HOSPITAL/HEALTH CARE CHAPLAINCY

Information Sheet
History of Hospital Chaplaincy

1. Before the national health service

The association between religion and the care of the sick goes back very far indeed, and certainly the Christian church has always regarded this provision as one of its members’ prime duties. In the Middle Ages there was a close relationship between ‘hospitals’ and the Church, ranging from the monastic infirmary where sick and elderly brethren were looked after, through the ‘special hospitals’ - the lazar houses - established in many places for the segregation and succouring of lepers, to the hospitals, charitably founded to care, as well as knowledge and skill allowed, for the bodies of those who were sick and for their spiritual welfare here and hereafter. Inevitably many of those in charge of medieval hospitals were priests and there can have been little or no distinction between ‘medical’ and spiritual care.

Two hospitals serving Londoners from the twelfth century - St Bartholomew’s and St Thomas’s - were brought to a temporary end by the Dissolution and refounded as Royal Hospitals a few years later. In both cases on refounding a paid Hospitaller was appointed who was to be in Holy Orders and who was primarily responsible for providing religious ministrations to patients. In the case of the Hospitaller at St Bartholomew’s Hospital he was also responsible for food supplies, for looking after patients’ property and for some medical work. In 1612 his salary was raised from 10 a year to 15. At St Thomas’s Hospital the Hospitaller also had duties in addition to his religious ministry and was also paid 10 a year but as well as this he had four pints of beer a day.

The eighteenth century has been called the ‘Age of Hospitals’ and a great many now famous hospitals in London and the provinces were then founded. It would appear that in all cases the founders were conscious of a duty to provide for the spiritual as well as the material care of their patients. In some hospitals a chaplain was specifically appointed and his office endowed: in others a local clergyman was made responsible with or without pay.

Hospitals continued to be founded in the nineteenth century, general hospitals and an increasing number of special hospitals, and whilst many are charitable voluntary foundations, Acts of Parliament provided for the care of the sick poor and destitute. There continued the sense of lively responsibility for the patients’ spiritual welfare and a variety of arrangements to provide it were made. The Lunacy Act of 1890 specifically provided for the appointment of an Anglican chaplain in each mental hospital.

 

The above is an extract from the Tunbridge Report published in 1973, a working party under the chairmanship of Sir Ronald E. Tunbridge, OBE, MD, FRCP, JP, Emeritus Professor of Medicine in the University of Leeds set up by the Joint Committee of the Churches to review and report on the hospital chaplaincy service as it was at that time. The Report is now out of print. Central Board of Finance of the Church of England.

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2. Chaplaincy Landmark Events

1941

Prime Minister, Winston Churchill, appoints Sir William Beveridge to make detailed recommendations for post-war.

1942

Beveridge Report published.

1944

First Government White Paper for NHS.

1945

End of Second World War. Labour Party elected to Government.

1946

Bevan enacts Beveridge proposals for NHS in Act of Parliament on 6 November. Chaplaincy written into this Act, following discussions between Archbishop Fisher and Secretary of State – largely taken over from pre-war London Teaching Hospitals.

1948

The 1946 Act becomes effective from 5 July 1948. NHS "a fact of life".

Approximately 28 W/T Chaplains, mostly working in Teaching Hospitals, become NHS employees with 5-year contracts and a possible extension for only 2 years, making 7 years in all before need to move.

W/T salary @ £500 pa (same as min/max CofE), but not part of NHS Pension Scheme. P/T for 500 Patients at £4 10s 0d per week. 25 Pts @ 10s per week.
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1951

Hospitals with over 750 beds of one tradition encouraged to make W/T posts. 5-7 year rule remains in force.

Approximately 36 W/T Chaplains in post. (New posts largely in big mental hospitals). Salary same as 1948 @ £500 pa. 25 Pts @ 10s per week for P/T.

1956 - 64

First major new hospital building programme – first DGHs.

1959

Mental Health Act.
First Guide to NHS Chaplaincy produced by HCC.

1963

Approximately 49 W/T Chaplains – mostly out of London in new DGHs.
Salary W/T @ £1,025 pa. P/T 300 patients @ £6 10s 6d.

1966

King’s Fund Report on The Hospital Chaplain.

1967

2nd Chaplaincy Handbook – Birmingham Regional Hospital Board, setting out duties and terms, etc.

1968

Approximately 56 W/T Chaplains.
Salary @ £1,280 pa.

1969

750 beds and 5 + 2 year rule relaxed by some hospitals.

1969 -78

2nd PHASE OF REBUILDING PROGRAMME OF DGHs OUTSIDE LONDON.

1969

Mr Justice Salmon introduces new Nursing Structures – CNO, PNO, SNO, NO, etc.
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1970

Approximately 65 W/T Chaplains @ £1,545 pa.

1973

First (of many) reorganisations of NHS – White Paper.
Tunbridge Report on Chaplaincy (HCC). Effectively the 3rd Handbook.

1974

Reorganisation becomes law with new AHAs & DHAs. Systems based on large DGH and first CHC. 750 bed and 5 + 2 year rule removed.

Approximately 100 W/T posts and introduction of WTA posts in DGHs outside London.

Mid 1970s

All W/T Chaplains become part of NHS Pension Scheme.

1978

4th Handbook on Hospital Chaplaincy.
Approximately 150 W/T Chaplains. Salary at £4,386 pa. P/T for 300 Pts @ £26.91 per week.
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1981 - 82

Reorganisation of DHAs with General Manager system introduced.
Approximately 185 W/T Chaplains @ £9,110 pa.

1986

DHSS Letter PM(86)15. Pay and Conditions of Service for Hospital Chaplains

1987

"A Handbook on Hospital Chaplaincy"
The first Handbook to be given an official DHSS recommendation.

1988

Approximately 227 W/T and WTA.
Salary @ £12,941 pa. P/T 40 Acute Pts @ £17.98.

1989

NHS Executive established.

1991

Internal Markets and first Patients Charter.
1992

Reorganisation – White Paper on NHS. Trusts given freedom to vary all terms and conditions, etc. HSG(92)2.

COLLEGE OF HEALTH CARE CHAPLAINS FORMED FROM NAWHC & HCF.

Approximately 250 W/T Chaplains @ £16,634 pa. End of NHS guidelines on P/T payscales.

1996

Appointment of National Training & Development Officer for Hospital/Health Care Chaplaincy, jointly between HCC and CHCC.

100 smaller HAs established to replace most work of RHAs and bring NHS nearer to local community needs.

1997

1st Multi-Faith Joint National Consultation with Department of Health and Secretary of State participation.

1998

Powers of RHAs again reorganised to give National Framework with local responsibility to HAs.

Approximately 352 W/T Chaplains @ £19,709 pa.

Churches Committee on Hospital Chaplaincy recommendations for P/T 40 Acute Pts @ £31.35.

1997 -
2001

Working Party set up to consider Multi-Faith Issues, Chaplaincy Spiritual-Care Teams, Departments, Leaders, Grades, Salary Scales, Appointments, Contacts, Use of Volunteers etc.

2002 Working Party completes its recommendations to the Department of Health on Chaplaincy-Spiritual Care.
  Formation of Multi-Faith Group for Healthcare Chaplaincy
2003 Department of Health issues new best practice guidance - NHS Chaplaincy: Meeting the Religious and Spiritual Needs of Patients and Staff.


By mid 1999 there were 401 Whole-Time Chaplains posts in the U.K. The estimate of Part-Time Chaplaincy sessions in the NHS was around 5,000 worked by approximately 3,500 clergy and Spiritual Care Givers, taken from all the faiths and traditions.

This page was updated on 31 October 2006