The Church of England only has itself to blame over women bishops fiasco

With more delays likely, it's already a byword for doublethink and procrastination.

Rowan Williams spoke on Sunday of "a corner into which the church has backed itself and out of which we are trying to get." He needn't have been so modest. The corner to which he was referring was created by himself and his fellow bishops when they inserted an unexpected new clause into legislation for women bishops after it had already been passed by the overwhelming majority of Church of England dioceses, but before it could be debated by the General Synod, which is currently meeting in York. 

The bishops' aim may have been to reassure diehard opponents of the change that they would still have a place in a church that fundamentally disagreed with their stance. The most significant effect of the clause, however, was to antagonise supporters of women bishops so much that many threatened to vote against the legislation rather than see women appointed on terms they considered "second class". Opponents of the change welcomed the amendments, which would give parishes the right to be looked after by a male bishop who shared their views about the ordination of women, but not sufficiently to persuade most of them to vote for it.

It now looks increasingly likely that no decision will be made either way, after the Synod's steering committee adopted a motion to adjourn the debate until November, by which time the bishops may have been persuaded to withdraw their amendments. This would be a success for the campaign group Women and the Church (WATCH) which has collected 5,000 signatures for a petition demanding the postponement. It would also be a humiliation for the bishops. But it would also a huge anti-climax, and it won't do much for the image of a church already a byword for doublethink and procrastination. Four months may not be long when set against almost two thousand years of Christian history, or even the twelve years that have passed since the Church began the process that was supposed to end with the consecration of the first female bishop next year or the year after. But it creates an impression of disarray at the top and factionalism lower down, an impression that may not be so far from the truth.

The problem stems, ultimately, from a deep-seated but unrealisable commitment to unity, if not of heart then at least of body. You might think that no compromise is possible between those who regard the failure of the Church of England to have women bishops is an embarrassing case of institutionalised sexism and those who believe that the Bible, or church tradition, forever rules it out. But this is a church that prides itself on being broad and non-dogmatic and has a peculiar horror at the idea of splits. It's a family that wants to stay together, even if it doesn't always pray together. In a very real sense, as clerics like to say, it wants to have its cake and eat it.

For Williams, the dilemma must be especially acute. He personally supports women bishops, and passing the legislation would make a fitting legacy for his tenure at Canterbury, now entering its final months. But time and again he has subordinated his private convictions – some would say principles – to the goal of keeping the Church of England, and the wider Anglican communion, in one piece. He was in typically ambivalent mood on Friday, telling bishops and clergy that he "longed to" see women wearing mitres, indeed that the Synod needed "to proceed as speedily as we can" towards a conclusion. But he equally "longed" to see provision for those Anglicans who hadn't yet accepted (and probably never will) the creation, or indeed theological possibility, of women as bishops. He is now discovering, perhaps not for the first time, where such irreconcilable longings can lead.

To a public uninterested in theological niceties, the question is a simple one: why on earth has it taken the Church of England so long to appointing women as bishops? When there were no female politicians, judges or police officers it was uncontroversial to assert that God reserved leadership roles for men. To say that now amounts to a claim, however fancily dressed up, that God is a sexist. 

Many inside the church agree. The C of E's glacial progress on the issue also puts it out of step with many of its sister churches. The fact is that there have been Anglican women bishops for many years now. Not in England, obviously, but in the USA, in Canada, Australia and New Zealand. Barbara Harris was consecrated as a bishop in Massachusetts as long ago as 1989. Around half of Anglican provinces allow for women bishops, although only a minority have got round to appointing any. The Scandinavian churches through which the Church of England is in communion via the Porvoo agreement all have women bishops, too.

This is not about the Church of England being radical or unilaterally jettisoning 2,000 years of Christian tradition. Rather, it's a story, repeated often in its history, of a church slowly and reluctantly adapting itself to the society of which it remains, at least constitutionally, an integral part. It will get there eventually; it always does, after exhausting all the other possibilities.


Rowan Williams will be hoping to pass the legislation before retiring as Archbishop of Canterbury later this year. Photograph: Getty Images
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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide