Religion and Ethics Forum
General Category => General Discussion => Topic started by: ippy on July 17, 2015, 08:11:27 PM
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http://www.independent.co.uk/life-style/health-and-families/health-news/nhs-patients-religious-services-should-not-be-paid-for-by-taxpayer-say-critics-10366214.html
ippy
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http://www.independent.co.uk/life-style/health-and-families/health-news/nhs-patients-religious-services-should-not-be-paid-for-by-taxpayer-say-critics-10366214.html
ippy
What a prejudiced little man you are! Your vicious anti-religion stance even extends to objecting to the ill and dying receiving some solace.. The amount of money involved is nothing in terms of the NHS total budget, and they undoubtedly waste millions and millions in all manner of other ways, which you choose not to highlight.
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I had no idea the NHS paid for people's religious needs, and believe that is wrong. It should be funded by the religious organisations. The NHS is strapped for cash as it is, it was formed to tend to the medical needs of the nation.
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What actual rights do people feel they're entitled to, regardless ???
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The right of being comforted at the point of death?
(funded by the religious body of their choice)
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I had no idea the NHS paid for people's religious needs, and believe that is wrong. It should be funded by the religious organisations. The NHS is strapped for cash as it is, it was formed to tend to the medical needs of the nation.
Dying is a sort of medical condition!!!
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http://www.telegraph.co.uk/news/religion/5123378/Chaplains-costing-NHS-32-million-a-year.html
Lets put this in perspective...
Chaplaincy costs the NHS £32 million pounds a year........
If people choose to have a fantastic belief it is totally out of order to expect the general public to pay to sustain that view. All the major religions are charities and therefore tax exempt, with a vested interest in looking after "their people". Why should we all pay to pander to their non medical needs.
How many nurses do you get for thirty two million quid, I for one don't mind paying for that because we all benefit not just the handful of deluded folk who can't cope without delusions of sky fairies and magic.
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http://www.telegraph.co.uk/news/religion/5123378/Chaplains-costing-NHS-32-million-a-year.html
Lets put this in perspective...
Chaplaincy costs the NHS £32 million pounds a year........
If people choose to have a fantastic belief it is totally out of order to expect the general public to pay to sustain that view. All the major religions are charities and therefore tax exempt, with a vested interest in looking after "their people". Why should we all pay to pander to their non medical needs.
How many nurses do you get for thirty two million quid, I for one don't mind paying for that because we all benefit not just the handful of deluded folk who can't cope without delusions of .
Anybody who can only debate using the "sky fairies and magic" clap-trap isn't worth listening to.
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http://www.telegraph.co.uk/news/religion/5123378/Chaplains-costing-NHS-32-million-a-year.html
Lets put this in perspective...
Chaplaincy costs the NHS £32 million pounds a year........
If people choose to have a fantastic belief it is totally out of order to expect the general public to pay to sustain that view. All the major religions are charities and therefore tax exempt, with a vested interest in looking after "their people". Why should we all pay to pander to their non medical needs.
How many nurses do you get for thirty two million quid, I for one don't mind paying for that because we all benefit not just the handful of deluded folk who can't cope without delusions of sky fairies and magic.
£32 million should be spent on attending to the body not the so called 'soul'. If people want a religious input it should be available freely from the religion to which they belong.
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http://www.telegraph.co.uk/news/religion/5123378/Chaplains-costing-NHS-32-million-a-year.html
Lets put this in perspective...
Chaplaincy costs the NHS £32 million pounds a year........
If people choose to have a fantastic belief it is totally out of order to expect the general public to pay to sustain that view. All the major religions are charities and therefore tax exempt, with a vested interest in looking after "their people". Why should we all pay to pander to their non medical needs.
How many nurses do you get for thirty two million quid, I for one don't mind paying for that because we all benefit not just the handful of deluded folk who can't cope without delusions of sky fairies and magic.
£32 million should be spent on attending to the body not the so called 'soul'. If people want a religious input it should be available freely from the religion to which they belong.
The NHS is there to care for the whole person, and the mental state of any individual is as important as the physical one: not that a curmudgeonly, biased and heartless person such as you would appreciate that.
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The right of being comforted at the point of death?
(funded by the religious body of their choice)
I've not got the slightest problem with that Anch.
ippy
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Sky fairies and magic ...... religious belief
What's the difference?
Do you have the slightest shred of evidence to help us differentiate?
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Sky fairies and magic ...... religious belief
What's the difference?
Do you have the slightest shred of evidence to help us differentiate?
I have the testimony of the New Testament, a book you have little knowledge of. But whatever you may or may not believe, there is nothing wrong with showing a little respect for the beliefs of billions, by refraining from such immature language.
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In between watching the cricket and eating lunch been doing some research. It appears the £32 million figure only relates to the money actually paid out in wages to chaplains and does not cover ancillaries, like;
I have been volunteering at my local super massive hospital since I retired, pushing wheelchairs about, fetching newspapers, making tea, stuff like that.
The hospital has a "large multi faith chapel" and 3 permanent offices attached for the use of chaplains plus a "peace garden" which takes up an enclosed courtyard. I can only assume that the cost of these spaces is not covered by the £32 million figure. Lots of other hospitals have similar spaces I believe. Yet my hospital is crying out for space for clinical use. I only work 2 mornings a week but only very rarely see anyone except cleaners and gardeners in these spaces.
If believers (of whatever hue) have a need for such spaces and services they should pay for them themselves.
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In between watching the cricket and eating lunch been doing some research. It appears the £32 million figure only relates to the money actually paid out in wages to chaplains and does not cover ancillaries, like;
I have been volunteering at my local super massive hospital since I retired, pushing wheelchairs about, fetching newspapers, making tea, stuff like that.
The hospital has a "large multi faith chapel" and 3 permanent offices attached for the use of chaplains plus a "peace garden" which takes up an enclosed courtyard. I can only assume that the cost of these spaces is not covered by the £32 million figure. Lots of other hospitals have similar spaces I believe. Yet my hospital is crying out for space for clinical use. I only work 2 mornings a week but only very rarely see anyone except cleaners and gardeners in these spaces.
If believers (of whatever hue) have a need for such spaces and services they should pay for them themselves.
The NHS doesn't seem to think so, though they do have plenty to say about the obese, and smokers, and drinkers, who actually use up huge amounts of resources by their actions. Maybe it's a question of priorities.
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We even have chaplains at our airports. Having chaplains in hospitals and paying them(they are working after all), hurts nobody but the warped minds of the intolerant secular fundamentalists.
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Actually, I agree - a wee bit - with Ippy here, JC.
It's up to faith groups to both provide and fund chaplains, for the most part.
Would you be happy if the hospital chaplain who turned up to see you was a Hindu*, paid and funded by your taxes.insurance?
* - nothing against Hindus - just using the description as an example.
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Actually, I agree - a wee bit - with Ippy here, JC.
It's up to faith groups to both provide and fund chaplains, for the most part.
Would you be happy if the hospital chaplain who turned up to see you was a Hindu*, paid and funded by your taxes.insurance?
* - nothing against Hindus - just using the description as an example.
One would hope that any sympathetic counsel would be acceptable to any in a serious condition.
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As all religions are on an equal footing as there is no evidence to substantiate any of them, it would be only fair that all were represented in hospitals, not just those of the Christian religion.
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As all religions are on an equal footing as there is no evidence to substantiate any of them, it would be only fair that all were represented in hospitals, not just those of the Christian religion.
Further, just looked this up quickly:
"Faith and Chaplaincy.
The chaplaincy provides religious, spiritual and pastoral care to patients, visitors and staff of all faiths or no faith.
Each hospital has its own team of chaplains and volunteer pastoral visitors. The chaplains are from the Hindu, Muslim and Sikh faiths and various Christian denominations. The wider team of volunteers also includes Baha'i, Buddhist, Jewish and non-religious / Humanist representatives."
Try researching now and again, Floo, before jumping in with your views.
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As all religions are on an equal footing as there is no evidence to substantiate any of them, it would be only fair that all were represented in hospitals, not just those of the Christian religion.
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Who's arguing?
Nut I contend that it should be up to each faith group to provide - and fund - candidates, who would then go through the usual PNC checks before being acredited as chaplains.
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As all religions are on an equal footing as there is no evidence to substantiate any of them, it would be only fair that all were represented in hospitals, not just those of the Christian religion.
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Who's arguing?
Nut I contend that it should be up to each faith group to provide - and fund - candidates, who would then go through the usual PNC checks before being acredited as chaplains.
Some think the NHS should fund the faith groups!
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Isn't it all about where the funding comes from?
I can't think of any reason why it would bother me if say, I was in hospital and the patient in the bed next to me held a full religious service or was just talking to a chaplain.
ippy
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http://www.telegraph.co.uk/news/religion/5123378/Chaplains-costing-NHS-32-million-a-year.html
Lets put this in perspective...
Chaplaincy costs the NHS £32 million pounds a year........
If people choose to have a fantastic belief it is totally out of order to expect the general public to pay to sustain that view. All the major religions are charities and therefore tax exempt, with a vested interest in looking after "their people". Why should we all pay to pander to their non medical needs.
How many nurses do you get for thirty two million quid, I for one don't mind paying for that because we all benefit not just the handful of deluded folk who can't cope without delusions of sky fairies and magic.
What is a sky fairy?
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What is a sky fairy?
Its someone who comes and installs Sky TV for you, free of charge, cyber. There are clearly some amongst our number, like john, who believe such creatures exist.
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Some think the NHS should fund the faith groups!
I see nothing wrong with a body, whose stated purpose is the wellbeing of individuals - physically, mentally and spiritually, funding people who serve those three purposes.
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Some think the NHS should fund the faith groups!
I see nothing wrong with a body, whose stated purpose is the wellbeing of individuals - physically, mentally and spiritually, funding people who serve those three purposes.
I don't think the NHS has a remit to support the spiritual needs of people - indeed I would have though that in medical terms spirituality is seen as a component of mental health.
So absolutely the NHS should be funding trained counsellors who are able to deal with emotional and psychological needs and to be able to provide that service to everyone irrespective of their religion or otherwise. I do not think the NHS should be funding religious chaplains, although I have no issue with hospitals allowing access to these people provided they are funded by their religious organisations and operate under strict guidelines to ensure that patients, who are often in a vulnerable state, do not feel pressurised into having conversations about religion that they don't want to have.
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Some think the NHS should fund the faith groups!
I see nothing wrong with a body, whose stated purpose is the wellbeing of individuals - physically, mentally and spiritually, funding people who serve those three purposes.
Well I do, if people require religion then it should be paid for by the appropriate faith groups, NOT funded by the cash strapped NHS.
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I don't agree Anchorman.
Being a Chaplain is a career. My Church has three pastors and supports many missionaries, we don't financially support chaplains that may or may not land a job at the hospitals or airports. Part of our pastors duties is to visit the members of the church that are sick or hurting. A couple days before mom died she told a nurse that she wanted to talk to one of our pastors. The nurse contacted us and we called a pastor and met him at the hospital and escorted him to mom's room. Mom didn't know this young fella, he was new to the job but had been in our church long enough to know our history there. We introduced the pastor and mom and then left them so they could talk in private. No Anchorman, NO Hindu will be called when I lay dying.
Small town hospitals can't afford a Chaplain program so all ministers take turns to be on call.
Our police forces have chaplains on staff. Why? Because they are needed.
http://metronews.ca/news/calgary/1133470/number-of-calgary-police-turning-to-services-chaplain-triples/
http://www.albertahealthservices.ca/3776.asp
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It makes me wonder how much our government is paying out unnecessarily on prison and army chaplains as well.
Nice little earner for these religious groups, free publicity paid for by the tax payer, not by the interested groups.
Humanist Chaplains do the work for altruistic reasons they're not working under the carrot and stick, looking for brownie points, or keeping the heavenly insurance payments up to date thus avoiding the heat.
ippy
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It makes me wonder how much our government is paying out unnecessarily on prison and army chaplains as well.
Army chaplains obviously being the ones who take a, shall we say, relaxed attitude to "Thou shalt not kill."
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It makes me wonder how much our government is paying out unnecessarily on prison and army chaplains as well.
Army chaplains obviously being the ones who take a, shall we say, relaxed attitude to "Thou shalt not kill."
I am told a better translation is "you shall not commit murder"
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It makes me wonder how much our government is paying out unnecessarily on prison and army chaplains as well.
Army chaplains obviously being the ones who take a, shall we say, relaxed attitude to "Thou shalt not kill."
Nice one Shaker, I like it.
ippy
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It makes me wonder how much our government is paying out unnecessarily on prison and army chaplains as well.
Army chaplains obviously being the ones who take a, shall we say, relaxed attitude to "Thou shalt not kill."
I am told a better translation is "you shall not commit murder"
Better according to whom or what? If something is better than something else there has to be a standard by which or at which such a judgement is arrived. What is this thing?
Murder is a legal term. If the law says that you can do X with impunity, X will earn you a higher rank in the services and very likely a medal or several medals and you will be regarded as a military hero. Do precisely and exactly the same thing without this same entirely arbitrary dispensation and you'll be a murderer locked up for a very long time indeed.
Short version: people make shit up to justify doing whatever they want to do.
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It makes me wonder how much our government is paying out unnecessarily on prison and army chaplains as well.
Army chaplains obviously being the ones who take a, shall we say, relaxed attitude to "Thou shalt not kill."
I am told a better translation is "you shall not commit murder"
Better according to whom or what?
Linguists, I guess.
I was just thinking about this - if that is a better translation, then it's a bit of a truism, isn't it? If murder is defined as killing which is unlawful, then you've got a law saying "it is against the law to break the law"
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I don't agree Anchorman.
Being a Chaplain is a career. My Church has three pastors and supports many missionaries, we don't financially support chaplains that may or may not land a job at the hospitals or airports. Part of our pastors duties is to visit the members of the church that are sick or hurting. A couple days before mom died she told a nurse that she wanted to talk to one of our pastors. The nurse contacted us and we called a pastor and met him at the hospital and escorted him to mom's room. Mom didn't know this young fella, he was new to the job but had been in our church long enough to know our history there. We introduced the pastor and mom and then left them so they could talk in private. No Anchorman, NO Hindu will be called when I lay dying.
Small town hospitals can't afford a Chaplain program so all ministers take turns to be on call.
Our police forces have chaplains on staff. Why? Because they are needed.
http://metronews.ca/news/calgary/1133470/number-of-calgary-police-turning-to-services-chaplain-triples/
http://www.albertahealthservices.ca/3776.asp
As I said previously I have no issue per se with chaplains as long as they are paid for by their own religious organisation and provided they only contact patients who have clearly indicated that it is their wish to have a visit by the chaplain.
When you are ill and in a vulnerable state (and lets face it have no option to 'run away' so to speak) it is important that you aren't bothered by people promulgating a religious agenda unless you expressly wish that to be the case.
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I don't think the NHS has a remit to support the spiritual needs of people - indeed I would have though that in medical terms spirituality is seen as a component of mental health.
So, in this section, you're saying that the NHS has nothing to do with mental health?
So absolutely the NHS should be funding trained counsellors who are able to deal with emotional and psychological needs and to be able to provide that service to everyone irrespective of their religion or otherwise.
And in this section you're saying that it does.
:o :o
By the way, chaplains will often talk about just about everything under the sun. The chaplain visited one of the folk in the same coronary ward I was in back in January. Religion was just about the last thing they spoke about and only at the instigation of the patient (and it wasn't very complimentary). After all, they are some of the most highly trained counsellors the NHS has.
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It's not a church that produces chaplains to be sent to hospitals, police and fire services, airports. You can have a Rev. in front of your name but that won't get you into a job as a hospital chaplain in my province. A person seeking this career in a hospital, and it is a career, must go through the Hospital Chaplaincy training Program run by the Spiritual care dept of our Alberta Health Services. Theses students must complete the extended CPE Unit and the Pilot Course CPE Practicum. These courses will cost about $2,500. This has nothing to do with a church or ministry. And what hospital is going to send a chaplain to a patient without a request from the patient? I mean really, come on now.
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It makes me wonder how much our government is paying out unnecessarily on prison and army chaplains as well.
Nice little earner for these religious groups, free publicity paid for by the tax payer, not by the interested groups.
Humanist Chaplains do the work for altruistic reasons they're not working under the carrot and stick, looking for brownie points, or keeping the heavenly insurance payments up to date thus avoiding the heat.
ippy
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Eh?
You think all prison chaplains do is try to get bums on seats?
Sorry to disabuse you.
I've shadowed a chaplain in my local prison. She was welcomed by all and sundry, of all faiths and none.
She didn't try to drag anyone anywhere, or ram any ideology down anyone's throats.
However, if an inmate initiated a conversation on 'matters spiritual', she naturally joined in.
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I am told a better translation is "you shall not commit murder"
Better according to whom or what?
The original Hebrew.
If something is better than something else there has to be a standard by which or at which such a judgement is arrived. What is this thing?
I suppose it is at this point that linguistics and Lit.crit. rear their ugly head and start to talk about litarary context, sociological and historical context, etc.
Murder is a legal term. If the law says that you can do X with impunity, X will earn you a higher rank in the services and very likely a medal or several medals and you will be regarded as a military hero. Do precisely and exactly the same thing without this same entirely arbitrary dispensation and you'll be a murderer locked up for a very long time indeed.
Short version: people make shit up to justify doing whatever they want to do.
'Murder' is also a contextually different word to 'kill'. In the UK it is often applied to a killing that is premeditated, planned and therefore in cold blood. In a way, the Americans' use of murder in the first/second degree, voluntary and involuntary manslaughter explains it better than we do here in the UK. https://en.wikipedia.org/wiki/Murder_(United_States_law)#Degrees_of_murder_in_the_United_States
Rarely would a soldier killing an enemy soldier be counted in this way because the argument woulhave something to do with protection or stopping that enemy from attacking a nation.
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It makes me wonder how much our government is paying out unnecessarily on prison and army chaplains as well.
Army chaplains obviously being the ones who take a, shall we say, relaxed attitude to "Thou shalt not kill."
Oh, really? And just how do you know what attitude they all take? Have you any evidence to support that comment? Do tell!
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Nice little earner for these religious groups, free publicity paid for by the tax payer, not by the interested groups.
Humanist Chaplains do the work for altruistic reasons
So, serving from the same reasons as religious chaplains.
...they're not working under the carrot and stick, looking for brownie points, or keeping the heavenly insurance payments up to date thus avoiding the heat.
As I and others have pointed out before, ippy, you seem to be very knowledgeable about all this; perhaps you can explain to those of us who don't work in this way why you (or so it would appear) feel that it is a good system. I'll then go and tell the chaplains I do know how they can improve their practice.
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It makes me wonder how much our government is paying out unnecessarily on prison and army chaplains as well.
Army chaplains obviously being the ones who take a, shall we say, relaxed attitude to "Thou shalt not kill."
do you show similar disdain for army medics and their relaxed attitude to "do no harm"?
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It makes me wonder how much our government is paying out unnecessarily on prison and army chaplains as well.
Nice little earner for these religious groups, free publicity paid for by the tax payer, not by the interested groups.
Humanist Chaplains do the work for altruistic reasons they're not working under the carrot and stick, looking for brownie points, or keeping the heavenly insurance payments up to date thus avoiding the heat.
ippy
Only humanist chaplains? Are no other chaplains voluntary?
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It makes me wonder how much our government is paying out unnecessarily on prison and army chaplains as well.
Nice little earner for these religious groups, free publicity paid for by the tax payer, not by the interested groups.
Humanist Chaplains do the work for altruistic reasons they're not working under the carrot and stick, looking for brownie points, or keeping the heavenly insurance payments up to date thus avoiding the heat.
ippy
Only humanist chaplains? Are no other chaplains voluntary?
He doesn't mean the pay. He means that Christians are only pretending to be nice so they can go to heaven - so they are Bad People, but humanists are doing it because they are lovely, so they are Good People.
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Ippy,
"carrot and stick....brownie points...heavenly insurance payments"
You really need to stop dropping your pants and trying to fire a rocket. Your popping off blanks is exactly that, blanks.
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I don't think the NHS has a remit to support the spiritual needs of people - indeed I would have though that in medical terms spirituality is seen as a component of mental health.
So, in this section, you're saying that the NHS has nothing to do with mental health?
Where on earth did I say that. Of course the NHS needs to deal with the mental, psychological and emotional health of people. That's why they employ trained professional so to do, whether they be psychiatrists, psychologists, counsellors or, indeed, nurses.
So absolutely the NHS should be funding trained counsellors who are able to deal with emotional and psychological needs and to be able to provide that service to everyone irrespective of their religion or otherwise.
And in this section you're saying that it does.
They do - through their psychiatrists, psychologists, counsellors and nurses. And of course if they weren't forking out millions on religious chaplains they could employ a few more of those people whose job is specifically to cater for the mental, psychological and emotional needs of everyone. If someone requires a specific religious service that should be provided (and funded) by that religious organisation, not the NHS.
By the way, chaplains will often talk about just about everything under the sun. The chaplain visited one of the folk in the same coronary ward I was in back in January. Religion was just about the last thing they spoke about and only at the instigation of the patient (and it wasn't very complimentary). After all, they are some of the most highly trained counsellors the NHS has.
While they might talk about other things they often talk about religion - let's face it that is their primary purpose. And guess what there are many people in hospital who do not want to be bothered by someone looking to talk about religion and that's why for many patients the chaplain is a divisive and unwanted visitor. So a visit from a religious chaplain should always be on the basis of a clear 'opt-in' from a patient. That isn't the case currently as I can confirm with my own parents when they were in hospital for various reasons, including dying.
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Where on earth did I say that. Of course the NHS needs to deal with the mental, psychological and emotional health of people. That's why they employ trained professional so to do, whether they be psychiatrists, psychologists, counsellors or, indeed, nurses.
Your opening comment is "I don't think the NHS has a remit to support the spiritual needs of people" - and you then go on to say that 'in medical terms spirituality is seen as a component of mental health'. Taking the two halves of the sentence as you have written them implies that mental health isn't something that the NHS has a remit to to support. After all, if you remove a particular element of any aspect of healthcare that aspect is not being supported.
They do - through their psychiatrists, psychologists, counsellors and nurses. And of course if they weren't forking out millions on religious chaplains they could employ a few more of those people whose job is specifically to cater for the mental, psychological and emotional needs of everyone. If someone requires a specific religious service that should be provided (and funded) by that religious organisation, not the NHS.
So, mental health care should be being funded, at least in part, by a private organisation? Isn't that part of the argument for doing away with the state funding of the health service and turning it into a commercially run one?
While they might talk about other things they often talk about religion - let's face it that is their primary purpose.
You have a seriously jaundiced view of chaplaincy; whilst I am sure that there are some such chaplains, both humanist and religious, the chaplains I know have a primary remit of providing solace and comfort, both to patients and family members. In the past, I have thought about working in hospital chaplaincy, but my age precluded it as, as a Christian, one has to be an ordained minister in order to get such a role and no-one considers training and ordaining someone already in their 50s. I could have been a volunteer chaplain, I agree, but as an unpaid role, I couldn't afford to do it - I've been unemployed for 5 1/2 years out of the last 7. That personal info aside, I spent some time discussing the role with several chaplains, and many said that they spent less than half their time talking about religion and far more time simply talking about what the NHS can do to help with mental and emotional issues, and providing basic counselling care.
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Wot Hope said.
Though I'd go a tad further.
My local health authority(Ayrshire and Arran) issuesan annual report.
In that report it states that the chaplaincy team is an
'irreplaceable element in the healing system'
(The chair of Ayrshire and Arran used to be held by an atheist, and, since the chair signs off the report annually, presumably he endorsed the findings which it contained)
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Wot Hope said.
Though I'd go a tad further.
My local health authority(Ayrshire and Arran) issuesan annual report.
In that report it states that the chaplaincy team is an
'irreplaceable element in the healing system'
(The chair of Ayrshire and Arran used to be held by an atheist, and, since the chair signs off the report annually, presumably he endorsed the findings which it contained)
I wouldn't be challenging anything you've said there Anch, for me it's about who pays the bill, not the state.
It's only about a half of the U K population that are religious believers now, even though all of that stuff is such old hat these people do really believe that stuff and if it gives them some comfort, any comfort speaking to a chaplain, well good luck to them, I wouldn't be having anything to do with chucking them out.
ippy
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Wot Hope said.
Though I'd go a tad further.
My local health authority(Ayrshire and Arran) issuesan annual report.
In that report it states that the chaplaincy team is an
'irreplaceable element in the healing system'
(The chair of Ayrshire and Arran used to be held by an atheist, and, since the chair signs off the report annually, presumably he endorsed the findings which it contained)
I wouldn't be challenging anything you've said there Anch, for me it's about who pays the bill, not the state.
It's only about a half of the U K population that are religious believers now, even though all of that stuff is such old hat these people do really believe that stuff and if it gives them some comfort, any comfort speaking to a chaplain, well good luck to them, I wouldn't be having anything to do with chucking them out.
ippy
Which is my point too.
I have no issue with chaplains provided that they are paid for by the religious organisation they represent. My only other point being that access to patients by chaplains must be on a strictly opt in basis, which I think is already in the guidance from the NHS, but clearly does not always happen in practice (as I can testify from experience).