What can we say as Christians about the Lord Darzi Rapid Review on the state of the English NHS?

Ara Darzi’s independent review into the performance of National Health Service (NHS) England, commissioned soon after the Labour election victory in July, was published on 12 September. The report has been well received as an honest appraisal of the current state of the NHS.

The fact that the NHS is in serious trouble will come as no surprise to anyone working there. Darzi offers a stark view, exposing ballooning waits in primary and secondary care and evidence that the health of the nation is deteriorating. Care for cancer lags behind comparator nations, and cardiovascular care is in reverse. Too much of the budget is being spent in secondary care. And all of this is exacerbated by insufficient capital funding and unhelpful and damaging reorganisations. Furthermore, too many staff members are disengaged, and the patients’ voices are not loud enough.

Yet, despite all this, once patients’ get into the system’, they receive good care. Darzi, therefore, concludes that ‘despite the challenges, the NHS’s vital signs remain strong’.

While specifically tasked not to look at solutions, Darzi gives some helpful pointers:

• Re-engage staff and empower patients.
• Shift care closer to home.
• Simplify and innovate care delivery.
• Drive productivity in hospitals.
• Tilt towards technology.

What can we say as Christians? We got together several Christian healthcare leaders recently and asked them just that. The group expressed that:

• Our response should be underpinned by a servant heart, remembering ‘it’s not about me’, but rather that we are called to be servants of the sick and to be salt and light without partiality.

• The report is a truthful and honest assessment of the current state of the NHS. With truth such a foundational Christian principle, this is both refreshing and welcome. The absence of truth in some of the dialogue around health policy in recent years has caused harm and got in the way of solutions. This is a foundation from which to move forward.

• There is little to disagree with in either the diagnosis or the initially proposed broad solutions. However, the ‘how’ is all important. Along with patients and other health professionals, Christians working in the NHS must not only have a voice but also be convinced that God’s voice through us is valid and important. We need a Christian voice where the policy is made, but perhaps more importantly, where the policies are implemented in a multitude of healthcare settings and planning meetings.

• We care about patients but also about the effect of new policies on staff. We want to serve both, to empower both, and to care for both. As Christians working in healthcare, we fundamentally have a pastoral heart, which we do not leave at the door on a Monday morning. It is as we comment and advocate on hundreds of occasions that we can make a difference.

• We have a whole-life faith. We are about whole-life patient care, and as Christians, we welcome the report’s focus on prevention. We see our patients as more than a diagnosis, but rather as whole people with a life beyond the hospital or surgery, all of which is important to true health.

• And so also with our colleagues, who have a whole life beyond the workplace. Our whole-life faith cares for the whole of our colleagues. We can help empower and re-engage our colleagues, supporting those who have just given up; we can be the glue that keeps the team together. Speaking up for and championing the care of our colleagues is vital to improving staff retention, without which failure looms.

• Sir Keir Starmer has said that the NHS must ‘reform or die’. There is a fundamental tension between this desire or need for radical change and an inevitable cynicism about how some previous changes have been introduced. And yet Jesus taught a radical gospel, where the first are last and the last first, where rulers are brought low, and the lowest is raised high. This good news remains relevant and radical to this day, perhaps increasingly so. Christians can be confident in that radical Saviour as we embrace change. In the end, God is in charge, and we can take confidence in that. That, in turn, makes a difference to who we are and how we are, so that we can be a non–anxious presence at work in the midst of change.

The Darzi report offers a striking appraisal of today’s NHS in England. The culture in which we practise and live our professional lives as Christians has changed enormously over the 76 years since the NHS came into being, but the Christian voice is as vital as ever. How the government implements change is critical. We need to believe that our voices, expressing God’s voice and his Kingdom values, are relevant and need to be heard and can (and should) be championed in a multiplicity of comments, conversations, papers, and discussions wherever we work and have influence.

Thanks to Rob Angus and Sue Holcombe, who helped with the discussions and feedback.