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Moral Purpose in Health Care?
The recent scandal about hospital care in the Stafford Hospital has not shown the NHS in a good light and, although not on such a systemic scale, there are recurring media reports about failures of care locally. Last week the Health Secretary (England and Wales) urged the NHS to find its moral purpose. But what is the moral purpose of a health service? It seems to me that it is inevitably related to the issue of what promotes good care. But what does good care look like? The acclaimed BBC series ‘Call the Midwife’ illustrates very well what good care is like. The drama, based on the memoirs of Jennifer Worth and set in London’s East End during the 1950s, illustrates an intimacy and individuality of care to which all health professionals would aspire. Such care is indeed to be found in our health service. There are many examples of excellent care that don’t hit the headlines as callers to radio programmes often testify. In the last few years family and friends known to me have experienced such high quality treatment and care from health and social care services. What then lies behind such basic failures of care as occurred in Stafford? The answers are complex and multiple. Ruthless imposition of targets by departmental officials, unwillingness to listen to the concerns of coal face workers and underfunding of services are commonly cited but this isn’t the forum for discussing them. Rather, I want to suggest that at a deeper level one cause is our society’s devaluing of the ordinary. The unique way in which ordinary ‘chores’ foster relationships has been devalued in the modern cults of achievement and celebrity. Our understanding of work that is menial has changed because our ability to grasp its meaning has changed. The word, derived from the 14th century Anglo-French meignial – belonging to a household – originally engendered a sense of rootedness and connectedness but nowadays only implies something that is monotonous and anonymous. This is significant, not only because it separates the menial nature of a carer’s work from its relational context, but also because it values this work solely in economic terms. Although at times there have to be ways of improving how things are done, the tasks of caregiving and bringing healing by health professionals should not be reduced to an exercise in efficiency. They are best measured by the quality of the work done rather than the speed with which it is accomplished. Finding moral purpose isn’t about trying to make those things which are ordinary somehow profound, but rather simply to consecrate them. Christians worship a God who has taken on our frail humanity and has lowered himself to meet us. So we need not dismiss the mundane routines of our physical state as inconsequential, but rather offer the ordinary tasks and the close relationships back to him, trusting that all work is indeed His own. George Herbert’s 17th century poem ‘the Elixir’ reveals the secret of finding moral purpose in work, whether voluntary or in paid employment. Teach me, my God and King, In all things thee to see, And what I do in anything, To do it as for thee. Noel McCune. Noel is Chair of the Board of Contemporary Christianity and worked as a Consultant Psychiatrist in the NHS.