As a hospital chaplain, I have had thousands of encounters with sick and traumatised people and I would like to share some of my perceptions.
I believe we are at a crucial stage in the history of the NHS, where its former pastoral influences are slowly being eroded by a mechanistic, scientific and finance-led approach to healthcare. I believe we need to challenge this trend and demand a deeper level of engagement with patients.
Challenging the impersonal
Recently, the NHS has been the subject of a lot of analysis and commentary in the media. Much of this is unnecessarily negative. Since its election to government in 1997, Labour has poured human and financial resources into the NHS.
However, along with these attempts to improve performance for patients, the last few years have seen an approach to patient care that is more reminiscent of industrial efficiency than the delicate treatment of vulnerable people.
In chasing efficiency, there is a temptation for health bodies to treat patients as units to be mended rather than as people. Ironically, this growing depersonalisation of healthcare goes hand in hand with an emerging rhetoric that flags up the "patient experience" as of prime importance.
The language of care
Although politicians, health authorities and trust boards mean well, patients' actual emotional experiences in hospital can be like going to a "biological garage". As the Bishop of St Albans, chair of the Hospital Chaplaincies Council, said during a discussion on the Palliative Care Bill in the House of Lords: "Language is always significant, and if we use only mechanistic language to shape our thinking about palliative care, we shall end up treating human beings like robots."
This mechanical, bureaucratic language is widely used in the NHS in seeking to explain our rationale of treating people. Karen Jennings, head of health for Unison, has warned against viewing patients as "customers".
She said: "The concern that I have is the term customer. What we are hearing more and more is the application of business ethos in the NHS. Equating patients with consumers is not useful.
"It's about how you approach the people you are looking after and that has nothing to do with being a customer."
Social climate change
Economic, social and ideological changes over past centuries have influenced how we view people as they go through health problems. In making appeals to technical experts, politicians today try to shape society (including healthcare) using evidence based on research and technical expertise alone. I have no problem with this, although it implies a loss of confidence in our intuitive capacities compared with our intellects.
Inevitably, patients' emotional and spiritual turmoil now register less on the NHS richter scale. But to patients, they still matter. I see their distress regularly. Recently, a young respiratory patient told me he wept every day in the toilets. His complaint was that the staff did not seem to realise he had feelings.
I believe we need to restore the NHS's compassion for the whole person. This includes their emotional and spiritual pain, as well as those uncomfortable feelings of anxiety, fear and depression that surround illness.
Modern healthcare is understandably committed to cure, but we forget that the origin of the word care is kara (Gothic), meaning lament. Care and cure are inseparable. Caring is emotionally costly, but it should value the patient as a whole person - mind, body and spirit.
The humanitarian task
Providing quality care is really about being a fellow human being. As a logo I recently saw said: "We think as professionals, but we act as human beings."
The most potent thing we can do is simply to be there for patients as fellow human beings. This is a rationale of our chaplaincy service - we have time for it. It helps people realise they are not alone in their difficult experience of illness.
This is "manna in the wilderness", as I found personally 30 years ago in hospital, when one nurse recognised the "me" in the patient and made time to address my anxieties. This was a healing encounter equal to all the necessary medical interventions. My plea is that we should put ourselves in their place. None of us knows when we might change places with them. Health, after all, is a precious and fragile thing.