(National) Healthy Church?

How healthy is the National Health Service? How healthy what some call the National Church? On the Wardman Wire, Simon Sarmiento reports an address to the July NHS Live event by Donald M. Berwick, Professor of Health Policy and Management at the Harvard School of Public Health, President and CEO of the Institute for Healthcare Improvement. He warmly endorsed the vision and principles of the NHS, compared to the fractured, exorbitant and frequently inequitable US equivalent, with its harrowing tales of medical bankruptcy. By way of constructive criticism, Professor Berwick came up with ten points for NHS policymakers, and Simon wondered how they could be cast as discussion starters for the C of E. Some provisional, kneejerk, suggestions:

1. (NHS) Put the patient at the center - at the absolute center of your system of care.
   (C of E) We exist for the common good; the people who don’t come weekly as much as the people who do. 82% of them used a Church in some way last year. How does what we do serve their real needs? How self-serving are we gathered congregations; how realistic and committed about the needs of people out there?
   
   
2. (NHS) Stop restructuring.
   (C of E) There are limits to the benefits of pastoral reorganisation. After forty years of it there are still doubtless anomalies out there, but people need some sense of stability out of which they can work. You can’t solve process problems by structural tinkering.
   
   
3. (NHS) Third (NHS) strengthen the local health care systems - community care systems - as a whole.
   (C of E) Parishes are where most good happens. People used to have a bumper sticker — “This car may not be a Rolls Royce, but its paid for and it’s in front of you.’ After fifty years of being told by clever people that the parish system has no future, it’s still there, and most people value their local church far more than bigger, slicker and more remote specialised units.
   
   
4. (NHS) To help do that, reinvest in general practice and primary care.
   (C of E) Subsidiarity! Bread-and-butter proclamation, celebration, community building, pastoral care, are not distractions, but the core. job. Deaneries, dioceses are enabling systems for what matters on the ground.
   
   
5. (NHS) Please don’t put your faith in market forces.
   (C of E) Money is a good servant and a bad master! We need to be transparent and realistic about resourcing and deployment, applying fair agreed criteria, but not mindlessly Darwinian. Often the parish church is all that’s left, in the country and Urban centres. Beware pure congregationalism and its attendant scourge, suburban captivity!
   
   
6. (NHS) Avoid supply-driven care like the plague.
   (C of E) For whose benefit are we doing this? Ministry is not all about Vicars, but gifted Christians in community, being enabled to do what they are called to do well. Recognise for whose benefit we are really doing this.
   
   
7. (NHS) Develop an integrated approach to the assessment, assurance, and improvement of quality.
   (C of E) Let’s get the act together! We have fine ideals, like the five marks of mission. Changes to clergy discipline and terms and conditions of service, along with other requirements from society (child protection, charity SORPS) are pulling things together pragmatically. We have mission audits and heathy churches, but very quirky and inconsistent means of assessing them across the network.
   
   
8. (NHS) Heal the divide among the professions, the managers, and the government.
   (C of E) Take responsibility for our own feelings and actions. Put the synodical and other stuctures we have to use, rather than being cynical about them. The answer to a crappy meeting is a good meeting, not no meeting.
   
   
9. (NHS) Train your health care workforce for the future, not the past.
   (C of E) We all want training. Do we all want to learn; and if so, for what? How does theological training measure up to real life? The gold standard of theological education is still often sometimes thought to be party biased, Victorian private institutions, in which perfectly sensible people are taught to aspire to ‘have their own church’ one day. They end up having to learn servant ministry on the job, if training institutions let them, and the rest of us, down like that. How sad if conventional colleges spend millions to provide all the potential of community, and then blow it by the kind of behaviour that hits the headlines. The Hind report has begun to restructure learning and training — but what about process and standards?
   
   
10. (NHS) Aim for health.
    (C of E) Aim for personal and corporate spiritual health. Numbers are fine, but what quality of corporate and personal holiness and excellence do people experience? Sometimes very high; and sometimes not. Sometimes both at one. To present everyone mature in Christ is quite a vision, and we need to be focussed and intentional about delivering it.