Religious Literacy
Below are the remarks made by Professor Joshua Hordern at a meeting hosted by Fiona Bruce MP and the All Pary Parliamentary Group on Religious Education at the House of Commons on January 31st 2017 in response to the report on Improving Religious Literacy.
Religious literacy in health and social care
Thank you for the opportunity to think with you today about the ideas and recommendations in the excellent improving Religious Literacy report. The report rightly emphasises that religious literacy is not just for schools and universities. Of course, it is for school – the education of children is key to societal religious literacy; and students going out into the complex globalised world need to understand religion. But, as the report says, religious literacy is for the ‘whole of life’. ‘RE, as with education more broadly, should not stop at the school gates or on the last day of school.’ (Report p.1)
The report focusses not only on education but also on the civil service and the media. But this is clearly just the start. The report signals towards the area of public life which is my focus, namely health and social care. So I’d add that Religious Education must not stop outside the hospital doors, the GP consulting room, clinical commissioning groups, medical and nursing degree curricula and so on.
Some oral evidence picks this up. Adam Dinham emphasised the ‘huge gap between professional training and the diversity of service users’ in the NHS.[2]That’s one reason why the report’s recommendations are so timely and well-focussed. For example:
Recommendation 12: the government should ensure that training programmes covering both equality and diversity and religious literacy are provided for civil servants and others in the public sector.
Recommendation 14 ‘the government should commission an inquiry into the effectiveness of training currently offered by the Civil Service and other public services for the improvement of staff religious literacy’
But I want to expand on the report by saying two things about religious literacy in public health and social care services:
· First, why religious literacy is important for health and social care
· Second, what can be done to improve religious literacy in these areas.
So first, I want to say why religious literacy is important in health and social care.
The plurality of our society with respect to faith should be a matter of absorbing interest to those working in health and social care.
Why? Well, health and social care should be tailored – personalised – to the individual or family. And personalised, in particular, to their experience of health and the suffering the loss of health occasions. Since such experiences are often shaped by religion, religious literacy is required.
NHS staff must be engaged and supported so that they can provide this tailored service. Indeed, the GMC and DoH guidance already encourages and even mandates such an approach. In effect they already say that religious literacy is key to communication between healthcare professionals and patients; and between the NHS and wider society.
The DoH guidance encourages staff to gain knowledge of how individuals approach end of life care in the context of their faith – a very important area of concern. But also, for those not at the end of their lives it recognises that [quote] ‘an individual’s religion or beliefs are increasingly acknowledged as playing an important role in the overall healing process’.[4] The GMC advice similarly affirms the importance of understanding spiritual, social and cultural factors when taking a patient history and sharing such factors with colleagues where appropriate.[5]
Let’s expand on this a little. The NHS is full of people experiencing many of the most intense, confusing and perhaps meaningful times in their lives or those of their relatives and friends – a birth, serious diagnosis, welcome healing, sudden trauma or time of slow decline towards death. Such events are often interpreted by patients and carers in ways influenced by religious commitments. Without religious literacy, a health or social care worker is liable to misunderstand ways of responding to suffering, healing and dying which fellow citizens hold dear. But with religious literacy, healthcare staff can reflect the best of our richly textured plural society, sensitively taking such factors into account, caring for and supporting each person in the depth that they deserve.
Professionals need then seek to understand patients’ beliefs and be sensitive to them in practice. But also the beliefs of their colleagues. It is a general principle that everyone deserves careful recognition and consideration of their beliefs and views in a democratic society. This also implies the possibility of disagreement and respectful criticism. Healthcare institutions are vital environments for the realization of this principle in practice. Health and social care professionals should ask sensitively, gain relevant information and contribute where appropriate. In this way, they fulfil a civic obligation to enhance a society’s overall understanding of its plural religious and cultural views.[6]
This fuller picture of religious literacy rather contrasts with the parsimonious response by the DoH to Fiona Bruce’s written question. That response largely focussed on legal protections against discrimination (4.16, p.30); important though such protections are, the response lacked the imagination about the benefits of religious literacy which the DoH’s own publications recommend. Reducing religion into the framework of the Equality Act rather than expanding the mind into values and beliefs of the first importance to patients and staff.
So religious literacy in healthcare is about adapting compassionate service to the values and beliefs of particular individuals and communities to ensure that their experience of life’s sorrows and joys is as appropriate as possible. This is undoubtedly a big and important task on its own. But religious literacy offers us more than this.
Because religious literacy is also about drawing on the rich reserves of wisdom and energy found within religious traditions to help all citizens in the challenges we face as a society.
On this, I was encouraged recently by Sir Stuart Bell, Chief Exec of Oxford Health NHS Trust, who emphasised that healthcare is not something done to people but something we citizens do together, a partnership. He made these remarks as the first speaker in a conference on Faith and Health. The main message was that NHS Trusts need to work alongside faith communities in the shared endeavour of health and social care.[7]
So that’s why we need religious literacy in healthcare: for the care of particular patients of faith but also in order to draw on the wisdom and energy of faith for the sake of wider society.
But second how can we move things forward on this agenda?
First, we need a wider and deeper religious literacy within community based health and social care. Some of the written evidence pointed in this direction with an emphasis on NHS trusts working with suitably trained faith groups to facilitate safe discharge of patients from hospitals to home.[8] If health and social care professionals increasingly embrace such partnerships, this can be part of the long-term answer we need to the social care crisis. A further recommendation from the report picks this up:
‘Recommendation 21: central and local governments should take steps to encourage public engagement in local and national dialogue and outreach initiatives between different religious and non-religious groups. They should also take steps to encourage the development of new local schemes which can build long-term relationships between people of different religions and beliefs in local communities. ‘
I think this is particularly relevant in health and social care in which religious plurality is a major mark of the highly diverse workforce, many of whom have not had the advantage or perhaps – if the report is to be believed – some of the disadvantages of religious education in this country. This complexly religious workforce may bring very positive ideas about the role of religious literacy in healthcare, ideas for partnership working fuelled by extensive and relevant knowledge of religion and culture. These are perhaps untapped sources of wisdom in our society. I’m thinking for example of the large number of healthcare professionals of African, Middle Eastern and Asian origin in the NHS workforce. If we are to be a truly internationalist, outward-facing, open-minded country, benefitting from our global links especially perhaps with commonwealth countries, we should seek to build on this latent expertise to improve religious literacy in health and social care.
But with that said, we do need religious literacy training of staff in the NHS at every level – not just doctors and nurses, but also health care assistants and other non-clinical roles – the people who may have more time to care but may feel lesspermission to take an interest. This means following through the well-intentioned words of the DoH and GMC with meaningful resources both for initial training and for CPD of health and social care staff. This needs to focus both on community engagement and on communication skills with patients and their families.
Second, we need to explore how religious literacy can help all of to us create and sustain the compassionate and professional healthcare service we all want. The taxpayer funded project I’m leading with Oxford University Hospitals Foundation Trust and with the Royal College of Physicians has this as its focus. With the hospital, we’re developing religious literacy among NHS staff in order to support them in their compassionate practice with particular patients and with their colleagues. And we’re doing this drawing on the great ideas and narratives of e.g. Buddhism, Christianity and classical thought.
And with the Royal College of Physicians, we’re thinking about how religiously literate professionals can becoming facilitators in local communities to bring together people of good will, including those of faith, in very practical ways such as enabling those who don’t need hospital care, to receive help at home.
This means shifting the ethos from a kind of secularity which is suspicious of and inattentive to religion; to a kind of faithful secularity in which the everyday is permeated by a respectful, critical attention to religious ways of thinking about life, aging, morbidity suffering and mortality. And to do this in conversation with non-religious sources of meaning in a way which enriches our public discourse.
In this way, healthcare institutions and social care networks can be key civilising forces, central to our sense of who we are as citizens because they make space for deep questions about human life and suffering, ensuring that our weightiness as human persons is recognised. Health and social care have the capacity to trouble the false dichotomy between religion as private belief and religion as a matter of public interest. Because in them we find the meeting point of human need and the human response of compassion.
In conclusion, religious literacy enables healthcare staff not only to attend to those of religious faith but also to learn from religion for the sake of the common good. It’s important to say that many health professionals already have some level of religious literacy. I echo what the report says which is that focusing on the health and social care sectors [quote] ‘as priorities is not necessarily an indication that levels of religious literacy in these sectors are particularly low. Rather it is a recognition that these sectors have a major impact on national life. Ensuring that employees in these sectors have appropriate religious literacy training is therefore extremely important.’ (6.8)
Nonetheless, growing religious literacy is a big ask for health and social care professionals who often struggle just to just keep going day to day. Having married into the NHS, I know how this feels. That’s why NHS staff need encouragement to develop their religious literacy from their professional associations, employers and from central government.
And that’s why the final thing I want to do is to underline recommendation 18
‘that a formal network of policymakers and academics should be created to discuss, comment and advise on upcoming policy publications concerning religion.’
I want to endorse this strongly and would only emphasise two points: first, that we need training programmes to support healthcare staff to put policy into practice; and second, that some policy publications ought to have regard to religion where they do not do so; the proposed network should be tasked with looking out for sins of omissions as well as sins of commissions, if you’ll pardon the pun. Thank you.
[1] ‘For this reason religious literacy – the ability to understand and engage effectively with religion and religious issues – matters, and needs to be taken seriously by everyone, including those who are not religious. It is important to emphasize here that improving religious literacy in society does not mean promoting adherence to particular religions, encouraging a more positive view of religion in general, or giving religion greater influence in the public sphere. The APPG believes that improving religious literacy means equipping people with the knowledge and skills to understand and discuss religions and issues around them confidently, accurately and critically.’ (p.2) ‘On a personal level, a lack of religious literacy can lead to overly simplistic assumptions about how beliefs, values and identities influence people’s actions. They can also result in an inability to understand the meaning of symbols, rituals and language with religious roots, which continue to make up an important element of our national heritage and identity. ‘ (p.4 1.9)
[2] APPG report Appendix 2, Oral evidence p.19
[3] ‘“I have given nurses training on world faiths to help them in their work and consider it should be a compulsory part of any training for those in social services / national health / police as well as those entering the teaching profession” Consultant and member of the Association of Religious Education Inspectors, Advisors and Consultants (4.7)
[4] UK Department of Health. Religion or belief: a practical guide for the NHS. London: DH, 2009.
[5] General Medical Council. Good medical practice. London: GMC, 2013. See also, General Medical Council. Personal beliefs and medical practice. London: GMC, 2013.
[6] For a fuller account, see Hordern, J., ‘Religion and Culture’, Medicine, 44:10 (2016), 589-592
[7] Faith Action evidence: ‘2. The ways in which Religious Literacy enriches the lives of individuals and positively affects ther engagement with their local community, society and public life Religious literacy in the whole of society helps people of faith to put their faith into action in the service of their communities. Across the UK, public services such as schools and social care services, and charitable work carried out by organisations such as foodbanks and shelters for homeless people, are provided by people and organisations motivated by faith. Where those who commission such services have fears about commissioning faith-based providers (for example, the fear that providers will focus on proselytism rather than service provision), faith-based organisations are denied the opportunity to serve their communities. Conversely, where commissioners have a good level of religious literacy and are open to the potential of faith-based organisations for meeting social needs, more people can be served.’
[8] ‘Such a spirit of good neighbourliness could help address the bed blocking problem by drawing on the resources of church groups to provide rotas to provide non-medical support to enable people to be discharged from hospital to their homes so that they can live at home with support. This can be done under the auspices of care-agencies who would provide all the CQC provisions, for a fraction the cost of a continued stay in hospital.’ (evidence, Appendix to report)
