Medicinal compound

Works every time

Photo by Fulvio Ciccolo on Unsplash

Imagine a bottle of special liquid. If you drink it regularly, it reduces your visits to A&E, improves your mental health, adds years to your life and makes you more likely to do well with chronic illness or trauma.

This same stuff, taken in group drinking sessions, speeds up development goals, getting people working together to address climate change, improve health and education, and provide decent work opportunities.

If two warring sides in a conflict both drink it, the prospects of peacemaking climb.

What is it? Hope. The UN declared a recent day (July 12) as ‘international day of hope’. They came up with a way of measuring hope. Then, having measured how much hope was in a person, they came up with what they claimed were research-backed findings on the effect of hope on all the things mentioned above. Their website offers some colourful graphs. I wasn’t myself greatly convinced by the graphs, but surely the direction is clear.

Here’s a further point though that, properly, the UN isn’t able to make: no-one is better at hope than the Christians. Because Christ is King, we hope for a transformed world to come when he returns; because Christ is king we expect, believe and work for a foretaste of the transformation here and now. (Otherwise why pray ‘Thy Kingdom come?’). We hope, and act, therefore, because Christ is King. It doesn’t matter that it’s slow. It matters that it’s in the right direction.

A superpower.

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Slow mission is taking a summer break and will be back in September. Thank you so much for reading.

If I get my act together, by September I will have moved the blog to Substack. This means my blog will be in company with others of its kind, –nice for it–and also opens options for me to add extra material, perhaps behind a paywall.

Because you’re a loyal subscriber I’ll stick you for free behind the paywall, so you won’t have to pay anything and you should continue to receive the blogs by email as you do now. Most of the blog will remain free to everyone, but I may put some extra stuff, perhaps my books or new books, behind the paywall.

I’m also launching a bookshop that contains all the books I’ve reviewed and loved over the years, all available outside the Amazon empire, and delivered to your house, usually at a discount to the retail price. A slice of the selling price goes to support independent bricks-and-mortar bookshops.

You can of course cancel, or indeed tell your friends to subscribe, any time you want.

I get more feedback from the blog than I’ve ever done from my books, and I’m really pleased if you find this stuff useful.

The title of the Substack will be ‘Patient Revolution’, but nothing much else will change.

See you in September!

Slaves of productivity

Ramses II was an enlightened employer compared with modern economics.

Photo by Vitaly Gariev on Unsplash

Economists worry that some things resist being made more productive.

This is a problem because increasing productivity is the bush everyone hides behind when we want a way of paying for more government services without charging more tax.

Some things are easy-ish to make more productive and all the fun things with AI and robotics may give this long trend a further nudge. So if you take a driverless car to a driverless train to get somewhere, you aren’t paying a taxi driver or an engine driver, so it’s cheaper. Productivity has gone up. Similarly if you build cars on a robotic production line rather than employing workers to fit panels and tweak nuts, you can do the same thing. With the money thus saved you, and the state, can do things that you couldn’t previously afford – more government spending, no increase in tax.

But some things resist being made more productive. And perhaps we are nearing the end of long experiment in proving this. For example, you privatise a cleaning contract. The new firm sacks the cleaners and rehires them at worse conditions. Productivity has gone up but actually all you’ve done is grind the faces of the poor and apart for being monstrous, this will bite you back, right where it hurts. Perhaps by paying people less, you have to pay more by way of supplements to the lowly paid, for example, or face greater absenteeism and ill-health.

Or maybe you can cut GP appointments from 11 minutes to 8 minutes. You see more patients. Productivity is up. But that ignores the research that says a good relationship with a family doctor improves health and decreases hospitalizations. Longer appointments, not shorter ones, may actually buy you greater productivity alongside greater human thriving.

Or you can replace teachers with computers but what you end up with is a bunch of kids who can do procedural maths, not the deeply learnt, flexible, adaptive maths education that everyone needs. Their turgid education lasts a lifetime at goodness knows what cost.

You can improve productivity (or at least people have tried) in the care sector by making visits shorter, but it doesn’t work. Lingering over a cup of tea with your client may actually produce more life and fewer of the deaths and diseases of loneliness than zipping in and out making sure they’ve taken their pills.

We are slaves of increased productivity. As a slave-driver, Ramses II was an amateur in comparison. What are we doing to ourselves? We ought instead to be slaves of human thriving. Some things can be speeded up, fair enough. Some things need to be slowed down, and done with love and creativity and passion.

Bridging the gap between healthcare and wellbeing #4

A final (for now…) post on the interesting shifts of culture and practice that might get state-supported health care and the church’s role at the heart of local communities finding common cause and networking together.

It could be a (quiet, slow) revolution in healthcare and it would not be the first time that church initiatives have altered the national landscape.

  1. The probation service was started by a pair of Anglican missionaries in the early twentieth century, and eventually nationalised.
  2. Educating the working classes was a job pioneered by the Christian churches, with both Catholic and Protestant examples. In the UK, Sunday Schools were teaching literacy and numeracy (and Bible literacy) to a quarter of the eligible British population of children by 1831. 1. (Schools until then were largely private, fee-paying and for the upper class and middle class boys.) In 1870 came the Education Act which made state education compulsory and a state responsibility.
  3. The hospice movement which had earlier (and largely Christian) precedents but in its modern form was established by the devout Christian Dame Cicely Saunders. So far the UK’s 220 or so hospices have escaped being swallowed by the NHS but at Dame Cicely’s death in 2005 were caring for 60,000 people in hospices and 120,000 people in their homes in the UK 2. Eight thousand other hospices followed her model around the world; part of the landscape for the dying. (Interestingly, Dame Cicely was a passionate opponent of assisted dying.)
  4. Possibly, hospitals themselves, invented early in the first millennium by St Basil and his fellow Cappadocian Fathers.

Bridging the gap between healthcare and wellbeing #3

Photo by Jon Tyson on Unsplash

So I have to request you be patient for a little longer. Here’s a third take on the changes intended for the National Health Service and how these changes take it into the arms of the Christian church, and how they can help re-establish the church in its centuries-old role as centre-piece of the good in a local community.

A newspaper report in April 25 said this:

The NHS is attempting to ease the pressure on GPs and A&E by sending a new type of health worker door to door in deprived areas to help detect illnesses before people need urgent care.

Community health and wellbeing workers (CHWW) are already deployed in 12 areas of England, with 13 others to follow, in an attempt to improve poor and vulnerable people’s access to care.

Each worker is responsible for 120-150 households, usually on a council estate, which they visit once a month to help residents with money, isolation and housing problems, as well as their health.

Wes Streeting, the heath secretary, is examining the scheme as he pulls together ideas to help “fix” the NHS that may be included in the forthcoming 10-year health plan. 3 The article points out these CHWWs ‘are not clinically trained staff, like doctors, nurses and health visitors. They are mostly recruited from the communities they work in and trained up for the role.’

It quotes the program managed of the National Association of Primary Care as follows:

‘CHWWs are supporting residents to access earlier and more appropriate forms of care, often in community settings.

‘They’re also helping to address wider determinants of health – like housing, finances and loneliness – which are frequently the root cause of escalating health issues that end up in A&E.

‘Their job is to build relationships with the people in their households and with health professionals and NHS services locally.’

Nothing in the article mentions the church. But what a nice job for someone as a CHWW, with formal or informal links to faith communities.

Bridging the gap between healthcare and wellbeing #2

Photo by Jon Tyson on Unsplash

So last week we saw that the UK National Health Service, groping its way to being a Neighbourhood Health Service, is seeing the value of directing people from GP surgeries to community groups. Faith groups–and especially in the UK, Christian churches–are the main source of community groups, and they are everywhere.

In a report about all this, the Theos thinktank notes that some GP practices employ social prescribing link workers (SPLWs, because the world needs more acronyms) to make and maintain these connections. So far so good. But the people at Theos make these observations:

  1. Where there’s a high turnover of SPLWs, many of the links are lost.
  2. When SPLWs merely ‘signpost’ people to things a lot of the potency of social prescribing is lost. (This is true generally with the dread word ‘signposting’. People are often refused help by one agency or another and ‘signposted’ elsewhere. This is fine for the people who are turning people away, but not so good for the people who are being turned away). It’s much better when SPLWs get to know groups personally and also take people along to them. The personal relationships matter much more than a listing of providers.

As the report said:

..We found a number of challenges … There are communication challenges because faith and health communities use different language to talk about very similar things. It is challenging for faith groups to connect and maintain relationships with the ever-changing social prescribing system. Similarly, link workers and local health practicioners don’t kow where to go to connect with local faith groups. Furthermore, there are administrative challenges that slow processes down and a lack of funding to keep activities running. (p15)

Further, ‘one explanation for poor integration between faith groups and healthcare workers … is stretched capacity in the NHS’ (p61).

But social prescribing is a ‘thing’ and the NHS has a long term plan for every person in England to access social prescribing through their GP eventually. 4

3. While there are relatively many hospital chaplains, there are relatively few ‘GP chaplains’ and this is a missed opportunity. N0t only so, but a qualification in social prescribing takes about 5 months’ study 5. No doubt lots of people have thought of this, but a GP chaplain who was also a trained social prescriber could make themselves very useful; if they were funded by a collaboration of churches, they would be less dependent on the vicissitudes of government provision.

Bridging the gap between healthcare and wellbeing

Sometimes you read something and it feels like you’ve swallowed a lit firework.

This happened to me recently, when I was reading a report from those good people at the Theos thinktank. I found myself catching myself to hold back the tears.

This is the report:https://www.theosthinktank.co.uk/research/2025/01/27/creating-a-neighbourhood-health-service-the-role-of-churches-and-faith-groups-in-social-prescribing

And I recommend you waste half an hour of your working day to read it. It’ll be time much better spent than doomscrolling.

The idea is simple and one that I’ve touched on before in this blog. Here I found myself lifting the curtain and seeing a whole landscape of people who have not just already thought of this but are integrating into their practice, and researching the problems, and finding ways forward, actual doers doing it. In other words, a bandwaggon, and this is me jumping on.

  1. Health care providers see the need for ‘social prescribing’ (involving people in caring communities) as a necessary supplement to their medical work. Indeed many people visit their doctors because their sickness is actually a mask for other ills, like grief or loneliness.
  2. Churches have been working for the common good for centuries.
  3. Why not put them together?

Here’s what our current Health Secretary, Wes Streeting, said about the report:

Faith groups are continuing a beautiful, centuries–old tradition of caring for your neighbour. They are delivering front line activities that will play a key role in shifting the focus of our health service from hospital to community, and sickness to prevention in the coming years. I welcome this report from Theos, which asks the right questions about how we can link faith groups into the system to provide partnership and support.” – Wes Streeting MP, Secretary of State for Health and Social Care of the United Kingdom

Or or a past president of the Royal College of General Practitioners, Clare Gerada:

I wholeheartedly endorse the invaluable role of faith groups in the social prescribing framework, as outlined in this report. By fostering trusted relationships and providing holistic support, faith communities are uniquely positioned to bridge the gap between healthcare and wellbeing, offering a preventative approach that prioritizes connection, care and community.

From the foreword:

Social prescribing utilises community offerings as non-clinical remedies in recognition that some things can be treated both more effectively and more cheaply this way. The particular genius of this is that in doing so, people know each other better; relationships between statutory and community groups are formed and become well-trodden; and when moments of crisis arrive, not only are communities healthier at local level, but more resilient.

In one sense, none of this is new; in another it is a confluence of trends in medicine, society and church that suddenly opens a vast horizon of opportunity.

  • Health care people know how vital is the social stuff surrounding a person’s health. We have an epidemic of mental ill-health (or possibly an epidemic of mental ill-health diagnoses) and we have another cluster of people with the too-much-stress illnesses caused by their bodies running hot with anxiety.
  • Many people are lonely and isolated, propped up by benefits.
  • Churches are caring for the common good in practically every community.

It seems there is within the NHS a job role called a Social Prescribing Link Worker whose job is to connect patients at GP practices to local community groups. It can be that on a single street, next door even, a GP practice can exist in one silo and a church with its community cafe or craft group in another silo. The SPLW’s role, paid for by the taxpayer, is to link people across silos.

Imagine if this were common: every GP practice, every faith community, personally linked together and held together by a network of relationships. Imagine the creativity, the imagination, the good and the healing that could flow.

Finally, though this is a branching-out for the NHS, they are branching out into something churches are already doing. My own little church has basically missed every trend that has passed through the Christian community in the past 40 years, with the possible exceptions of minor brushes with charismatic Christianity, the Alpha course, and worship songs that were contemporary twenty years ago.

But we haven’t missed community groups for the common good because it’s what we do: a community cafe, food supplies, separate men’s and women’s breakfasts, a carpet-bowling club, a craft cafe. We do this all the time for the common good and also because, further in, people may find the glowing Rock at our centre and a framework, indeed a Person, around whom to construct a good life and a good death. They may find worship. They may find they can step back from the daily routine and glimpse eternity. We’ve done these community things, as have so many churches, because that is what we do, because it fits the grain of who we are.

A trellis to grow your life on

A word to the battered and weary.

I keep reading of people who quite tired of figuring out what’s right, what’s wrong, what a good life, what it’s all about. Dating is a minefield. Success is a mirage, celebrity is depressing, freedom is enslaving, hope turns sour, dreams disappoint.

Photo by Jan Canty on Unsplash

Some of these battered and weary people are becoming Christians or if you like, Christian-adjacent, seeing the ancient Christian values as useful signposts even if they are tentative about going the whole hog, or perhaps, the whole dogma.

There’s a lot to this.

For one thing, creaking though it maybe, Christianity is ancient and it has infused our culture and spawned many good lives like nothing else. A couple of hundred yards from our home is a church that was founded in the ninth century. (As I have mentioned before and often think about.) The fields around it had been harvested for hundreds, perhaps thousands of years already by then. But still: for the last one thousand, one hundred years Christian worship, Christian faith and Christian values have been seeping into village and national life and collective memory and ancestry.

For a second thing: Christianity is mainly and mostly about the heart. It isn’t a programme for national prosperity, or preventative health care, or political reorganization. Primarily it pins us like collected butterflies down to one main things: Above all, guard your heart. Blessed are the poor in spirit, the meek, the mourning, the peace-making, the pure in heart, the hungry for justice. And the test of these reformed and reforming hearts is not the mystic poetry they write about the experience (for example), or great revolutionary or counter-revolutionary acts (for another example), but the practical outworking of goodness and faith in their daily lives.

Which can lead to any number of different, interesting, varied, full lives.

No wonder it’s inspired lives across 50 generations, has experienced ups to match its downs, and may yet catch on widely again.

How to transform every community in the West

Nothing too ambitious….

Photo by Jon Tyson on Unsplash
  1. Start with a worshipping community of Christians
  2. It has to use some energy maintaining itself but
  3. It has spare energy to use outside itself so
  4. Do some theology. Christians are heralds of a new world where God and people are together. We can’t make that new world, but we can be a sign of it, an instrument of it. A portent of it, if you like.
  5. Do some Bible study. Around Ash Wednesday (not so far from when I’m writing this) the great passage in Isaiah 58 defines what ‘fasting’ looks like:

“Is not this the kind of fasting I have chosen:
to loose the chains of injustice
    and untie the cords of the yoke,
to set the oppressed free
    and break every yoke?
Is it not to share your food with the hungry
    and to provide the poor wanderer with shelter—
when you see the naked, to clothe them,
    and not to turn away from your own flesh and blood?
Then your light will break forth like the dawn,
    and your healing will quickly appear;
then your righteousness[a] will go before you,
    and the glory of the Lord will be your rear guard.
Then you will call, and the Lord will answer;
    you will cry for help, and he will say: Here am I.

(Isaiah 58:6-9

6. Understand the times. We are not, in the West, surrounded by masses of starving people. But think of all the lonely people.

7. Think of one of the fruits of the covid pandemic. In the UK, local authorities started trusting churches to do community things decently and well. It has always been happening to an extent (it isn’t new) but covid was a kind of crash course for the nation.

8. Think of the need in our day for social prescribing. How many doctor’s surgeries are plagued by the lonely? How many ills (mental ill-health but much else also) can respond to the balm of community? In how many ways can community complement all that the state attempts to provide (housing, cash, healthcare)? Why can’t GP surgeries prescribe community in the same breath as they’d like to prescribe exercise and diet? Why are their options limited to applying chemicals or knives to human bodies?

9 Churches have premises, a certain facility with tea-pots, and a tolerance for the misfitting people whom every congregation anyway hosts.

10. Community heals. Humans are a herding species. Churches have the plant, the location, the resources, the opportunity and — best of all — the moment. We can built the connections. Every community in the West. Think of it.

Community can heal

I was gob-smacked and jaw-dropped, if you can be both, when I watched this this week:

As well as a few side-benefits – a second revolution, saving the NHS, that sort of thing – it was a glimpse into what the future could be like for all of us. And what a happy, healing place it looked like.

At root it what’s being described is, I think, an NHS GP practice in one of the most deprived areas of London, that has realized doctors only get to a fraction of illness. The rest is caused, or cured, by things like employment, education, environment and creativity.

With that realization taken seriously, what has evolved is a thriving community with an NHS medical practice (and, as it happens, a church) at its heart.

I do recommend you put this on next time you are cooking or driving or working out or something. (You don’t need to see the video and the pictures anyway add little to the story.) Instead of a clinical setting, think cafe, community, art, creativity, fun … it’s just really something.

Why not me?

Healing seemed to come quickly in the New Testament

Photo by Johannes Roth on Unsplash

Today (yesterday as you read this), my wife and I listened to the Pray as you go app as we often do, a little daily dose of Ignatian spirituality. The passage was about the person with leprosy who said to Jesus, ‘If you are willing, you can make me clean’ and Jesus’ reply, ‘I am willing! Be clean.’

My body was still upside down after our very recent and lovely holiday in Singapore. We had arrived back three days earlier. I was extremely breathless, perhaps exacerbated by jet lag. The previous evening it had taken me many minutes and several stops to walk the 200 yards in the dark and cold to our post box and I was frightened.

My first thought on hearing the passage was ‘why not me?’

But this was followed by a second thought: ‘It is you, and has been you.’

This lifted my spirits as I realized it was true. It was true in the larger sense 12 years ago when I recovered from a coma in which I was expected to die after my church held a 36-hour prayer vigil. But it was also true in the lesser senses of other bad times and fears negotiated. It was true in the smallest sense of daily acts of grace and goodness to my life and soul. I am a child of the kingdom! What a thing. I am a beneficiary of the power of Christ! Goodness and mercy has pursued me all my life! The (remaining) light and momentary afflictions are not to be compared with the glory to be revealed. In all these things we are more than conquerors through him who loved us.

This time of year we are also putting away the cards and letters received over Christmas, and I see these tendrils of love and faithfulness extending into lives all over the place. So many grateful! So many restored, or maintained, in life and health!

Why not me? It is us. In the midst of the shadows all around, it is us.