Bishop backs skills drain campaign
26 June 2005
The Bishop of Manchester has backed the BMA’s campaign to tackle the skills drain of healthcare professionals from developing countries. In his sermon at the BMA service, the Right Reverend Nigel McCulloch said: ‘It is a scandal that we are effectively robbing Third World countries of their own doctors and nurses.’ He called for the building of links between ‘our centres of medical resource and places of poverty where there is little or nothing’.
Full text of the sermon for the BMA Service by the Bishop of Manchester, the Right Reverend Nigel McCulloch
George Bernard Shaw, living at a time of rising confidence in technological advance and scientific progress, observed wryly: " we have not lost faith, but we have transferred it from God to the medical profession."
You may not necessarily have a desire to take the place of God; but these days you may find yourselves wishing occasionally that a greater residue of such firm faith in you could still be discerned. Questions of faith and trust are certainly involved in many of the critical issues that now face society - and indeed our two professions. Unfortunately, as professions we each have our Achilles heels. When doctors or clergy misuse their position, and are seen unreasonably to misbehave or misjudge, then public confidence in all of us is eroded. The mother of one of my clergy was a victim of Dr Shipman. Sally Clarke used to be one of my parishioners. Abuse of knowledge and position devastates lives - be the perpetrators medics or priests.
But, however damaging to the reputations of all the misdeeds of a few may be, it is even more undermining to the work of doctors when the government appears to lack trust in the medical profession. "Why don't politican's trust us?" has been your cry . "Involve us, listen to us, trust us" , your plea to the Secretary of State, on behalf of family doctors. Sadly, in the National Health Service, the word "trust" has become part of the management-speak vocabulary - its once valued sense of reliability and integrity diminished.
The activities of the British Medical Association - not least through its core values that will be read later - do much to counter that and to build up the mutual trust and faith that are essential to a healthy society.
Praise God for the overwhelming majority of doctors who, at whatever level and in whatever context, are regarded with respect and gratitude for their integrity, expertise and kindly care. Vocation is an unfashionable word - but one that in a climate of consumerism speaks of a dimension to life beyond the force of economics. It is about a quality of commitment that can be part of everyone. As the Swiss doctor and spiritual writer, Paul Tournier, put it: 'For the fulfilment of his purpose, God needs more than priests, bishops, pastors, missionaries. He needs mechanics and chemists, gardeners and street sweepers, dressmakers and cooks, tradesmen, physicians, philosophers, judges and typists...God is not served just in the brief moments of a religious service, or when I read the Bible, or pray, or discuss the meaning of life...As a doctor I serve him just as much when I am giving a patient an injection, or lancing an abscess, or writing a prescription, or giving medical advice.'
It is still true that many doctors, maybe most, enter the profession because they do have a sense of vocation and an altruistic desire to care for their fellow human beings; but all too easily find themselves placed under unfair and intense pressure because of unrealistic expectations on the part of patients and an ever-growing burden of bureaucracy. It is an utter tragedy when the pressures doctors face are so unreasonable that their morale collapses, addiction sets in and their own health is destroyed. It is incumbent on the government and the public to treat doctors in a way that enables and releases them to do their job so that their vocation becomes a daily joy not an hourly burden.
A GP who had been a medical missionary abroad among very poor people told me how difficult he found it on his return here to face the often selfish and unreasonable demands made by patients who were not really ill at all. They don't realise, he said, that most people in the world feel ill every day. That's normal. To have a day when you feel well- that's a bonus.
Such selfish insularity remains with us. Over 10 million children a year die needlessly. Life expectancy in Africa it is now lower than it was 30 years ago. I've seen for myself on visits to East and Central Africa how sparse the facilities are in their hospitals; how health-care in rural centres is often non-existent. I have seen wards with desperately ill people taking it in turns to share one bed; I have been to a rural health clinic where the unqualified health worker showed me the single needle with which he had injected dozens of children that morning. These poor countries desperately need more doctors and nurses - and there are so few. Why? - partly because all too often their own doctors and nurses are over here helping us.
How right you are in the BMA to question that skills drain - for you act not only in your own good conscience but also as a conscience for the government and society that allows it. Of course there should be some interchange and training. But what is happening is far more. It is a scandal that we are effectively robbing Third World countries of their own doctors and nurses.
Here indeed is a vocational challenge: to think globally beyond our own needs, and take to heart the famous text from the Book of Genesis - and to think of it in world terms: 'Am I my brother's keeper?'. Yes, I am - and my sister's too.
Maybe, instead of draining these countries of their skills, we can, through the BMA build further on the twinning idea - encouraging contacts between our centres of medical resource and places of poverty where there is little or nothing. Not grand schemes but simply the creating of personal links that enable individuals to understand the disparities, and encourage secondments and visits that, in a quiet but practical way, really can help to make a difference.
Our story tonight from the New Testament told of a needy woman who went to Jesus for healing because she had spent all the money she had on doctors - for doctors were available only to those who could pay. Two thousand years on most people in this world still do not have either the money or the facilities for even the most basic health care. Are we not guilty of receiving medicine for the rich at the expense of medicine for the poor?
The issue of world poverty and how it impacts upon us all is one of several key concerns of fundamental importance about the sanctity and value of human life that we in the churches and faith communities share with you in the medical profession. Much in debate at present, in parliament and elsewhere, are the deeply complex ethical issues surrounding assisted dying and the withdrawal of prolonged treatment. Whilst it has long been accepted that people should not be officiously kept alive, life itself is a gift from God that is to be revered and cherished. The kind of care and protection that the vulnerable and dying receive is a good way of gauging how civilised a society has become. The view of the mainstream Christian churches and the major faiths is that any back door to euthanasia is completely unacceptable.
The sanctity and value of human life equally affects the difficult and sensitive issue of abortion. What is wholly undesirable is the high level of abortions in this country and, in particular the not insignificant number of cases where abortion seems to be used as a kind of late contraceptive. Many Christians recognise, as I do, that in certain rare medical circumstances termination might be, as it were, the lesser evil. But this is a difficult and emotive issue made all the more complex by society's concerns about rights and individual choice. The case for and against a reduction in the time limit, which I strongly support, will I know be argued by you with cogency and integrity - and with that desire for healing, wisdom and compassion that, whatever the intensity of your debates on many subjects, will I pray, always shape your purpose and form your judgement.
We live in a society that sometimes appears to encourage us to put self before others; a society that is quick to claim rights and slow to take responsibilities. But to care for our brothers and sisters is the vocation of the medical profession, the Christian church, the great faiths, of all human society. How often we all fall short of that target.
Yet you and I are called, in our different ways, to strive for the common good, to rebuild faith and trust, to encourage in ourselves and others a sense of integrity and altruism, to embrace an agenda of justice and to recognise our vocation for nothing less than it truly is: to value the life of everyone - whoever they are, whatever they are, wherever they are.
Because, as Psalm 139, puts it: each of us is fashioned by, each of us made in the very image of, God.