AS the Wye Valley NHS Trust reviews its chaplaincy service, as reported recently in the Hereford Times, it is important to recognise the difference between the existence of such a service and the practice of hospital visiting by the ministers of local church congregations.

It is a difference similar to that between a hospital specialist and a GP – to some considerable extent a matter of skills, but even more a matter of focus.

There is of course a long history of hospital visiting by local ministers. When I came to Hereford in 1967 it was my practice, and that of most of my colleagues, to visit the County and General hospitals every week to see parishioners whose names would have been passed on by their family or neighbours. It was simply part of parish life, and was centred on the patient’s personal concerns.

It was a ministry for which patients and ward staff (and sometimes even consultants) expressed appreciation. I thought it a worthwhile use of my time, but it certainly was not chaplaincy.

When the Diocese of Hereford raised with the then health authority the desirability of creating a hospital chaplaincy it was on the basis that the work of a chaplain would be concerned not only with patients and staff but with the whole life of the hospital as a complex, pressurised and stressed institution in which human relationships are allimportant.

Much would depend on the appointment of a person who could both win the confidence of and be given access to staff in all departments and at all levels.

As a member of the hospital staff, working within its rules (not least on confidentiality) the chaplain would have access to patients’ names and be able to consult other ward staff in deciding priorities in making contacts with patients.

A chaplain does not displace visiting local ministers, but can be more available to a patient whose minister might well be unaware that they are in hospital.

Visiting local ministers do not usually see themselves as having a responsibility for the well-being of hospital staff, but this will be a major concern for the chaplain and overflows into a concern for the effective working of the organisation in which they work.

The chaplain needs to understand the functions and how they affect working situations and relationships, and must learn to discern where the personal becomes submerged by the institutional, creating unnecessary stress for individuals. Such discernment comes only through continuous involvement and reflection on the whole organisation’s life, and will not be achieved by even the most regular visiting local minister.

In fact, no amount of usually “hit and miss” ward visiting by any number of willing but already hard-pressed local ministers can begin to provide a substitute for an effective chaplaincy in which one person (ideally within a chaplaincy team) is given responsibility for the pastoral needs and demands of the hospital and its patients and staff.

THE VENERABLE LEN MOSS, Saxon Way, Ledbury.