“Gosh - I haven’t heard anyone mention ‘spiritual journey’ and the NHS in the same breath for I don’t know how long.”
The scene: my meeting with a Director of Public Health and Director of Prescribing and Pharmaceutical services. We were discussing how to make a start on reducing the Size 22 carbon footprint of NHS pharmaceuticals. We had rattled around the many ways pharmaceuticals get wasted within the system. Phrases like “GP’s say 50% of patient use is non-compliant,” and “we see the tip of an iceberg,” cropped up. We recognised that drugs seep inexorably into the local environment, the landfills and the rivers. And we’d come up with some possible starting points for a project.
I was trying to explain how NHS staff can engage in grass roots ‘resource efficiency’. I know, it’s not a very catchy tune. My throw way line, “if you like you can see it as a spiritual journey.” The Director’s response was a surprise to me, but only because I hadn’t really thought much about the importance of spirituality in future health care. When you do, it is obvious. Individually we all are engaged in a lifelong spiritual journey (well I know for sure that some of us are, the rest I shouldn’t speak for). People working in health care are incredibly fortunate. After all you could have chosen another career where it might be much more difficult to see your work as worthwhile. Instead of which you’ve finished up in an incredibly prosperous country, that hasn’t seen a mega-war in 60 odd years, and which allows you to do a well paid job, that you know is worthwhile, and gets you covered in love and public admiration and recession protection. How lucky is that!
Yes - and? If the very process of doing this wonderful worthwhile job is wrecking the world, what then? The Government’s Climate Change Act (Nov 2008) and the NHS Carbon Reduction Strategy (Jan 2009) both set course for an 80% reduction in CO2 emissions by 2050. That’s a heck of a hurdle for our whole society. Some scientists and environmentalists will tell you that it is nothing like fast enough, or drastic enough to stop run away climate change. We have just taken far too long to get started, have made far too timid a start. Possibly. The MIT report on this website (June) postulating a median 5.2 degree increase this century underlines the concern. What would it mean? Try Googling ‘six degree increase’. Words like catastrophic and apocalyptic get threadbare. Put it another way if those guesses are right we might just as well let off all our atomic bombs. In fact under the pressures of that kind of climate change it is quite likely some ass will. This makes nuclear proliferation the biggest health risk in a period of rapid climate change.
Fortunately I seem to be alone with that thought, and hope I am wrong. So let’s travel with optimism or we’ll never get started. A grain of optimism is an essential ingredient in any spiritual journey. It is easy to see how a craftsman like a carpenter or a surgeon gets job satisfaction, and some spiritual satisfaction from doing their work well. So shouldn’t the same be true for the admin junior in accounts, the receptionist, the boiler man, or the unglamorous workhorses in the lab? Being tidy, orderly, doing the job well, getting it right first time, having time to care, time to learn, being part of a team, being of service, not wasting, these are all part of living a spiritual working life. What I am sidling towards is this point: if we are going to deliver spiritually satisfactory health care for both staff and patients, we are going to have to do it in a way that travels light, leaves no lasting footprint, that does not harm the health of future people and indeed of life itself for the future. Somehow our health care model has to recognise we only have the one planet to live on. Our current NHS model, if adopted everywhere, would need several planets.
It may help to remind ourselves that through history health care has always been part of our spiritual journey – the village shamans and healers, the religious orders and their hospices, the very roots of empirical science on which we base modern medicine. Perhaps the Director was saying we have lost sight of spirituality in health care. It has become so big, so busy, so complex, so expensive, so technical, so driven, so much a media football that we have lost something precious. The revolution needed for the NHS to play its part in preventing catastrophic climate change is not going to happen because the government decrees it, ministers order it, the DH imposes targets, Boards devise Trust strategies. You can’t do it top down because the top couldn’t do a single one of the jobs in delivery, although a bit of effort at the top would certainly help. But by recalling the spiritual journey, making it part of everyday health care, our myriad champions and ambassadors, Trojan mice and storm troopers may well find a thousand ways for health care to travel light, leave no trace. Giving them some method and tools to do it is a piece of managerial cake. Making it okay and letting the brakes off, that’s the challenge.
Here are some other perspectives that may help to bring spirituality and sustainability into our health care systems. When faced with a difficult call ask ‘How much love is in this decision?’ And, ‘If the way we act were known to all would their trust in us be stronger?’ (MPs have just donated a vivid example of this with their recent expenses saga). Or find again the child in you and ask: ‘Is this fair? Does is harm something beautiful? Is it benevolent towards life? Is it hopeful and optimistic?’ Try the child’s questions on a regime that runs gas chambers or gulags; try it on Guantanamo Bay, Enron, World Trade Agreements, crashing airliners into Twin Towers, Third World debt, The World Bank, Apartheid, attempts to force GM products on an unsuspecting public, stem cell research on human embryos, capital that chases the cheapest labour around the world. Try it on things you regard as positive and negative. Try it on the squandered resources you see around you in the NHS. The child’s is a rather clear eyed perspective. It can see through our self-serving adult hypocrisies by referring back to a more pristine expectation.
My child’s eye says providing health care in a way that wrecks the future is not spiritually acceptable. Pioneering ways to do it that are in tune with our world could also restore a spiritual sense of oneness that seems to have gone missing. In fact, now I think of it, I don’t see that you can do one without the other.
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