The case of Caroline Petrie, a community nurse suspended for asking a patient if she wanted prayer, hit the headlines in January and created a national and international storm. (1) It prompted Bernadette Birtwhistle and others to table motions at the BMA ARM recognising the importance of spiritual care, (2) and that doctors and other health professionals should not face censure for offering prayer and other spiritual support. While the meeting supported the former it rejected the latter, although as ARM Chair Peter Bennie reminded the meeting, even if they did not pass a motion, it did not mean that the opposite held. We hold that spiritual matters still belong at the frontline of healthcare. (3)

This January, the Department of Health quietly issued equality and diversity guidelines for NHS trusts on religion and belief. (4) While containing much of use, they are also extremely vague and open to interpretation on issues to do with expressing faith in the workplace. (5) At the same time the Employment Equality (Religion or Belief) Regulations (2003) (6) make it unlawful to discriminate against people on the grounds of their faith. The legislation and the guidelines differ, and are open to wide and often contradictory interpretations, so creating ambiguity and confusion for NHS staff and management.

There is a major gap in health policy on spiritual care, in England in particular. While the Scottish Executive has required all Health Boards to develop policy since 2002, (7) and similar guidelines have been developed by the Welsh Assembly, there is nothing comparable in England. Some centres, such as Southampton, (8) have developed spiritual care policies and staff training programmes, but the overall picture is poor. A recent Nursing Times survey showed that although most nurses saw spiritual care as an appropriate role, most felt there were inadequate guidelines and a lack of training and support. (9)

Caroline Petrie's case was not unique. She and others we know of admit that professional bodies and trade unions are just as unclear about the rights and wrongs of these situations. CMF, Christian Nurses and Midwives (10) and the Christian Legal Centre (11) are supporting those who have been affected. Caroline sees her case as catalysing the debate on the wider issues of the place of Christian faith, prayer and spiritual care in the NHS. (12) It is important we do not ignore this challenge, but see it as an opportunity to speak up for Christ in the NHS. (13)