Article

Character

Comment

Politics

9 July 2024

6 min read

Why the Prime Minister should swear this new oath

A proposed new constitutional instrument is a hopeful recognition of the human condition.

Yaroslav Walker

Yaroslav is assistant priest at Holy Trinity, Sloane Square, London.

Keir Starmer stands in the House of Commons and recites an oath from a card held up in front of him.

Starmer swears allegiance to King Charles III, September 2022.

Thank the Almighty, the General Election is over! We have a Prime Minister. We have another cadre of MPs, some old hands and many Young Turks, all ready for the excitement of Parliamentary procedural intrigue and (hopefully) hungry to exercise their power for the betterment of their constituents. As a nation, we can all breathe a sigh of relief. We have emerged, blinking, into the sunlight of what I can only hope is five years of a milder political climate.

What happens next?

Well, today, every MP, new or old, will swear the Oath of Allegiance to King Charles III. This is not optional. Anyone refusing to do so cannot exercise their rights as an MP and will not receive their salary. Ultimately, the refuseniks can have the reality of their election voided. The wording of the oath excels in comprehensive brevity:

I swear by Almighty God that I will be faithful and bear true allegiance to His Majesty King Charles, his heirs and successors, according to law. So help me God.

The Monarch is anointed as the protector of the realm, always seeking what is best for Great Britain, and so to swear an oath to be faithful to the Monarch is to swear to seek the best for their realm. It is all perfectly simple and logical.

But is it enough?

It would seem that swearing fealty to the Crown is no longer enough. Now the PM must specifically swear not to lie to the Sovereign and the nation.

Some would argue not. Our political life has been marked by controversy for as long as I have been old enough to be politically aware. MPs expenses, the coalition Government, the Brexit referendum, parliamentary gridlock, Downing Street lockdown parties…Liz Truss! It’s all been like a circus, except all the animals are dead, the clowns just sit around screaming and crying, and the tent burns down. Trust in our political establishment could hardly be lower. Perhaps in light of this, a couple of constitutional scholars have mooted the idea of an extra oath - one for the Prime Minister.

Professor Andrew Blick, of King’s College, London, and Baron Hennessy of Nympsfield have written an open letter, on behalf of The Constitution Society, inviting the new Prime Minister to swear an additional oath specifically for their office.

The oath is intended to act as a confidence booster - an extra promise that the most powerful MP in the land will abide by the conventions of our constitution: Cabinet Government, The Ministerial Code, Civil Service Impartiality, etc. In an effort to restrain the darker impulses of the PM, the oath would also mean swearing to uphold the seven Nolan Principles: Selflessness, Integrity, Objectivity, Accountability, Openness, Honesty, Leadership. It would seem that swearing fealty to the Crown is no longer enough. Now the PM must specifically swear not to lie to the Sovereign and the nation.

In a moment of unattractive despair, I can’t help but let out a depressed sigh.

Yet, I also have hope. This new constitutional instrument would, on the surface, be a morose admission of defeat. We can no longer assume honesty in those who wield the most power and influence. Look deeper and you see a fascinating, and hopeful, recognition of the political (and human!) condition.

The very act of swearing an oath is itself a virtue. It is an act that puts one face to face with absolute truth, goodness, and beauty.

I find this new oath fascinating, and rather cheering, in spite of all my previous electoral gloom, because it clearly speaks to the human need for the transcendent and the eternal. So often our politics seems to be mired in the drudgery of the immediate: will the economy grow in the next quarter, will NHS waiting lists diminish by the end of the calendar year, will the crime stats be favourable any time soon. We rarely hear of any ‘vision’ for our country the looks to the horizon - not even the decade, let alone the voyage into the forever. Yet this oath does just that!

It does so in two ways.

Firstly, by seeking to enshrine the Nolan principles, it recognises the distinction between ‘values’ and ‘virtues’. Values have the veneer of the absolute but are far too easily jettisoned when necessity dictates. Commitment to a value is good, but is in constant competition with other values: openness battles the need for state-secrecy, honesty’s sword is often broken in the face of obfuscation’s onslaught, etc. The holding of values is a static thing, which can wilt and die in the burning heat of reality. A virtue, on the other hand, is something which must be constantly practiced and nurtured. A virtue always looks to its ideal form - a universal perfection of honesty or selflessness. Swearing an oath to uphold the Nolan Principles means committing to operating by them every day, and so allowing them to grow in the individual, becoming easier and easier to live by until the practitioner of virtue struggles NOT to operate in their eternal light.

Secondly, the very act of swearing an oath is itself a virtue. It is an act that puts one face to face with absolute truth, goodness, and beauty. The act of making an oath recognises that our lives and deeds are not simply contingent moments in the pitiless march of time, but that they resound in the halls of eternity.

I think this is why Jesus warns people against swearing oaths in the fifth chapter of the Gospel according to Matthew. When reading this warning in the light of the serious, radical, and even hyperbolic speech that comes before, it is clear that Jesus doesn’t want us to avoid making promises, but that he realises just how bad we are at keeping them. Swearing an oath (invoking eternity, the absolute, the divine!) means that when we break our oaths we diminish ourselves in the face of God.

“Let your word be ‘Yes, Yes’ or ‘No, No’; anything more than this comes from the evil one.”

This is not a command to avoid promises and promise keeping, but a radical call to live one’s life always in the light of eternity, so that even the simple ‘yes’ is the truest oath one can make.

We need leaders - political and otherwise - who can offer the human soul something more than simply an uninspiring roadmap for five years of moderate economic improvement. We need leaders who can inspire the nation with a vision of eternity. We need leaders who point us to that horizon of the absolute where we do not see individual good acts warring against the forces of apathy and indifference, but see the Good itself illuminating our every moment with hope and joy.

Perhaps an oath - an admission that there is meaning beyond our momentary finitude - is the best way to inject a bit more universality and meaning into a political system that has left this author feeling quite so cold so far.

I shall pray for our new Prime Minister, and for all our new MPs. I shall hold them before the face of God who is beyond all immediate concerns and pray that they may have the vision of our eternal destiny ever in their minds and in their hearts. I shall earnestly intercede that they recognise that their oaths are not simply a formula of words, but a positive spur to lead us into a future that never ceases to grown brighter and brighter with the light of our eternal destiny.

Article

Care

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.