HL Deb 17 February 1992 vol 535 cc983-5

The Lord Bishop of Exeter asked Her Majesty's Government:

Why there was no consultation with the Christian Churches or other religious organisations prior to the issue of NHS Management Executive Circular HSG (92)2 on meeting the spiritual needs of patients and staff within the NHS.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)

My Lords, there was no review of policy in this instance. Had there been one we would have consulted as we have in the past. The objective of the circular in question is to clarify the existing powers and duties of health service bodies and to update previous guidance to reflect both management arrangements following the National Health Service reforms and the relevant Patient's Charter standard.

The Lord Bishop of Exeter

My Lords, I thank the Minister for her reply. I appreciate the value that is put upon the spiritual care of patients and staff in hospitals. Does the Minister agree that for the satisfactory implementation of the circular continuing consultation with representatives of the Churches and faith organisations would be appropriate, particularly in order to maintain and monitor common standards of performance in this area of work across the country? Can the Minister hold out hope that there will be a full review of chaplaincy in this consultation?

Baroness Hooper

My Lords, the Government recognise the importance of this aspect of meeting patients' needs. In terms of chaplaincy services, we have regular contact with the Joint Committee for Hospital Chaplaincy—a body with representatives from the Church of England, the Roman Catholic Church and the Free Church Federal Council—as and when necessary. I understand that a meeting has been arranged for 27th March to discuss the new guidance. There are no formal links with other religious bodies but we do have informal contact from time to time.

Lord Ennals

My Lords, bearing in mind that there were changes in this circular compared with the previous one, was this not an opportunity to hear the views not only of the Church of England and the Catholic Church but also of other faiths? Why was there not this consultation? Does the Minister feel that her Answer was satisfactory, there being no consultation?

Baroness Hooper

Yes, my Lords. The guidance has been generally welcomed. It does not significantly alter the duties and powers of the health service. Perhaps for the first time it makes explicit the necessity to provide for the needs of patients of all religions. However, that was the custom and practice in places where best practice was operating. Certainly the guidance highlights a number of options available to health service managers to enable them to provide those services. The changed management structure is also reflected. There was no intention to have a whole review of policy in that area.

Lord Hailsham of Saint Marylebone

My Lords, in order to enlighten the House about this exchange, can my noble friend say what exactly was the change of policy and what was the point of substance taken in this case?

Baroness Hooper

My Lords, I had hoped to have made clear by now that there has been no change in policy. The objective of the guidelines that were issued was to update previous guidelines in reflecting both the changes that have been brought into National Health Service management as a result of the reforms and in relation to the Patient's Charter standard.

Baroness McFarlane of Llandaff

My Lords, while welcoming the breadth of the advice given applying both to patients and to staff, and to those of all faiths, does the Minister agree that assurances were given from 1989 onwards that there would be a review of the chaplaincy services? Does she agree that such a review is particularly needful in terms of national standards of training and performance?

Baroness Hooper

My Lords, in view of the contact with the Joint Committee for Hospital Chaplaincy, to which I have already referred and which takes place on a regular basis, and contact with other organisations, I think that we in the department are up to speed on thinking in this matter. If and when any changes of policy are needed then obviously a full consultation will take place.

Baroness Phillips

My Lords, having had the misfortune to be detained in three hospitals recently, I should like to express appreciation to the right reverend Prelate for the splendid way in which the Church of England, the Catholic Church and other denominations look after the patients and staff in hospitals.

Baroness Hooper

My Lords, I am grateful to the noble Baroness for making that point. It is important to recognise that hospital chaplains have played a major role in caring not only for the spiritual but also for the wider needs of hospital patients and staff. We wish to emphasise that whenever it is possible.

Lord Elton

My Lords, arising out of my noble friend's answer to the question of my noble and learned friend Lord Hailsham, does the Minister agree that the second point in the first paragraph of the document in question arranges for hospital chaplains to be paid under arrangements made by contract with the local provider unit and that in the past they have been provided for centrally? For them that represents a considerable change of policy.

Baroness Hooper

My Lords, the changes in management arrangements following the National Health Service reforms include the fact that National Health Service trusts have responsibility for employment where appropriate. The object of these guidelines is to ensure that people making those decisions at local level are aware of the general policy in that area.

Lord Desai

My Lords, is the Minister confident that decentralising this responsibility to individual provider units will guarantee patient choice, especially as regards minority religions? Individual provider units may not have the facilities to guarantee that patients' special needs are met.

Baroness Hooper

My Lords, the best possible way to meet specific needs is to ensure that decisions are made at a local level which reflect local circumstances. As we all know, the composition of populations and the needs of those populations in cultural and religious terms differ widely across the country.

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