Growing Old Gracefully

This week I'm taking part in a 24 hour event for clergy who are coming up to retirement. So here's another in a series of occasional blogs on retirement "from the front line". This one's about growing old.

And it's trending nowadays. We baby boomers are about to add to the pressure on our struggling health and social care provision. My generation was born just after the last war. We're getting to the age when we're going to need looking-after in the last years, even decades, of our lives. Some have already reached that difficult turning-point in life where we can't go on without the help of others, whether we're wholly or partly dependent on family, friends, neighbours or social welfare.

The trouble is, we are living too long, a lot longer than was imagined in the 1940s and 50s when I was born. And this at a time when healthcare expectations and the strains on our public finances are greater than they have ever been. Many of us retired people in the so-called "third age" enjoy a quality of life that compared to most others across the world is altogether extraordinary. We look at people like Cliff Richard in his seventies and Joan Collins in her eighties, and can't quite believe they aren't still in middle age. (Perhaps they think they are!) Even at this modest age of sixty eight, I occasionally get told off for pretending to be older than I really am, old enough to be retired.

Well, most of us last played that game of pretending when we were kids, trying to get in to watch "A" films at the local cinema. Or worse... I can see you're worried. Let me reassure you. It was nothing salacious, but I was underage, eleven probably, when I went to see Whisky Galore after school one day with a friend. How grown-up it felt! (Who was that friend? I wish I could remember. Another symptom of ageing, that...)

"Be your age" we used to scold our children. But of course that's precisely the point about how ageing tends to be viewed in western society. "You're as old as you feel" we're told; "sixty is the new forty. Welcome to middle age." And while I get impatient with that kind of talk, there's some truth in it. We don't really feel our calendar age. My consciousness of being "me" tells me that I'm fundamentally the same person as I was a lot earlier in life. Inside, I feel I be back at school again, or getting married, or starting my working life, or having children. And a lot else. Use your imagination. It's when bits drop off my body and its parts start to fail or stamina falls off that I'm reminded where I am on this timeline of being, not Adrian Mole aged thirteen and three quarters, but Michael, now fast approaching seventy. It can feel hard at times.

But why should it be hard to admit that? It's a very western problem to see growing old in this nostalgic regretful way. Most other cultures respect the old. The Japanese even have a special "day of the elderly". Yes, we should look back and be thankful for all the good things that have happened to us in youth and middle-age, all that has blessed and enriched us, fulfilled us and made us glad to be alive. Thankful too for the capacity to recognise our mistakes, say sorry and try to put them right, or at least live well with memories that will always be sad or painful or dark. And especially I am trying to be thankful for God's inestimable love, as the General Thanksgiving in the Book of Common Prayer puts it, God's constant presence and care from first breath to last, whether I knew it or not. If being human means lifelong learning, then no experience we've undergone is ever wasted.  Yes, there's a lot that's been lost, and most of all the people who have loved us and have died. But "all in the end is harvest". Loss is real, but the memories of cherished souls still touch my life and continue to make me what I am.

I've just read a rather wonderful book by Lynne Segal, Out of Time: the Pleasures and Perils of Ageing. She writes with insight about the ambiguities of growing old, and how the elderly are perceived in our society, especially by the young. We comfortable baby boomers who "never had it so good" are, she observes, increasingly resented by young and middle-aged people who struggle with unemployment, lack of opportunity, poverty, poor (or no) housing and the near-collapse of proper social welfare. By contrast, as some see it, baby-boomers' self-interest has begotten consumerism with all its ills, caused financial mayhem across the planet and has continued to plunder the world's resources when we should have known better. Add to that (too late for the book) how the young regard the silver-haired generation who have stolen their future from them by voting so decisively for a Brexit they (the young) do not understand or want.

Segal recognises that there's caricature in some of this. When has any generation not scorned or blamed their forebears for the predicaments they find themselves in. And yet... I know as we all do, so many inspirational young people who want to make the world a better place and find common cause with my contemporaries who want the same thing. Self-interest is not, I think, age-specific. I'm always heartened by that saying in the Rule of St Benedict about how we need to listen to the young, for God often tells them things he withholds from those who are older but not necessarily wiser.

The book urges me to be honest and realistic as I answer the question, "how old are you?" And that's about much more than what I'm feeling. Having read it, I now want to respond as truthfully as I can and acknowledge what belongs to the age I am rather than five, ten or twenty years younger. There's dignity in that, especially when it includes facing up to our physical or mental deterioration, our dwindling beauty or attractiveness, our sexual prowess or athletic ability. It isn't always easy to own up to. We can long to recapture those first, fine careless raptures wherever, whatever they were. In one way or another, we can devote all our lives to that attempt to re-set ourselves to some point in the past.

In the end, though, it's a futile quest. We are mortal. We know that one day we shall die, even if we pretend (back to that word again) that we can sit out the summons to join in the dance of death. When I laid down my work as a stipendiary priest, I wondered whether retirement might prove to be the last really big rite of passage of my life until either my wife or I myself died - a portentous thought to concentrate the mind. But more gently, ancient wisdom invites us to cultivate the art of living well in the time that we have left, to make old age a true summing-up of all that we've tried to be in life. Paradoxically, as we contemplate death, far from finding it a depressing or sinister thought, we discover that perhaps it's the clue to embracing life in all its fulness and living joyfully in our old age. Read the great seventeenth century classics of spiritual writing, Bishop Jeremy Taylor's Holy Dying and Holy Living if you don't believe me.

Late in life, I'm trying harder to celebrate the miracle that I am "alive, alive-oh" to quote the title of a book by that doughty writer on old age, Diana Athill. I don't mean anything dramatic, simply learning how to be more present to being alive, how to pay more attention. To live contemplatively and thankfully in the present tense is truly transformative. And that's also to recognise the past and future tenses of ageing, how grace has brought me thus far, and how, I trust, it will lead me home.

I realise (how can I not?) that "old age is not for wimps". It takes courage to peer into the possible futures that could await us in this adventure of growing old. Some of them could be bleak indeed. The spiritual question I live with is, how do I keep alive the sense of God, whatever may happen? When it gets hard, I so want still to be able to sing alleluia. But even if courage fails in whatever ordeals may await, I hope I shall always hear that still small voice calling to me deep down, and be able to whisper back: For all that has been, thanks! To all that shall be, Yes!

The NHS: in gratitude on its 70th birthday

Today is the 70th birthday of the National Health Service. Services and celebrations are happening across the nation. We are right to honour this great institution and be profoundly thankful for it.

I'm not one of those with a dramatic life-and-death story to tell about the NHS. I've not troubled my GPs overmuch in my lifetime. Most of my ailments have been small beer compared to what many others have had to face: childhood infections and abrasions, adolescent allergies, the odd broken limb, hypertension, mild atrial fibrillation, psoriasis. I've undergone a vasectomy, a prostate op and keyhole surgery for hernias. I have NHS hearing aids. Too much information? I suspect that for a man coming to the end of his seventh decade, it's pretty standard fare.

The Archers, the NHS and I are almost exact contemporaries. After the war, my mother became a nurse at the old Charing Cross Hospital in central London where I was born. Neither she nor my father were people of faith, but they did instil in me from a very early age a kind of hushed reverence for the NHS. (The Archers had to wait a few more years.) Our GP in north London was an elderly German-Jewish exile called Dr Landstein. I recall him quite clearly from the mid-1950s: kindly, compassionate, wise. Nothing was too much trouble for him. He enjoyed home visits and chats with my mother who like him had also survived the Holocaust. It felt like a family bereavement when he retired. I remember his successor too, Dr Giwelb. He was younger, less priestlike, more professionalised, more "modern", but he too was among the gods of my childhood pantheon (where they were flanked by Miss Bull, my primary school headmistress, and Owen Brannigan who lived three doors away on our street). Between them, they shaped my expectations of healthcare for a lifetime. And they have been abundantly fulfilled in adulthood. I'm thinking especially of two marvellous GPs had in Sheffield and Durham. Perhaps they know who they are.

When I was a parish priest, I was also the official chaplain to the town's infirmary, paid by the NHS. I learned a lot about healthcare in those years, not least when I was involved in the in-service training of doctors, nurses, administrators and support staff. I was proud to be a tiny part of that exemplary hospital, proud to have a role in an institution that was so valued in the community. If I ever entertained doubts about the virtue of universal healthcare (I'm not sure that I did), my experience in that place of truth and love quickly dispelled them.

So I understand why Polly Toynbee writes as she does about the NHS as a kind of surrogate religion. It's simply there, like the good old C of E, a benign institution that we're glad exists to bless our nation and provide for it at times of need, even if we rarely have to trouble it ourselves. For my generation and for everyone younger, it has hatched us, patched us up and dispatched us. We've felt safe and cared for. We've never known anything else. We can't quite understand why the whole world doesn't emulate the NHS, why the United States, for instance, has struggled so hard to provide even the rudimentary ObamaCare for the most needy that is now being unravelled by Donald Trump.

But we know for ourselves how politicised health care has become. No government has dared to tamper with the idea of universal healthcare free at the point of use. It would be a certain vote-loser. And yet the sustainability of the NHS is under threat in a way that would have been inconceivable even a quarter of a century ago. Conservative administrations have been reluctant for decades to say openly that excellence in healthcare requires that we all put our hands in our pockets to pay for it through our taxes. Only now is there a belated acknowledgment of this in the Prime Minister's £20 billion funding commitment. It's a welcome start. But it's nowhere near enough if the NHS is to be stabilised. It's now an urgent case of playing catch-up. Years of chronic underfunding must be put right if the founding vision of the NHS is to be honoured in our day. To achieve this, our leaders have to believe in it. Back to the NHS as a quasi-religion that needs vision and faith if it's to serve us well and flourish.

I recently read Adam Kay's book This is Going to Hurt. He was a junior hospital doctor specialising in obstetrics. He loved his work and showed every sign of going on to a promising career as a consultant. But the pressures on him as a healthcare professional became intense - not because of any failure of his, but because of "the system": impossible working hours, lack of resources, an absence of proper rigorous supervision, the ever-increasing likelihood of making a life-threatening mistake. So he resigned his position and is now a writer. His book is candid about his experience. It is by turns very funny and extremely alarming. We've known for years what GPs and junior hospital doctors have to contend with. But when you read something as personal and vivid as this, you begin to worry. You wonder how on earth the NHS can carry on as a viable institution, let alone have a future.

Like so many other things - the environment, arms sales, ethical trade, reform of our financial structures, the benefits system, Brexit, it comes down to the political will. Do we really want a future in which the founding vision of the NHS continues to play a central part in the welfare of our people? If so, are we willing to pay for it? Our politicians must come clean. And while we're on the subject, that applies to social care for the elderly too. We baby-boomers are getting old. Demographic projections show how our demands on the NHS will put it under ever-increasing strain until our generation has died out. Before that, we are going to need social care that is beyond the means of many people to afford. For those who are "just about managing" or not managing at all, the prospect of ageing is bleak and even terrifying. After a lifetime of looking after others, who will look after them?

Today we celebrate the vision and courage of those pioneers of 70 years ago who believed that the nation should look after its people from cradle to grave. That's not about setting up unhealthy dependencies so much as creating structures of mutual giving and receiving so that those who need care have access to it and need not fear that it will be denied them. It's old-fashioned to speak of "the idea of a Christian society". Yet I profoundly believe in this ideal of a public caring institution which is for all people, and from which no-one is excluded. It's a practical expression of the great commandment to love our neighbour as ourselves. On this NHS birthday, and out of gratitude for all that it represents, I believe we must renew our heartfelt political commitment to it so that our children and grandchildren may benefit as we have done.

But a birthday is for celebrating and being thankful. The NHS is not a perfect institution but I want to say, unhesitatingly, that it is a great one So this is a day to be glad and set our hopes high. As the Archbishop of Canterbury tweeted today, "The NHS is an expression of our deepest shared values. Whatever its challenges, it’s about us living out our concern for solidarity and the common good. It reflects God’s concern for every person without exception. Today let's pray, give thanks and recommit our support. The NHS can be proud of its first seven decades." Indeed.  Floreat!