debate.  In the 1960’s, secularism was assumed, and faith was a private matter. The growth of Islam has challenged the idea that faith is a private matter; it’s a whole way of life affecting every aspect of behavior. This has led to tensions in places like France in reaction to the ban on Muslim women wearing the hijab.

Many people now choose humanist alternatives. People feel the need to contract in to faith communities or in to secularism. We must remember there is a spectrum of secular belief just as spectrum of depth of commitment to religion, the strident new atheists do not speak for all non-believers.

Europe is not a global prototype. There was an assumption that as other countries modernized they would become increasingly secular; but secularity is not spreading to the rest of the world. Europe is secular because it is European, not because it is modern. The US is extremely modern and not secular; similarly southern Africa, Brazil, Pacific rim.

These factors push and pull in different directions. In much public discourse, (ie. the media) there is a tendency to focus on just one factor, which is exaggerated in importance. Secularisation continues to advance at the same time that religion has a higher profile in public debate. Currently we have an ill-informed, ill-mannered debate on the contribution of religion in public life, with a widespread lack of religious literacy  as evidenced by the Ignorance and prejudice expressed online

What can be done? Religious education is very important, but in the UK it is badly done, under-resourced and undervalued.


We should advocate for a genuine pluralist society, with space for all groups not in conflict with other areas of society

There are difficult issues of vocabulary. We need to be careful in the use of the term secular – it’s not necessarily a bad thing.

Who are the groups who don’t feel safe with church? Don’t trust the moral values, no space for them there?

GP’s are trusted; patients share their stories; many are troubled in their mind and wanting to make sense of personal crises in terms of their overall story.

Large sections of the population would rather not engage the spiritual.

Hospital Chaplains

The British Humanist Association is currently arguing to remove paid hospital chaplains from the NHS. It wants to set up an alternative to healthcare chaplain called ‘secular pastoral advisors’ . It has asked a London hospital chaplain to help train them.  Since this chaplain has helped train Sikh and Jain chaplains, how could she say no despite misgivings. Much of the caricature of chaplaincy by the BHA is not what chaplains do – hence the  intention to use this opportunity to educate the BHA. Throughout the country many hospital trusts have 24 hour cover provided by a small number of hospital chaplains. “I hadn’t realized how hard the job is” said a BHA chaplain trainee.

GP’s perceive a need to improve the communication and links between hospital chaplains and GPs, particularly as more and more healthcare takes place in community.   There are projects developing community chaplain roles in Birmingham and in Warwickshire.

Religion and welfare.

There is huge ambiguity amongst religious groups on the morality of taking public money, which can then bind or compromise expression of a faith commitment.

The Nehemiah foundation is a multi-faith community workers, responding to local needs. Supporting people in pioneering community work. They find a richness in working with  other faiths.  They have always been very clear that they would speak as a spiritual group and would expect to be able to criticize the government.

Archbishop Justin Welby has said he will always speak of Jesus Christ, but he wants to listen to other people and will accept sometimes he will disagree. There is a need for clarity, transparency and integrity.

Do groups rewrite their mission statement in order to get public money? We need to be clear what we are taking public money for? There are issues of integrity if we are taking public money in order to secretly proselytize, there is no integrity if we take money under false pretenses. If you are a public or third sector provider, have you compromised your prophetic voice when you take government money?

Importance of relational health and neighbourhood engagement.

We need to be clear if we are talking about church structures or intimate personal faith. There is a distinction between carrying in an intervention package or stimulating a response owned by the community.

We need to be clear about what we believe and what others believe: Engage and be clear about our values.

Summary: We work in a bigger context, historically determined, currently changing and that brings challenge as well as new opportunities.


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