Page 5, 22nd January 1993

22nd January 1993
Page 5
Page 5, 22nd January 1993 — Charting the stormy health care waters

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Charting the stormy health care waters

The Federation of Catholic Hospitals is bringing a renewed sense of purpose to the health care pioneered by religious orders in

the last century. Murray White reports. THE next decade does not bode well for some Catholics working in health care. Observers, even from within the field, are predicting that a significant number of institutions could face closure. In the care of the handicapped alone, the transition from large mental hospitals to smaller communitybased houses is already producing chaos.

Gone are the days when a group of concerned Catholics could just walk in off the streets and set up a home for, say, alcoholics. The home has got to meet rigourous standards, with the right-sized bedrooms. even the right number of fire escapes.

Rules governing the running of institutions are so complex that religious orders with a long and distinguished history of working in hospitals and caring for all from the handicapped to orphans. the elderly and the dying, are facing a tough time in a rapidly changing environment.

The Federation of Catholic Hospitals and Health Care Institutions, an umbrella body for more than 50 orders and other organisations in the field. has recently embarked on a re-charting of the waters for those caught in the health care storms.

Chairman of the Federation, Canon Louis Marteau, analyses the sea-change as one of "too many institutions trying to shore up in lighthouses, shining a Catholic light out from a (too safe) distance, when the real need is for lifeboat crews prepared to dive into the thick of the waves".

The Federation is pushing forward on two fronts. Firstly, it has developed "mission statements" to point its members from the largest institution to the smallest ward towards workable reform.

-Canon Louis explains: "At one time it was easy to see what a Catholic hospital was, simply because there were a couple of nuns on the wards. Nobody questioned them, no matter how badly they behaved. Now our hospitals are

increasingly run by lay staff, we need to seriously think about what they can provide."

At the same time. the Federation has been at pains to clarify to potential patients why there is a need to have Catholic hospitals at all. In particular, says Canon Louis, to come clean on the thorny issue of private medical care.

This century, while there has been a technological leap forward inconceivable to the orders who set up Victorian hospitals, the price of such health care has been high. The harsh reality is that modern medicine is an expensive business.

The Government's solution has been to stamp price labels on everything from brain scanners to syringes. This creates an unenviable dilemma for the GP, explains Canon Louis. If said doctor skips an X-ray for a patient who subsequently is diagnosed as having a broken ankle, he will be criticised for professional misconduct. If he sends a patient for an X-ray who subsquently turns out to have a mere sprain, the criticism will be for financialoinefficiency.

"If the budgets are fair, the new system will give the doctor a chance to be in command. I only hope it will not go as far as the Polish or East German system where doctor; get a budget for the year and if they run out of drugs, patients have to wait until next year." he says.

Such an uncertain climate means being strict with the purse strings. The 17 Catholic hospitals and numerous other homes in England and Wales would like to counter the pay-as-you-operate ethos, but cannot afford to be kind.

Yes, they do take in private patients, but there is no hesitation in rebuffing the cries of the Justice and Peace sector of the Church that demands "free medicine for all". Profits are often ploughed back into associated hospices for the dying and other needy causes. They have recently introduced the novel (even to the secular private sector) concept of "fixed price surgery". where the cost of an operation or other treatment is agreed beforehand; no hidden extras. So what they can provide? "A certain amount of comfort, privacy, the chance to take communion whenever you want, a telephone for businessmen to keep in touch," says Canon Louis.

"We are not just just offering health care for the rich. In fact with the hospice work, we are being somewhat unjust to the rich to help the poor. And with the new contracts, we may even end up buying in NHS patients."

Speaking at the London hospital where he is based, Canon Louis elaborates on the Catholic ethos: "There is an attempt, here at St John's and St Elizabeth's and elsewhere, to put some personality back into care. If we are not careful, hospitals can become a factory. The Church has only got a place in this field if it is pioneering or if it is demonstrating something of Christian quality."

He is not unsympathetic to the pressures that the National Health Service faces. He even tells how he once wrote harshly to the producers of the BBC science programme Tomorrow 'a World, saying that viewers were coming to expect each great technological advance shown to appear instantly in their hospitals.

He suggested that expectations would be more realistic if the programme put a price tag of each item on the screen. That would surely go down very well at the Department of Health.

For further information, contact The Federation of Catholic Hospitals, 60 Grove End Road, London, 1VW8 9NH.

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