What? No more free accommodation and no pay increase to cover the extra cost!

Just when I thought life was becoming easier without the demands of out of hours work on top of a very pressured and long working day, the government piles on additional QOF [1 ] demands!

These could easily be the comments of a Foundation 1 doctor and a GP. Hidden within such statements is the assumption that it is my 'right' that working conditions, pay and prospects should always improve. It is very easy to let indignation and feelings of being used and abused determine behaviour. But, can the current culture of 'rights' ever sit comfortably with a Christian, who by definition has given up their rights in submission to the lordship of Jesus Christ?

Before we can begin to grapple with the position a Christian in today's world should take, we are on much firmer ground if we are prepared to spend time understanding the age in which we live, learning from history and challenging the robustness of our theology. It is outside the scope of this article to engage in an in-depth analysis of our society; however, there are certain pointers that may be helpful.

Learning from history

Christians were influential in the establishment of trades unions in the 19th century as a response to the exploitation of the poor. However, by the first half of the 20th century there was a growing conviction amongst evangelicals, particularly those from nonconformist backgrounds (ie members of churches other than from Catholic or Anglican denominations), that involvement in politics and protest was not something that a real Christian engaged in. Indeed in some evangelical churches, voting in political elections was frowned upon.

I vividly remember an elderly man in the church I attended boasting that he had never voted in his life. For him this was a mark of his separation from the world, his love for God and his commitment to Jesus. As a teenager, this did not seem right to me. I remember having huge discussions about politics, rights and trades unions – which were always regarded as ungodly, if not downright sinful organisations.

Such a position, from today's perspective, seems extreme and probably the province of those on the margins of the evangelical church. However, many who were sympathetic to such views had a deep love for God. Among them were professionals, some of whom were involved in the influences that brought about the founding of CMF. One consequence that still lives with us is that in 1967, when the Abortion Act was passed, hardly an evangelical voice was raised in protest. That would not happen today.

We live in an age that views things very differently. But are we right? 50 years ago such an article as this would never have been considered. The evangelical position that I have described was, to some extent, a reaction to the 'Social Gospel' that had developed at the end of the 19th century, influenced by liberal theology and the rejection of the evangelical belief in the Bible as literally true and containing all that was needed for salvation. Polarisation ensued. Things were either black or white. In many ways those days were more simplistic but also more dedicated, self-sacrificing and self-denying than our own.

In the eyes of many there was a clear separation between issues to do with the world and issues to do with church. For many, the latter consisted of preaching the gospel. Anything else was only valid if it enabled such preaching or evangelism. Nothing was good for its own sake. Indeed, in the more reformed (ie Calvinistic) part of the church, a sort of 'worm' theology had developed – all that was not directly seen to be from God, or the preaching of the gospel, was to be regarded as of no value. The best I could do was 'like filthy rags' [2], in comparison to what God could do.

A sense of vocation

50 years ago the world was a more ordered place. There was a sense of service and altruism. The word 'vocation' was in common use, certainly for those entering the Christian ministry, or becoming missionaries and committing themselves to a life of service, and in some cases intense poverty. To some extent it is still understood today that those entering such a lifestyle and ministry will only do so out of a sense of calling. But in the past, those entering the professions of medicine, nursing and teaching, would also have been expected to have a similar vocation, especially, but not exclusively, in Christian circles.

Medicine being a vocation, rather than a job, led to a very different mindset. Being a doctor defined me. It was not what I did, but what I was. It was a great privilege. My whole life was to be spent in caring for others, rather than seeking for the best ends for myself.

The great danger, of course, would be just to assume that this was in every way correct, because it sounds so full of high principle. But there were downsides. Like Christian ministers, many Christian doctors' families suffered. Children could feel that they came a poor second to their father's care of everyone else in the community. There was little challenge to a system that often needed to be challenged. Often Christians stood aloof from the messy world of politics and debate. There were some, however, who combined a costly vocational call, with a willingness to challenge the system and bring about positive change. These, if their lives also reflected the love and grace of God, were men and women of great influence. The late Dame Cicely Saunders, one of the founders of the hospice movement, was a good example.

From vocation to job

In the mid 1970s junior doctors began to challenge the safety of long hours and some very real situations where juniors were, if not abused, certainly used by their consultant bosses against whom they had no means of defence. This led to the beginning of the movement away from 'profession' to 'job.' Overtime was paid for the first time. A one in three rota (ie working 9am to 5pm every weekday plus every third night and every third weekend) was introduced as the standard to which every hospital should aim for junior doctors. Junior doctors' pay increased.

Nevertheless there was a downside. Free accommodation and food ended. In hospitals all over the country, the junior doctors' mess was closed. This had been the meeting place and centre of a supportive community of colleagues. It usually consisted of a dining room where food was always available free (frequently even during the night), with a kitchen, a television lounge and often a library and a bar. Hospital management willingly took back the accommodation, often turning it into administrative offices. The cost of insisting on 'rights' was the loss of privileges. The culture had moved from community to workplace, from vocation to job, from the cost of vocation to the cost of rights.

Was this the correct way to go? I do not know. There can be no right or wrong in these circumstances. This, after all is not a moral judgment, but rather a choice of culture, vision and work philosophy.

Today, the Christian junior doctor faces similar if somewhat different choices.

It is probably true to say that, as in the mid 1970s, insisting on rights will mean losing privileges. There is always a trade off. How do we decide what to do? The easiest answer is to find some legalistic formula by which we can work out what God wants us to do. Yet God does not look for people who follow formulas. He looks for those who seek for relationship with himself. Jesus spent much more time in the middle of crisis and difficulty, with those who were regarded as sinners by the religious people of the day, than he spent in the synagogues of those who made a separation of the sacred and secular and therefore regarded themselves as set apart and spiritually superior. Jesus looked for relationship with men and women, not sterile religious observance and legalistic formulas.

The importance of right theology

Evangelical theology can be very reductionist. Part of the problem for many of us brought up in the latter half of the 20th century, was that evangelical belief had been reduced to a sort of 'lifeboat' theology. It suggested that: 'this life is only a testing ground for heaven. We need to be saved, thus getting into the lifeboat, so that we may end up in heaven. Our only other role is to pull people into the lifeboat with us so that they also may be saved. All else that does not serve this purpose is of no value.'

While the need for men and women to find God, and to find salvation in him cannot be given too high an importance, the problem with this approach is that evangelism becomes the narrow objective of our lives. Everything that I read in the Bible, however, seems to suggest that true evangelism is the result of the entirety of our lives. It is not so much an external activity that we engage in but the consequent actions of a life lived in dynamic relationship, experimental faith and obedience to the Father. Evangelism is the inevitable result of a life lived to the full in relationship with God, in his world; recapturing the heart that he expressed when seeing the world before the fall, 'God saw that it was good.' [3]

Evangelism is the outflow of a life filled with the Holy Spirit, fully engaged in God's world, as well as being a formal activity. But the formal activity is based on the natural outflow of a life lived in this way, never the other way around. In other words – we should live as Jesus lived.

What would Jesus do?

Firstly, he would not have followed a formula. He would have spent time with his heavenly Father, seeking his will and wisdom. Secondly, he would have been where the people were, no matter whether the religious people of the day considered them to be sinners, outcasts or even hated Romans. Thirdly, he would always be listening to what he believed the Holy Spirit to be saying, and then, as a man, needing to take the step of faith to obey what he believed he was hearing.

In the same way, there is no formula about how we should behave towards, or negotiate for, what we perceive to be rights and justice. We, like Jesus, need to seek the perspective and wisdom of our heavenly Father. We then need to walk in obedience and above all humility. Unlike Jesus, we are sinful and we can get things wrong. The man or woman who has the confidence to stand and say, 'this is what I believe,' while having the security in God also to acknowledge to themselves and others that they could be wrong, is powerful indeed.

Such quiet confidence – rooted in the knowledge that God loves us more than we can ever understand, that he will gently correct us and restore us, and that he cares more about the issue than we do – leads to a place of rest and security. But it does require us to walk in God's grace rather than legalistic observance, to walk by faith rather than formula, and cultivate humility rather than pride. Far from stamping us into uniform conformity, God will call us different ones to radically different activity over the same issue. Some may be called to an intense secret life of prayer, some to great exposure and public profile. The key thing is to know his day-by-day leading whatever we are called to do.

Derek Munday is a part time GP who leads Christians in Caring Professions