Friday, April 10, 2009

Hospitals have never needed Chaplains more

A&E departments are a war zone. There could not be a worse time to get rid of their chaplains

There is no way of telling how many prospective doctors and medical students watched The Hospital on Tuesday night, but we should, for all our sakes, pray it was a low number. The first part of Channel 4's fly-on-the-wall series, which runs for another two weeks, looked into the modern world of emergency medicine. This wasn't ER or Scrubs, this was ugly reality - wave upon wave of young people, drunk, regardless, violent and rude, brought in with various terrible injuries as a result of intoxication.

It was some of the most powerful documentary television I've seen: the young people were both victims and propagators of alcoholic mayhem; the doctors were dead-eyed, high-pay-grade streetsweepers.

We would be sensible to regard it as a modern morality play, especially in a week when the National Secular Society called for the NHS to stop funding hospital chaplains. The society estimates that £40 million a year is spent on giving religious groups a presence in hospitals. In many areas secularism has much to recommend it. In this instance they are wrong and mean-spirited. There has never been a greater need for a spiritual presence in hospitals.

What was so interesting about The Hospital, apart from its shock appeal, was the moral landscape it painted of our society. Here was a stage, you realised, where everyone had become brutalised. The patients showed a total lack of responsibility for their actions. They swore at staff, they smirked, they were abusive, complaining, obstructive, hysterical and completely unapologetic. As for gratitude, why, it's a free service, isn't it? What's to be grateful for? There was an almost total lack of the embarrassment or thanks that former generations would have displayed.

Even when approached, sober, for their reflections they were not given to remorse. Rather they were insouciant. Danielle, a 19-year-old mother of two, who had arrived at A&E after being trapped under a taxi, her shattered legs bent up over her shoulder, was oblivious of any moral subtext. After she had spent a month in hospital she was asked if she had paid a high price for her drinking. Nah, she joked, I only spent £20 and got a free taxi.

Equally you could see the impact on the battle-fatigued staff. Like military mercenaries, their moral values had either ceased to exist or they had been buttoned away for fear of revealing disgust.

I've encountered exactly the same dead eyes in big city A&E departments. Once, at one of these hospitals, notorious for dealing with relentless violence and knife crime, I attended my child who had been rushed there with a suspected neck injury. Fortunately it turned out just to be a torn muscle, but I found it an unnerving experience, and not for the obvious reason.

The doctor, a young man with empty eyes and a hard-drinking face, did not engage with us. He spoke as if we were five miles away. For all he was utterly professional and faultless, I felt as if something had died inside him. He was almost like an addict: I wondered if he was so hooked on the adrenalin of coping with stab wounds and fights that nothing less than that stirred him.

You see the same look in abbatoir workers' eyes. They shut down all feeling, all judgment. The patients, deserving or not, have become lumps of meat to them. Monica Garnsey, the maker of the documentaries, believes that what patients want most is the sense that their doctor is sympathetic. But their patience has been stretched too far.

So maybe a little moral panic would be a good thing; maybe we need more chaplains, if only to check the growth in this new amoral, compassion-neutral transaction, where the drunk and feckless not only waste billions of pounds but leave hospital as ignorant and unreformed as they went in. Maybe we need to be a bit more judgmental, for all our sakes.

In a world sometimes scarily lacking in values, chaplains have a vital symbolic role as well as a practical one. Chaplains, in my experience, do not proselytise; they simply afford patients the kind of time, care and compassion that medical staff can no longer give them. No, they cannot cure binge drinking, but they do stand for something resolutely good and wise.

The secularists have missed the point completely. They contacted 233 acute and mental health trusts, which spent £26.72 million on chaplains. This money, they say, could be used to employ 1,300 nurses or 2,645 cleaners, which is as facile as saying that we could save £3 billion plus in A&E budgets by banning booze. Terry Sanderson, the president of the society, even claimed that people in hospital should seek visits from their own vicar, priest, rabbi or imam if they needed religious support.

What an arrogant man he sounds. It is non-religious people, lost in a crisis, who need chaplains the most. Look at Jade Goody, married and blessed as she was dying. Look at the tragic, chaotic lives of some of the young people lying in A&E with no family to phone. It is the injured, the dying and the bereaved, who seek, not necessarily God, but a little kindness and succour at their time of greatest need.


Are boys naturally violent?

Is the impulse to play with guns natural? Do boys naturally go through a violent stage, that they eventually grow out of? Times writer Anjana Ahuja visits Alpha Mummy with her view:

You don’t have to thrust a plastic gun into the hand of a toddler to teach him about violence. He is perfectly capable of fashioning, and deploying, his own weapons from the stuff around him. Branches become swords, remote controls are transformed into death sabres, saucepan lids are magicked into trusty shields.

In fact, a toddler intent on waging war, often against an invisible enemy, is an awe-inspiring vision of energy, resourcefulness, creativity and imagination. And yet, to my reckoning, such behaviour is in danger of becoming pathologised. Several mothers at my daughter’s school have stopped going to the local playground because the play has become a bit rough. This includes waving broken branches around (“it could poke someone in the eye”), tearing around at high speed (“someone could get knocked over”) and shouting at younger children (“bullying”).

When a parent explained this to me, I returned an analysis of the situation: yes, there is one boy in this gang of terrors that might have behavioural problems, but they are just young boys letting off steam after a day in the classroom. Boys are a bit more rough and tumble than our girls, I shrugged, and we can always intervene if things go awry.

I might as well have admitted to having had Pol Pot over for dinner.

Attempting to cleanse our playgrounds of aggression is a pointless and, quite possibly, harmful pursuit. I can completely understand why parents want to do it: you fear that someone is going to get hurt, that to not intervene is to sanction violence, that a child who learns violence will perpetuate it later in life. But, for the most part, the kids in the playground are not products of broken homes. They do not share the squalid backgrounds of the brothers in the Doncaster village, accused of torturing two boys and leaving one for dead.

Our playground nemeses are nice, middle-class children, boisterous rather than brutalised, and careless rather than calculatingly cruel. By waving broken branches around, they are exploring the boundaries of acceptable behaviour. In the course of their waving, they might whack a child accidentally. In which case, the whacker must deal with the consequences of what he has done. The whackee, meanwhile, learns to articulate his displeasure, and perhaps demand redress. And so, sometimes with the assistance of fretful parents, the two children learn the art of conflict resolution.

As we know, the brain learns from experience, rewiring itself and maturing with every new encounter. Each playground battle is grist to the neurological mill, setting us up for adult life as thinking, moral beings who have empathy with, and awareness of, other people.

The issue of aggression, especially the fondness of pretend guns by little boys, is sewn into many a thread on parent blogs (see, for example, this one). Mothers, especially, worry about their sons playing with guns (girls appear not to have the same gun-toting urge). The overwhelming response from other parents is: don’t worry about it because everyone little boy seems to go through it and then grow out of it. There is also much advice suggesting such play is not forbidden, so as not to turn guns into a source of illicit curiosity (and, as one gun-banning parent noted, her enterprising son simply chewed his sandwich into the shape of a pistol).

And, somewhere in that thread, lies a piece of wisdom, courtesy of Kathy, who observes: “Play is really the way that they (children) figure everything out.” Play is learning. That is not to say that play should never be policed: but a parent can judge when their child’s curiosity crosses over into unhealthy obsession.

By definition, children who do not push the boundaries - who do not even press their noses up against the fence of social norms - don’t learn by experience. They will dutifully obey their parents, and not even bother to pick up that torn branch. They don’t explore what it’s like to transgress; they never feel the shame of reprimand burning on their cheeks. In other words, they are not really learning. Personally speaking, I’d rather those kids wielded a broken branch in childhood and learned early, than picked up a Beretta in adolescence.


Failing Jewish school bounces back after emphasizing religious standards

AN Orthodox Jewish primary school has achieved some of the best results in the country despite living with the threat of closure after failing an Ofsted inspection.

Pardes House in Finchley ensured every boy who took national tests in English, maths and science last year achieved the Government's target Level 4 grade in all three subjects. Many scored better than expected, given their social backgrounds and academic records, placing the school top of the league for Barnet, and 13th out of 1,600 primaries in London. It was a remarkable change for the school, which had been under Ofsted's "special measures" since a failed report in October 2006.

Robert Leach, the 34-year-old head, said inspectors were critical of poor standards of behaviour and teachers "not doing their job".

"Classroom management was just totally inadequate. There was no respect," he said.

The school took a radical approach, changing 80 per cent of its staff and focusing on reinforcing its religious ethos and standards of behaviour in the belief everything else would follow.


Bob Quick should slow down: "British police arrested 12 people in anti-terror raids in northwest England overnight, a spokesman said, in what reports said was a major operation. The raids were mounted in locations including Liverpool John Moore University and Manchester, according to BBC television, adding that they were part of a long-planned operation brought forward by a security gaffe. Britain has been on high alerts since July 2005 suicide attacks in London killed 56, while car bomb attacks were foiled in London and Glasgow in June 2007. The operation was ordered hours after Britain's top counter-terrorism policeman, Scotland Yard Assistant Commissioner Bob Quick, was caught on camera clutching sensitive documents as he arrived in Downing Street. The documents, which included full details about planned operations, were legible on pictures taken by photographers and distributed around the world, the BBC said. Shortly after the raids were announced Scotland Yard said that Mr Quick apologised to his boss, Metropolitan Police chief Paul Stephenson, saying he "deeply regretted" leaving the document on show. "Assistant Commissioner Quick accepts he made a mistake on leaving a sensitive document on open view and deeply regrets it. He has apologised to the Commissioner and colleagues," said a Scotland Yard spokesman. [The speedy one was also the cop behind the controversial raid on the offices of a member of Parliament]

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