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Health carers called to serve those on the margins

JESUIT Father Mark Raper has posed some difficult questions for Catholic health workers at their national conference.

Fr Raper, the Australian provincial of the Jesuits, delivered the keynote address “Seek Justice – Come to the Edge” to the conference in Perth at the end of last month.

“Are you just a another service provider or are you in ministry?” he asked those gathered.

Fr Raper said most of the 65 Catholic hospitals in Australia and the hundreds of Catholic nursing and convalescent homes and homes for the elderly and for children, were founded by religious orders.

He said “Seek Justice – Come to the Edge” was a poetic and perhaps provocative way to describe their mission in Catholic health.

Fr Raper said the facilities were founded for all in society, not just to serve Catholics.

“The followers of Catherine McAuley and of Mary Aikenhead went into health care because of the needs and the poverty at the edge of the society of their day.

“The Australian Grey Sisters, for example, were founded to go to the homes of women who could not afford to go to the doctor or travel to surgeries and hospitals.

“They went against the conventional wisdom of the centre at that time.

“They went to the poor, to women, and they went with few resources.”

Fr Raper said the leadership of many of the organisations that the religious began had now transferred to lay hands, and, as businesses, were doing very well.

He said the business magazine BRW, in its August 11 edition, reported that many of the country’s largest, best and fastest growing medical enterprises were private operations run by Church and charity groups.

The article said the not-for-profit hospitals provided nearly 40 per cent of Australia’s private hospital beds and listed two reasons for their success.

Fr Raper said the magazines quoted the reasons as “government policies promoting greater private sector involvement (including the 30 per cent rebate on health insurance premiums), and the steady real growth in medical spending”.

He said clearly Catholic health had handled the transition from religious leadership to lay leadership superbly from the operational and financial standpoint.

“Our question today is whether you can bridge the gap between corporate success and marginal people.”

Fr Raper said Catholic health care had various accountabilities to balance.

“Your contractual obligations to the government, your moral obligations to your clients and your faithfulness to your mission.”

He asked if the Church’s service was indistinguishable from other services in the market what was the point of it.

“Is it conventional managerial and economic wisdom, which says we should stay in the mainstream and help more people for the same cost, so that at least the middle class have high level service even if it means the poor people miss out?

“Is it the belief that our institutions must survive on free market business principles?

“Or that we can only afford to assist the people under private insurance and, therefore regrettably, we let the insurance companies tell us which ailments we may treat?

“Are we really only talking about a market edge, a trendy slogan setting Catholic health apart from our competitors, while in reality we market a product indistinguishable from the other players?”

Fr Raper said every major religion tried to make sense of suffering.

“The cross, that piece of wood hung on the wall in many Catholic hospitals and homes, speaks of a suffering that gives hope.

“The image of the cross fixes in time and space an event that occurred at the edge of Jerusalem, an event that transcends our comprehension.

“But the care and service you offer in your institutions gives it meaning.

“Yours is a ministry offered because you believe that human suffering can have meaning.”

He said walking with people on the edge gave a new perspective on our world.

“Catholic health care means solidarity, means walking with people who need it, and adjust what is on offer to their reality.

“That solidarity will inform our stance towards governments and insurance companies who fund health care.

“Regarding your service and the defence of rights, how much freedom do you retain when you offer services under contract with government or agree with insurance companies?

“There must be times when you are under pressure to become like a government agency on the one hand and like commercial business on the other.

“Whereas your role should be to protect the individual against the power of the state and also of the economy, you nonetheless run the risk of being precisely the agent of those forces.”

Fr Raper said it could be a regular exercise for Catholic health care to ask which needy community they were not reaching out to and which they were pushing the government to attend to.

“If your service is to be both a sustainable business and give priority to the poor, then your institutional leaders will need to be imbued with that mission.

“The job descriptions and key performance indicators and bonuses of your CEOs and your directors will be designed to reflect how well they implement that mission.

“Your policies will combine realism with compassion, and will be reinforced by research, by experience and by formation of co-workers.”

Fr Raper said Catholic health care workers would know the people who they served.

“You will walk with them at the edges of their lives, at the edges of our society, and you will bring justice.”

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