February 2008


As a priest, I should not be surprised at how often sometimes perfect strangers ask me to pray for them.  Sometimes it is related to a specific difficulty or crisis – more often than not people understandably take comfort from the reality of being prayed for.

Intercession, prayer that is to ask God for something or somebody, is a very complex reality and problem.  Intercessory prayer centres on prayers of asking, but God is not insensitive, deaf or unyielding, and we need to be careful not to try and twist God’s arm.  One wonders whether God answers prayer, or, indeed, how boring it must be to hear the stream of intercessions that flow from earth to heaven!  This image and the presuppositions that lie behind it raise another set of questions for another day.   But, let’s remind ourselves of what this balance of thanks and praise, pointing up local events and world events, might be about.

We place all in the palm of God’s hand, letting go of our control and waiting to discern, in trust, how God will take and shape situations with us.  This means we have to be sensitive and alert, to discern and respond with action and commitment to the shaping that God gives us.  Bearing up a situation faithfully before God is as important as being an agent of change for Christ in that situation.

But God does not need reminding that we need to offer certain of our hopes and feelings to him.  We do not need to be too long in our asking, but need to try and pick up what is deeply felt by others.  My daily prayer is enriched by the needs and concerns that are shared by such diverse number of people in various places and situations.

So prayer is about being in close attention with God and growing into God’s presence in a self-forgetful way.  But in our praying we ought to search out and grasp some measure of integrity and balance.  There are always two sides to a story and we should try to achieve that balance in the words we choose for prayer.  I wonder what petitions have been offered in and around the present complex situation in Iraq?  Praying for both sides and for common understanding in a dispute, strife or war enlarges our humanity.

So today, I thank God for all those people who ask me to pray and I offer the following list as a challenge to deepen our intercession which is no less than:

Standing before God

Longing for God’s grace

Asking for those in need

Naming those needs before God

Hoping for grace and love.

And so, in the standing, longing, asking, naming and hoping we pray that we might be changed as the Kingdom of God is proclaimed.

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rib-cage.jpg  The rib gage from a useful anatonomy text book. My interest? Last thursday I slipped on a step and fell only to discover 36 hours later that I had broken a couple of ribs. Frustrating and painful – in equal measure. Nigel – a doctor friend – came to the rescue. A wonderfully careful man who reassured, explained and encouraged. I was astonished to learn more about bone structure and the process of mending. He also told me that that there was always something to learn about from illness – quite a challenge shared with his priest!!

I am taken aback by the sheer unpredictability of life and how easy it is to break something!! What an amazing capacity the body has for change and growth and mending. How powerful the experience of pain and comforting those who express their care. Soup and paracetemol are most welcome.

I have never really appreciated before those who spend great amounts of time in physical pain and I now see and feel their plight in a new way. I also now know how important sleep is having had several nights interupted by the sharp pain of my lower ribs!!

As Lent begins today I am resolved to slow up – and get in closer touch with my body – ribs, heart muscles and waiste line!!!  And please – a warning – WATCH YOUR STEP!!

Contrast two scenes. The first is a restaurant – where the food is carefully prepared and warmly served in an atmosphere which seeks to delight its customers.  The second is a hospital.  Parking the car is nearly impossible – the long impersonal corridors where people avoid eye contact.  The noisy ward – the short temered administrator; the disinterested receptionist; the doctor talking over the patient who feels ignored.  There is no space or time or sensitivity.  If we were treated like in a restaurant we would complain and ensure that we warned friends against any contact with that place.

We are proud of the NHS and its values.  It is deeply rooted in a philosophy of care for all – it aspires to mend and heal; to prevent and support.  It inspires great public service from energetic practitioners who want the best for those they serve.  We have all benefited from the developments and investments in health.

However, there is a crisis deep within our culture.  It is a crisis of care – the way we treat people; how we engage and listen to our service users.  If we believed that patients paid our salaries then we simply would not go on failing them.  Managers have a responsibility to oversee the shape of the culture within which health targets are delivered.  We are shapers of both systems and structures.  Are they fit for ‘care’ purpose?  How radical is our commitment to the patient and their experience in all its complexity?  How responsive and people-centred are our transport access, reception areas, our wards or consulting rooms?  Would an ordinary older woman be empowered to respond to her doctor with gratitude for his time and compassion?  Are hospitals places of understanding?  Is the PCT Board meeting a place where feedback from the patients is as important as the financial results or the latest set of targets?  If we want to develop and grow, then managers should take a lead in asking: ‘Don’t tell me what is going well here – let’s look at what is wrong!’  I do not doubt the intentions of those who work in the service – but there are preciously few people who are angry at not getting it right enough for people.  We exploit their fear and dependence at very vulnerable moments of life by failing to enlarge humanity through the sharing of power and control.

Dismiss this plea at your peril.  There can be no improvement of quality without attention to creating communities of compassion where the person is the beating heart of our work.  We must make the jump from seeing things from others’ perspectives.  Here are some actions that might help you explore the added value of putting care firmly on your organisational agenda.

1.  Find time and places where you can observe your organisation at work.  Take note of those things that would be unacceptable to anyone about whom you care.

2. Invest in listening to the patient experience.  Respond to complaints as opportunities to deepen care.

3. Ask others how they would describe your place of work with one adjective.  Be energised by the gaps between how we describe our aspirations and what the actual practice is!  Let us do away with the minimalist functionality of much of the space where we deliver care.  What about the imaginative use of colour, light and texture?

4.  How much power and control do we give to the patient?  Are they partners in decision making?  Let them decide what is appropriate – we do not always know what is best!  In Birmingham, our Palliative Care Network has launched a compaign to ensure that choice is given back to people at the end of their life.  What shape would your campaign take?

5. Discover what makes your staff tired and de-motivated.  Invest in programmes of staff support so that we can be energised by service.  Too often our staff makes the experience of going into hospital like going to a foreign country – an alien land where no-one tries to understand your language let alone engage with your vulnerability.  Our staff need to be supported to deliver care differently.