Address to the Catholic Health Australia Conference, 26 August 2015
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These are hard times for the Catholic Church in Australia. Church attendance continues to decline. Those in the pews are not getting any younger. More of the able bodied priests are from overseas; they are missionaries who have come amongst us who are adapting to the concept that we are once again a mission land. The talent pool for future bishops is not what it was a generation or two ago. The royal commission into Institutional Responses to Child Sexual Abuse continues to fill us with dread that we have not yet adequately identified why the incidence of abuse reported in our institutions is higher than in other churches. The divisions amongst our bishops, previously unreported and unknown previously to many of the faithful, are disheartening. Just this week we have heard Bishop Geoffrey Robinson who was an auxiliary bishop to Cardinal Pell when he was archbishop of Sydney telling the royal commission that His Eminence 'had lost the support of the majority of his priests and that alone made him a most ineffective bishop'. Cardinal Pell is the most promoted Catholic cleric in Australian history. The point is not whether Bishop Robinson is right or wrong. The point is that we are part of a social institution which is suffering an acute loss of institutional coherence when an auxiliary bishop sees a need to make such a public statement about his erstwhile archbishop.
Two days ago at that royal commission a letter was tendered for all the world to see. It is a letter from Bishop Robinson to His Excellency Archbishop Franco Brambilla who was the papal nuncio here in 1996. According to Bishop Robinson, the nuncio had earlier asserted that there was no such thing as child sexual abuse in the Italian Church. The nuncio had written to Robinson castigating him for criticising the Vatican for being too slow to respond to child abuse in the Church. Robinson had been speaking at a conference dealing with sexual abuse at Sydney University, attended by 'about 40 victims and 40 journalists'. One of the participants had suffered abuse at the hands of a Melkite bishop (who died in 2012). Bishop Robinson replied on 8 June 1996:
Turning now to the particular case, I was well aware that in the audience I was speaking to there was a woman who for nearly twelve months had been the victim of the sexual abuse of Bishop George Riashi. He admitted the abuse to Bishop Peter Connors and to yourself at the end of 1993. He also admitted it to the victim in the presence of Bishop Connors. You reported the matter to 'Rome' and he was withdrawn from Australia in November 1994. In the month before that, during the last Synod, Cardinal Clancy and Bishop Connors personally informed the Cardinal Prefect of the Oriental Congregation of all aspects of the matter.
From overseas Bishop Riashi continued to insist that he was still Eparch of Australia and would be returning. In June 1995 this was confirmed in a public letter from the Melkite Patriarch. In August 1995, however, Bishop Riashi was instead promoted to be Archbishop of Tripoli in Lebanon. In this capacity he then returned to Sydney in August-September and made many public statements about his innocence and about bad people who sought to discredit him. He succeeded in turning many people against his own victim so that they blamed her rather than him.
Bishop Robinson went on to say to the Apostolic Nuncio: 'In the matter of Bishop Riashi 'Rome' has been of no assistance whatsoever to the Church in Australia. It has, instead, created the potential for a massive scandal in this country.' I daresay none of us had any idea that this sort of thing was going on. How could it have been possible for such a man to be further promoted in the church hierarchy when there had been admission of such wrongdoing and full disclosure to all relevant church authorities just 20 years ago? How could the papal nuncio who knew all this be writing to castigate a bishop who was saying that there must be a better way, especially when that bishop was the one steering the bishops' conference at that time to finalise the Towards Healing protocol?
So things are not easy. They are not easy for me as a Catholic priest in the public square. They are not easy for those of you turning up to work each day in your healthcare facilities to further the mission of the Church. They remain wretched for many victims who doubt that the Church can again be trusted. I thank you for your perseverance and pray that together we can make a better fist of holding out to the world the face and hands of Christ. And that's our task this morning.
I know that you are working on a CHA Health Blueprint which sets out four key priority areas for Catholic healthcare:
1. Strengthening primary and community care — with a strong focus on preventative health and health promotion
2. Improving integration and transitio — from silos to a system
3. Facilitating community engagement, empowering and resourcing
4. Embracing future challenges for our health system — including climate change, obesity
You will recall that when later explaining why he chose the name Francis as pope, Jorge Bergoglio said, 'How I would love a church that is poor and for the poor.' Does this readily transpose into a hope for an Australian Catholic health sector that is poor and for the poor? If so, I daresay you would need to change radically the use of your key assets at this time. For understandable reasons, your hospital assets are mainly in the private sector providing excellent health care but usually only for those able to afford their own private health coverage. You are in a market where you compete not only with the Ramsays but also with each other. It's reached the stage that a reader of the business pages can track a dispute between a Catholic private hospital and Medibank, with public insights and suggestions being offered from the sideline by another Catholic health provider. To what extent can you realistically work together as collaborators in mission? To what extent are you really competitors in the marketplace and with the major funds seeking more bang for the buck, trying to keep premiums low for the consumer?
You will recall that great quote from Pope Francis in his interview with the Jesuit periodicals soon after his election as Pope when he said:
The thing the church needs most today is the ability to heal wounds and to warm the hearts of the faithful; it needs nearness, proximity. I see the church as a field hospital after battle. It is useless to ask a seriously injured person if he has high cholesterol and about the level of his blood sugars! You have to heal his wounds. Then we can talk about everything else. Heal the wounds, heal the wounds. ... And you have to start from the ground up.
Perhaps with your more recent forays into aged care, palliative care, and primary care, you are better situated to break free from the shackles of your assets and to set up services more akin to the field hospital. How realistic is it to expect that you would be able to reach out and provide such services in partnership with self-determining indigenous health providers in remote Australia such as the Apunipima Cape York Health Council from whom we heard in the opening plenary?
One of the great challenges for you in Catholic healthcare is determining the structures and personnel to provide the rudder for the ship of health care to negotiate the shoals of financial accountability, professional service, and delivery at the margins, especially to those who are under-served, those who are priced out of the market.
Here I think of your trustees and the emerging structures of PJPs. We all know that there is a handful of diverse charisms you have inherited from those religious congregations who pioneered Catholic health care in our land. But what would be the ideal number of PJPs for appropriate accountability and mission planning and direction in the future? Would it be 6, 16, 60 or 600? Have you given any thought to this question, or have you thought it best to evolve organically usually making a virtue of necessity? What's the profile of your ideal board and of your ideal group of trustees? I don't think I have been quite forgiven for having offered the observation when I was on the board of SVHA: 'The trustees seem to be the professional Catholics and the board are the Catholic professionals.' Do you want Catholic Health to be a tangible sign of 'a church that is poor and for the poor' known more for its field hospitals and outreach than for its maintaining a Catholic foothold in the market of private health care? Or is that a distraction, or a second order issue?
What sort of imagination do your trustees, board members, and management need to hold together the insights: 'This is what the market will bear, so this is what we will do', and 'This is what the mission of the Church demands, so this is what we will attempt to do.' In the end, yours is not a ministry just of presence or advocacy. It is a ministry of healing. In his 2014 address to the International Federation ?Of Catholic Medical Associations, Pope Francis said:
There is no human life more sacred than another, just as there is no human life qualitatively more significant than another. The credibility of a healthcare system is not measured solely by efficiency, but above all by the attention and love given to the person, whose life is always sacred and inviolable.
I have the good fortune of having a father who is an accomplished lawyer married to an accomplished doctor. When leaving for a year as visiting professor at Boston College a year ago, I asked him what I should be thinking about during my year away. He responded:
To create, by example, by precept and by proclamation, the social conditions that facilitate the dignified treatment of every person in order to allow each person to live in dignity. But more, by the same means, to explain in terms comprehensible to the contemporary individual, the significance of God's love and the life God has intended for human kind and to demonstrate the vastly enhanced significance of dignity to the believing individual and the moral unacceptability of undignified treatment because it interferes with the divine plan for human kind.
Now that's not a bad mandate for Catholic health providers. Whatever your resources and whatever your professionalism, you are required to take a stand in solidarity with those in need. Let me share a slide with you.
When chairing the National Human Rights Consultation in 2009, I arrived in Kalgoorlie, Western Australia for a community consultation accompanied by lawyers and secretariat staff from the Commonwealth Attorney-General's Department. We were to hold a community consultation on human rights at the race track on the afternoon of 12 May 2009. That morning we learnt that many people were gathered at the local courthouse for the resumed coronial inquiry into the death of Ian Ward who had died of heartstroke in the Kalgoorlie Hospital on 27 January 2008. I thought it best that we visit the court in the morning to get a sense of the human rights issues occupying the local community. I insisted that all members of the secretariat keep out of the public eye. On arrival, we encountered an Aboriginal protest outside the courthouse. There was a bevy of media on hand including the ABC 4 Corners crew.
Walking towards the courthouse, I heard a cry, 'Hey, Father Frank, over here! You've got to support us mob.' Looking around I saw Ben Taylor, an old Aboriginal friend from Perth whom I had long known in the local Aboriginal Catholic Ministry. He was often accompanying Fr Bryan Tiernan on visits to Aborigines in jail and to Aboriginal families in need around Perth. I was torn. What should I do? I was chairing a national consultation at the request of the Commonwealth Government. I did not want to politicise our presence in town. And I did not want to end up on television or in the newspapers in relation to a much publicised coronial inquiry I knew little about. But then again, I did not want to abandon Ben and his colleagues in their hour of need. I walked across to the group of grieving relatives who were surrounded by protesters including Ben. They all stood in front of an Aboriginal flag. Some were crying out for justice for their deceased loved one. Ben was holding a simple placard which read, 'White Australia has a black history'. I stood with the group, in silence, in solidarity. I then accompanied Ben into the back of the courtroom where we heard the appalling testimony about the last hours of Ian Ward, a respected Aboriginal community leader, an artist, and a traditional owner. He had been picked up for drink driving in Laverton on Australia Day. He was denied bail. He was being transported into Kalgoorlie in the back pod of a prison vehicle. Alistair Hope, the State Coroner found:
The deceased was transported in the vehicle from Laverton to Kalgoorlie, a distance of approximately 360 kilometres. The deceased was taken on a journey of approximately 3 hours and 45 minutes on an extremely hot day with the outside temperatures being over 40 degrees centigrade.
The air conditioning for the pod was not working. There was very little ventilation in the pod. It had no windows and only very limited airflow. The Coroner was to find that 'the deceased suffered a terrible death while in custody which was wholly unnecessary and avoidable'.
After hearing some of this evidence, I and my secretariat proceeded to the racetrack for our community consultation on human rights. It was a tame meeting, carrying none of the pathos, anger or disgust of the morning's coronial inquiry. Next morning, I flew from Kalgoorlie to Perth. Next to me sat a lady reading her morning newspaper featuring a photo of the Aboriginal protest outside the courthouse. There was an unmistakable 6'4" white male with them — Fr Frank Brennan. I hoped this would not jeopardise our inquiry. I was pleased to have stood in solidarity with the grieving Aboriginal protesters at the request of my friend Ben. What else could I do? What relationships do you want to cultivate as Catholic health providers so that you might be invited to take a stand in solidarity?
Fr Peter C. Phan the Georgetown theologian recently reflected on the Church in Asia which he describes as 'the cradle of the world's religions'. Profiling the concerns of the Federation of Asian Bishops Conference, Phan writes:
The FABC's dominant concern is centred on the kingdom of God (not on the institutional church); mission (not inward-self-absorption); communion (not splendid isolation); dialogue (not imperialistic monologue); solidarity with victims (not victim-blaming and withdrawal into an otherworldly 'spirituality'); care of creation (not exploitation of natural resources); and witness/martyrdom (not cowardly compromise).
I wonder whether its possible for CHA to provide member bodies with some benchmarks for training and assisting leaders and staff who want to develop their capacity for standing in solidarity, and for centering on communion, dialogue, and care of creation. We are buoyed up by the leadership of our Jesuit pope Francis who embodies so much of what we espouse and who challenges us to respond with full hearts, applied minds, and willing hands.
Remember how Pope Francis ended his address to the journalists in Rome on the day after his election when he gave a blessing with a difference. He said:
I told you I was cordially imparting my blessing. Since many of you are not members of the Catholic Church, and others are not believers, I cordially give this blessing silently, to each of you, respecting the conscience of each, but in the knowledge that each of you is a child of God. May God bless you!
Now that is what I call a real blessing for anybody and everybody — and not a word of Vaticanese. Respect for the conscience of every person, regardless of their religious beliefs; silence in the face of difference; affirmation of the dignity and blessedness of every person; offering, not coercing; suggesting, not dictating; leaving room for gracious acceptance. These are all good pointers for you who are the custodians of the Catholic health heritage in Australia. Beside sickbeds, in your chapels, on your ward rounds and in your board rooms, you hold Roman authority and Catholic ritual in trust for all people of good will, including all your staff and patients, as you discern how best to make a home for God in your lives and in your world, assured that the Spirit of God has made her home with you.
In his encyclical Laudato Si' Pope Francis calls us to consider the tragic effects of environmental degradation especially on the lives of the world's poorest. He says:
The problem is that we still lack the culture needed to confront this crisis. We lack leadership capable of striking out on new paths and meeting the needs of the present with concern for all and without prejudice towards coming generations. The establishment of a legal framework which can set clear boundaries and ensure the protection of ecosystems has become indispensable, otherwise the new power structures based on the techno-economic paradigm may overwhelm not only our politics but also freedom and justice.
Developing the culture, the leadership, and the legal framework. These are the challenges to those of us who want to be intelligent believers responding to the call of the Spirit. Developing culture, leadership, and the right regulatory framework is not new to anyone in this room. It is heartening to note the pope's humility born of true consultation with bishops' conferences (17 of which are quoted directly in the encyclical) and detailed meetings with experts including scientists, economists and political scientists as well as philosophers and theologians. Having noted, 'There are certain environmental issues where it is not easy to achieve a broad consensus', he concedes that 'the Church does not presume to settle scientific questions or to replace politics. But I want to encourage an honest and open debate, so that particular interests or ideologies will not prejudice the common good'.
Returning to your board tables and to your ward rounds, you are invited to be inspired by Pope Francis's vision of St Francis of Assisi who is the model of the inseparable bond 'between concern for nature, justice for the poor, commitment to society, and interior peace'. Mind you, I do think the encyclical would be all the stronger if it conceded that the growth in the world's human population - from 2 billion when Pius XII first spoke of contraception to 3.5 billion when Paul VI promulgated Humanae Vitae to 7.3 billion and climbing as it is today - points to a need to reconsider the Church's teaching on contraception. It would of course be ridiculous to suggest, as some of our critics do, that the Church's teaching on birth control is a major factor contributing to climate change. The pope is quite right to insist that the reduction of population growth is not the only solution to the environmental crisis. But it is part of the solution. It may even be an essential part of the solution. Banning contraception in a world of 7.3 billion people confronting the challenges of climate change and loss of biodiversity is a very different proposition from banning it in a world of only 2 billion people oblivious of such challenges. I doubt that you would find any papal adviser today who would advocate that the planet's situation with climate change, loss of biodiversity, and water shortages would be improved if only all people of good will had declined to use artificial birth control for the last 50 years. I suspect the time is coming for Catholic health providers to lead the way distinguishing contraception from respect for all human life, especially at the bookends of the life cycle. By clinging to papal teaching on contraception, we put at risk the acceptance of the more fundamental teaching about the need to respect life — both human life and the life of the planet.
Celebrating the 50th anniversary of Vatican II and preparing for the forthcoming Synod on the Family, we can take heart from the changes in our Church which permit and encourage such questions and dialogue. You will note that one effect of the recent encyclical is that it is no longer just liberal Catholics who are labeled as cafeteria Catholics. Some erstwhile conservative Catholics and papal apologists have become very exceptionalist in their discussion of this encyclical. We are now all welcome to the real world of questioning engagement in a Church that we cherish for its teaching office and sense of tradition. John O'Malley SJ, the finest contemporary historian of Vatican II writing in the English language has provided us with 'a simple litany' of the changes in church style indicated by the council's vocabulary: 'from commands to invitations, from laws to ideals, from threats to persuasion, from coercion to conscience, from monologue to conversation, from ruling to serving, from withdrawn to integrated, from vertical and top-down to horizontal, from exclusion to inclusion, from hostility to friendship, from static to changing, from passive acceptance to active engagement, from prescriptive to principled, from defiant to open-ended, from behaviour modification to conversion of heart, from the dictates of law to the dictates of conscience, from external conformity to the joyful pursuit of holiness.'
For you Catholic health providers, I will address three questions about Pope Francis's encyclical Laudato Si' which is 'on care for our common home'.
Why would Pope Francis write to everyone?
Pope Francis is not the first pope to address a social encyclical to everyone. Pope John Paul II addressed his 1988 encyclical Sollicitudo Rei Socialis to members of the Church and to 'all people of good will'. Pope Benedict XVI did the same with his 2009 encyclical Caritas in Veritate. In comparison with his predecessors however, Francis has been more inclusive in the process of writing the encyclical and in the final content of the document. He quotes from 17 different conferences of Catholic bishops. This was rarely done by his predecessors. He is at pains to indicate that he is collaborative and that he takes the principle of subsidiarity very seriously. He convened meetings of various types of experts including scientists, economists and political scientists. He is not afraid to indicate that the final product is something of a committee job, with various authors. He notes, 'Although each chapter will have its own subject and specific approach, it will also take up and re-examine important questions previously dealt with…. [Q]uestions will not be dealt with once and for all, but reframed and enriched again and again.' Being the final redactor of the text, he has felt free to interpolate some very folksy advice from time to time — from the need to use less air conditioning, to the appropriateness of consumer boycotts on certain products, to the desirability of saying grace before and after meals. He has also taken the liberty of inserting some very blunt, evocative images of environmental and economic devastation: 'The earth, our home, is beginning to look more and more like an immense pile of filth. In many parts of the planet, the elderly lament that once beautiful landscapes are now covered with rubbish.' He gives pride of place to Patriarch Bartholomew of Constantinople, the leader of 300 million Orthodox Christians. For the first time in a papal encyclical there is a reference to his fellow Jesuit the paleontologist Pierre Teilhard de Chardin — although he could not quite bring himself to quoting him. He does quote the Protestant Paul Ricoeur who wrote “I express myself in expressing the world; in my effort to decipher the sacredness of the world, I explore my own'. Encyclicals characteristically end with a prayer composed by the Pope. We are given two prayers: one for Christians and one for all believers. This is a pope wanting to reach out to all persons who have a care for the environment and for the poor, regardless of their religious affiliations.
His concerns are not narrowly dogmatic or pedagogical but universally pastoral. He knows that millions of people, including erstwhile Catholics who work for Catholic health providers, are now suspicious of or not helped by notions of tradition, authority, ritual and community when it comes to their own spiritual growth which is now more individual and eclectic. He wants to step beyond the Church's perceived lack of authenticity and its moral focus on individual matters, more often than not, sexual. He thinks the world is in a mess particularly with the state of the planet — climate change, loss of biodiversity and water shortages, and with the oppression of the poor whose life basics are not assured by the operation of the free market, and with the clutter and violence of lives which are cheated the opportunity for interior peace. At the conclusion of the encyclical he describes the document as a 'lengthy reflection which has been both joyful and troubling'. He is going to great pains to demystify his office and to demystify papal documents. Clearly he wants all people of good will to emulate him and to be both joyful and troubled as they wrestle with the problems of the age.
Why would Pope Francis have something to say about climate change?
Francis thinks the planet risks going to hell in a basket. He says he is 'pointing to the cracks in the planet'. Perhaps we should take heart from Leonard Cohen's observation, 'There is a crack in everything. That's how the light gets in'. This is the only home we have got. And the science is in. It indicates that climate change is real. The loss of biodiversity is real. Human activity continues to contribute adversely to both changes, though of course there are other causes. We cannot undo the other causes. We do have the power to change and to address some of the human causes. An untrammeled free market will not provide the solution, neither will untrammeled governments whether they be self-seeking and corrupt or populist and short sighted. Francis sees an urgent need for people to be well educated, to be concerned about future generations, and to be focused beyond their national borders. He sees an urgent need for governments to abide by the rule of law. He sees an urgent need for markets to be regulated so that self-interest and economic imperatives can be better aligned to pay dividends for the planet and for future generations. He doesn't see how this can be done unless more people, especially those designing laws and regulations for government and economic actors, are integrated in themselves finding completion in a deep interior life marked by concern for neighbor and for creation as well as self. Francis calls us to consider the tragic effects of environmental degradation especially on the lives of the world's poorest.
Hailing from Argentina, Francis puts his trust neither in ideological Communism nor in unbridled capitalism. Like his predecessors Benedict and John Paul II he is unapologetic asserting, '[B]y itself the market cannot guarantee integral human development and social inclusion.' His concern is not to settle arguments about politics, economics or science. He makes no pretence to give the last word on anything. He is not even much concerned to give the last word on scriptural interpretation or theological insights into topics such as anthropocentrism. He is wanting to enliven the passion and the spiritual commitment of his readers who, grasping the link between care for the earth, care for the poor, and care for the personal interior life, will be motivated to work for real change.
What new ideas are to be found in Pope Francis's letter?
Francis calls everyone to engagement in an honest and open debate, respecting the competencies of all, and inspired by the vision of St Francis of Assisi who is the model of the inseparable bond 'between concern for nature, justice for the poor, commitment to society, and interior peace'.
There are probably no genuinely new ideas in the encyclical. Like many, he is convinced that we need to phase out our reliance on fossil fuels - coal, oil, 'and to a lesser degree, gas' - progressively and without delay. He thinks any scheme for buying and selling carbon credits is deeply flawed. He is a great advocate for solar energy. But what is new is the integration of the scientific, the political, the sociological, the spiritual and the theological — an integration given the stamp of approval of the leader of one of the world's most significant religious communities. Granted that the Judeo-Christian tradition has done much to inculcate the notion that we humans are to subdue the earth, it is heartening that a pope has been able to say:
The best way to restore men and women to their rightful place, putting an end to their claim to absolute dominion over the earth, is to speak once more of the figure of a Father who creates and who alone owns the world. Otherwise, human beings will always try to impose their own laws and interests on reality.
It could be even more helpful for us to move beyond the patriarchal view of God. It is not only the Church that has been complicit, but it has been complicit especially in ventures of colonisation aimed at plundering the resources of indigenous peoples. Francis notes, 'Modernity has been marked by an excessive anthropocentrism.' He draws a good simple lesson from the Old Testament creation accounts noting:
The sheer novelty involved in the emergence of a personal being within a material universe presupposes a direct action of God and a particular call to life and to relationship on the part of a 'Thou' who addresses himself to another 'thou'. The biblical accounts of creation invite us to see each human being as a subject who can never be reduced to the status of an object.
Those of you who are not religious might garner the same sense by recalling Gemmy in the opening of David Malouf's Remembering Babylon when he calls out, 'Do not shoot. I am a B-b-british object!'
In his folksy style, Francis notes that 'sobriety and humility were not favourably regarded in the last century'. He calls us back to a 'serene attentiveness', reminding us in a grandfatherly way 'that being good and decent are worth it'. Following the lead of the Australian bishops, he calls us to an 'ecological conversion', having a go at those 'committed and prayerful Christians (who), with the excuse of realism and pragmatism, tend to ridicule expressions of concern for the environment.'
Joy filled and troubled, let's do something to change the market settings and political settings here in Australia to modify the behaviour of all Australians in the future, and let's attend to our own Franciscan interior ecological conversion with our care for the vulnerable and 'an integral ecology lived out joyfully and authentically'. For starters, I should probably start rejoicing each time I catch the Murrays coach to Sydney rather than the Qantas jet, regardless of who's paying. Even in the Canberra winter, I should also take to heart the Pope's observation, 'A person who could afford to spend and consume more but regularly uses less heating and wears warmer clothes, shows the kind of convictions and attitudes which help to protect the environment.' I wonder what any of this could mean to Catholic health providers running large carbon emitting operations. If the Australian government has been too modest with its targets, is there any way that you could further modify your admissions in line with what an appropriate national target would be? Or would that simply be economic suicide for you? Is there any place for a renowned, green Catholic health provider?
When addressing Italian doctors last November, Pope Francis quoted St. Camillus de Lellis who suggested that the most effective method in caring for the sick was simply to 'Put more heart into those hands.' Francis said to the doctors: 'Put more heart in these hands! This is also my hope.' I wish you well in the coming year as your set about strengthening primary and community care, improving integration and transition, facilitating community engagement, and embracing future challenges for our health system. As you set up your field hospitals amongst the poor, and as you maintain the highest quality care in your private health facilities (regardless of how green they might be), remember always to put more heart into your hands and animate your staff to do likewise.