Theological Reflection on ‘Care and Support Reimagined’

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I have recently been reading Gregory Nazianzen’s funeral oration for Basil of Caesarea in which he describes the work of this fourth century bishop as a seamless integration of theological study, prayerful contemplation, excellent liturgy, and skillful political influence to set in place structures to care and support those in need:

Of his care for and protection of the Church, there are many other tokens; his boldness towards the governors and other most powerful men in the city:…his support of the needy, most of them in spiritual, and other ways in which the true man of God, working for God, would benefit the people

The Archbishops’ report ‘Care and support reimagined: A national covenant for England’ launched last week rightly aspires to stand in this tradition. It is based on an engagement and listening exercise with stakeholders, gives an account of social care (statutory and voluntary) in England, analyses the strengths (few) and the weaknesses (many), and proposes a way forward. It is informed throughout by key Christian ideas: the imago Dei, the interdependence of the body of Christ, and the love commandment of Jesus. 

It’s a short report (50 pages with a lot of pictures), so naturally lacks depth and detail. Much of what it documents about the current situation is well-known; for example it doesn’t seem necessary to have gone through the formal listening and engagement exercise to conclude that ‘the current system of social care is broken’(p.19). The analysis and proposals are organised around a coherent and fairly reasonable set of ‘principles and values’ which draw on theological themes (though there is no room for more than a scattering of biblical references to support them) and are brought together as a ‘vision’ (p.21):

  • Care and support enables people to flourish and live life to the full 
  • Access to and funding of care and support is universal and fair
  • How we care for one another reflects loving kindness and empathy
  • Society, including churches, are inclusive of all people, of all ages and abilities
  • How care and support are delivered promotes mutuality and is based on trust

Much of my working life in the NHS in the 1990s and 2000s was devoted to the design and implementation of systems of person-centred goal planning for people with complex disability living in the community or in residential care, so I can say on the basis of experience that there is nothing new here, though it does no harm to re-state these sorts of values, especially in a post austerity, post Brexit, and post pandemic context. I don’t think these values have been lost in health and social care; it’s simply that the resources to pay for enough managers and practitioners to meet demand, to deliver training, and provide technology are simply not there. The staff who are still working in these areas are also exhausted and dispirited. 

The authors of the report offer a defence to those who might read it as ‘theology-lite’, insisting that there is an authentic if not distinctive Christian theology at its heart. I found its expression of this odd at times. For example some of the things it claims for Christianity such as human beings created in God’s image, the concept of hesed, and the command to love one’s neighbour as oneself are actually Jewish. Overall, other faiths tend to be presented as add-ons – ‘they believe something like this too’ – and the Christian narrative feels very protestant; there is not a single reference to Catholic social teaching nor indeed any references to Roman Catholicism at all. Perhaps the oddest theological statement in the report is a description of sin as a ‘form of cognitive blindness’ (which probably refers to a lack of curiosity), a singularly unfortunate phrase in a document aimed at inclusion and respect of neurodiverse people. 

There are some helpfully specific suggestions for the way forward, for example the formation of a coalition of faith, voluntary, and other interest groups with a common vision and values to influence government policy in this area. It is also good to see an unambiguous call for fair pay for care givers, a just and rational system of funding across the board, a change of political attitude, and the support of a culture of fuller civic engagement.

The main question for me is around the role of churches in implementing any of this beyond the many wonderful initiatives that happen at grass roots level, several documented in the report. The Church of England does not currently seem to be highly trusted (and it is interesting that despite the emphasis on trust the document nowhere mentions safeguarding). In a Channel 4 News interview on the day of the report launch Matt Frei asked the Archbishop of York why anyone should listen to an institution that had lost moral authority due to its attitudes to women and LGBT+ people. This seems a very long way from the influential position of Basil, and the need for partners in advancing the agenda is clear.

The report itself acknowledges a need for the church to reflect on its culture and practice, and in particular its approach to inclusivity; nevertheless, I think its issue of institutional ageism still goes largely unacknowledged. My years as a diocesan older people’s adviser showed me the pervasiveness and seriousness of the problem. Ageism and the obsession with youth and growth are two sides of the same coin; both are symptoms of a mortal fear of irrelevance and annihilation. It’s absolutely right that the church continues to engage proactively with pressing societal issues but it’s also important that at the same time we deal properly with our existential anxiety so that we can speak from a place of confidence and peace.