“A Samaritan came near the man who had been mugged, and when he saw him, he was moved with pity. As ministries of the Catholic Church spread across Australia, our work is inspired by the God who in Jesus went out to strangers to heal and to make our world just. Like the Good Samaritan, we in Catholic health and aged care in Australia are committed to walk with those in need, regardless of their beliefs, rich and poor alike. In this way, we remain true to the call of the Gospel.”

I am very humbled to have received this invitation to be with you during this conference, and I express my thanks to the president and the members of the Pontifical Council for being able to share these few days with you.
The words I opened with, that reflect on the Samaritan and the importance of the parable to the Church’s health ministry, are not my words. They are instead the words of the shared purpose statement under development by the hospitals, medical research centres, aged care homes and home visiting services that are operated by our wonderful Catholic lay people and religious in Australia.

It is really on behalf of these talented lay people and religious that I am here today. We are blessed that Catholic hospitals and aged care services in Australia are strong. There are 75 hospitals and 550 aged care services. The Church operates 10 per cent of the nation’s hospitals and aged care services. These services are growing. A decade ago there were 55 hospitals. Two thousand extra aged care beds have been added to Catholic services in the last three years. Forty thousand staff work in these services, almost all of them lay people.

Our hospitals and aged care services in Australia are organised by nature of their history. Nearly all services were started by religious congregations over past decades in response to community need. As the numbers of religious started to decline, a number of partnerships were formed between different religious congregations to ensure ministries were able to continue. In more recent times, lay people have started exercising managerial and governance roles once performed by religious.

In all, there are 76 different canonical bodies that today oversee health and aged care services. Very few of these are bishops. In fact, there is only one bishop in Australia, the Bishop of Lismore, who has responsibility for a Catholic hospital. Unlike the case of Catholic schools, most bishops in Australia readily acknowledge that it is the religious and lay people who have given the gift of Catholic healthcare to the Church in Australia, and that it is these religious and lay people who deserve the support to carry these ministries through into the future.

We the bishops of Australia have three separate means of relating to these wonderful Catholic ministries in health care.

The first is through the Australian Catholic Bishops’ Conference. I chair the Bishops Commission for Health and Community Services, and we meet with the leaders of health and community services as needed. The relationship this commission has with Catholic hospitals and aged care services is very good, and we are grateful that whereas the hospitals and aged care services are mostly canonically independent of the bishops’ conference, we nonetheless have a sound working relationship built on the principles of mutual respect.

The second is through Catholic Health Australia, the association of Catholic hospitals and aged care services. The association is very strong, reflecting the collegiality with which the different hospitals and aged care services work together in fulfilling the health ministry of Jesus. Catholic Health Australia is a key adviser to the bishops on health policy. Catholic Health Australia is a strong voice for Catholic teaching in the political and media landscape of Australia, and not only focuses on health and aged care policy but is also a champion of the social determinants of health.

It is the social determinants, known as early childhood experiences, schooling, access to food and housing, and employment security, that the World Health Organisation says determine how long a person will live and how healthy they will be. Catholic Health Australia is driving governments to focus on the social determinants of health, and the Church, through its social services and schools, is well qualified to be making this case on behalf of the poorest and neediest within the Australian community.
The third is through our diocesan connections. Each of the hospitals and aged care services within a bishop’s diocese is constantly seeking bishops’ involvement in the health ministry of the Church. We bishops are blessed to have excellent working relationships with those who exercise the mission of the Church in health care in Australia.

Through these three channels of engagement between bishops, hospitals and aged care services, we have put in place several formal mechanisms.
The first is the Code of Ethical Standards of Catholic Health and Aged Care Services. I have several copies with me for anyone who might be interested. It is a practical guide for staff in Catholic hospitals and aged care services on how to live the mission of Christ through informed understanding of Church teaching of health ethics. It was authored by both the bishops and Catholic Health Australia, and is used even beyond the walls of Catholic hospitals. It is a document that draws from the teachings of this Pontifical Council’s Charter for Health Care Workers.

The second mechanism is near to completion. The bishops and Catholic Health Australia have authored the Guide for Understanding the Governance of Catholic health and Aged Care Services. It came about in recognition of the reality that lay people are today exercising the governance responsibilities once carried out by religious, and that bishops themselves have very rarely, if ever, exercised such responsibility. The guide expresses agreement of Catholic Health Australia and the bishops on how Catholic governance can best be practised in recognition of civil law, canon law and theological requirements.

The guide also describes certain requirements of Catholic formation, and the need for this formation to be ongoing and more engaging over the course of a person’s maturity in faith. It is my hope that back in Australia where the bishops are this week meeting as a conference that they will ratify the final draft of this guide which is the product of 18 months of work by bishops and Catholic health administrators.

We bishops are very proud of our Catholic hospitals. They are some of the best and most trusted hospitals in Australia. At a time when many Australians are suspicious or cynical about organised religion, they trust the place of Catholic hospitals within the community. The face of Jesus is presented with compassion and expertise to the Australian community through our excellent Catholic hospitals.

Governments across Australia have a high regard for Catholic hospitals and aged care services. Unlike the situation in some other countries, our state governments actively fund 21 Catholic public hospitals to provide services to any person in need. Our 550 Catholic aged care services all receive some type of federal government funding. Government health funding is in fact very good in Australia, as universal access to health care is provided through a taxpayer-funded system called Medicare. Medicare enables any Australian to see a doctor, be treated in hospital or receive pharmaceutical treatment for free if they are not themselves able to afford the cost of their healthcare.

That does not mean that governments always take the same view as the Church when it comes to certain ethical positions. Abortion is legally accessible in Australia. Euthanasia is not legal, but there are many in the community – including some parliamentarians – who are campaigning to have it legalised. The bishops and Catholic Health Australia are working to ensure that the movement in favour of euthanasia does not see it legalised in the years ahead. This will continue to be a very difficult task.

Governments do, however, respect the ability of Catholic hospitals to operate in accordance with Catholic ethical teaching. No Catholic hospital does or is required to provide abortion services, or to provide contraceptive advice or assisted fertility services. Governments respect Catholic ethical teaching within Catholic hospitals and aged care services, allowing them to operate in compliance with the Code of Ethical Standards of Catholic Health and Aged Care.
Catholic hospitals in Australia face many of the same problems as the wider Church in western nations. Church attendance is declining in Australia, as is the number of practising Catholics. The number of people willing to take on a life-long commitment in the priesthood or religious life is similarly falling. This is placing pressure on Catholic hospitals and aged care services as to how they are able to administer the sacraments to hospital patients or aged care home residents.
Lay people are undertaking bachelor degree qualifications in theology to serve as mission leaders and pastoral care givers. Committed Catholics are working in large lay pastoral care teams to tend to the spiritual needs of the sick. Clergy continue to have a presence, but this presence is declining. As well, some of our brother priests find the pace of modern-day hospitals a very real challenge.
Just as many Australian parishes do not have priests, some hospitals and aged care services have difficulty in having clergy available on all occasions when they are needed. In some circumstances, particularly in country areas where clergy are most stretched, access to the sacraments is sometimes limited. There are no easy solutions to this problem under current circumstances where committed Catholic lay people are available but not empowered to celebrate those sacraments reserved to the ordained clergy.
Whilst our Catholic health services in Australia are vibrant today, the challenge for us bishops is to keep pace with the changes which are continually occurring. We need, in partnership with all involved in Catholic health care, to “read the signs of the times”.
Technology is moving fast, new ethical challenges arise with almost every new treatment, and with declining numbers of Catholics in the Australian community there are less Catholic lay staff, religious and priests available to work in Catholic organisations. We must support those willing to work in the service of the Church, and find pathways to sound ethical decisions. The future for the Church in healthcare is strong, if we put faith in our lay leaders and continue to assist them in their formation and understanding of Catholic identity and support them in their work for God and his people.

Those of us involved in Catholic health care in Australia take heart from Pope Benedict’s words to this Council last November: “To bend down like the Good Samaritan to the wounded man, abandoned by the side of the road, is to perform that ‘greater justice’ that Jesus asked of his disciples and actuated in his life.”
We in Australia commit ourselves wholeheartedly to continuing our ministry in that spirit.