Prevention is better than cure: the media coverage of our recent paper in the BMJ

The front page headline for the Daily Mail last Thursday was ‘Heart attack deaths halve in 8 years’. This was a report of our paper published that day in the British Medical Journal (BMJ) and to be found here.

The paper also made the front pages in the Telegraph and Express and into the Guardian, the Independent, the Mirror, the Huffington post and onto the BBC News (radio and television), the Today Programme and even into a newspaper in Winnipeg (according to Kate Smolina – the first author of the paper and until recently my DPhil student (jointly supervised with the co-authors of the paper: Michael Goldacre and Lucy Wright)). Unfortunately the paper doesn’t seem to have made it into the Daily Mash yet as one of our other papers recently did.

Our paper presents several ‘findings’ but the main finding is, in my view, that just over half of the decline in heart attack deaths between 2002 and 201 in England was caused by fewer people having heart attacks and just under half by more people who had heart attacks surviving. We knew already that the number of deaths from heart attack was declining and suspected that this was partly due to fewer people having attacks and partly due to more people surviving attacks but we didn’t know for certain which was more important and now we do.

I therefore find the headline of Jeremy Laurance’s piece in the Independent ‘The curious case of the vanishing killer’ and its opening lines particularly irritating. Laurance says ‘It's a good news story that has [not’ had’ note] medical researchers baffled: in the past decade, deaths from heart disease in the UK have fallen spectacularly, and no one knows why…’. Has he not read our paper? Does he not get the point? But what was the point of our paper as opposed to its main finding? I’ll try and explain that later but meanwhile what did the media reports think was the point.

The reporting of our paper has been extensive but also extremely variable with the report by NHS Choices being one of the best and the report by Sky News  being one of the worst.

Many of the reporters don’t seem to have bothered to try and contact the authors of the paper for their views on the pointy of the paper or even what the paper says but have relied instead on comments from others – notably the British Heart Foundation. The best report I have seen – from NHS Choices – does not rely on comments from others but draws its own conclusions. I don’t entirely agree with all of its conclusions as I do not entirely agree with everything that is said in the paper. (A paper written by multiple authors is always a compromise.)

In particular – as NHS Choices says - ‘It should be noted that although the study shows a fall in heart attacks and also in death rates among heart attack patients, it does not tell us the precise causes of either.’ It’s probably because the paper is so clear in its main finding – and sorts out an important question – that speculation on both fronts has been so rife. For my own speculations see the news story from the University of Oxford University

Some of this speculation is quite frankly ‘wild’. There is some wild speculation in our paper itself such as: ‘The increase in acute myocardial infarction event rate in London between 2007 and 2009 may be a result of the financial crisis that peaked in 2008 and greatly affected the London financial district.’ How on earth did this get into the paper I am now thinking? This rather small, foolish bit of speculation seems to have been reproduced in several articles: as if the financial crisis just affects the ‘London financial district’. See for example the Telegraph.

So what are the real causes of the a) decline in the number of heart attacks b) the death rates among heart attack patients? These are many and varied and could well be displayed in the sort of map that the Government’s Foresight Programme developed to ‘explain’ the causes of obesity and which I have discussed previously on this blog here.

I was tempted in my one (rather ill fated) media appearance in relation to the paper to suggest that improvements in food labelling had played a major role in the decline in the number of heart attacks. Implausible? Equally plausible, in my view, as the suggestion that the financial crisis had important effects on the trends.

There is actually some research into (rather than speculation on) the causes of the decline in deaths from heart attacks in England - admittedly from an earlier time period i.e. from 1981 - approximately the point at which the decline in deaths from heart attacks began - and 2000. This research - from Simon Capewell and his colleagues at Liverpool University - suggests that 58% of the decline can be attributed to ‘population risk factor reductions’ (principally smoking, 48%; blood pressure, 9.5%; and cholesterol, 9.5%). Given that the annual decline in heart disease deaths between 1981 and 2000 was roughly the same as between 2002and 2010 it is not unreasonable to suggest that this research should be used to interpret our results. Did any of the journalists do this? No of course not.  We did mention this paper in our paper but perhaps we should have given it a bigger billing.

Of course interpretation in science is largely value driven rather than evidence driven. There are two interpretations of our results which I like. The first comes from Andy Burham - Labour's Shadow Health Secretary.

Any Burham seems to be suggesting that the introduction of the National Service Framework for Coronary Heart Disease – introduced by the last Labour Government – was a cause of the fall in heart disease deaths. He says ‘In Government, Labour launched a national drive to cut deaths from heart attacks through the national service framework on coronary heart disease. It succeeded because of the strength of the NHS structure - which Mr Cameron is now to break apart.’

Andy Burnham’s contention that the National Service Framework was a major cause of the decline in heart disease deaths is a tad speculative - particularly as the decline started in around 1980 long before the National Service Framework was introduced (in 2000) but nevertheless it is true that our study ‘calls into questions whether the NHS needs to change radically in the way it does things.’ And Andy Burnham’s point the ‘if the NHS isn’t broke why fix it?’ is appropriate – at least with regard to the treatment of heart disease which, it should be noted, is one of the causes of ill-health in England, if not the biggest. Note that both David Cameron and Andrew Lansley have used the argument that England’s high rate of heart disease (compared with say France) justifies their proposed reforms.

The other interpretation I like I haven’t found anywhere yet. This is that our study shows that ‘prevention is better than cure’. Note that more than 50% of the decline in heart attacks deaths is due to the decline in the actual number of attacks and less than 50% of the decline is due to improvements in survival after an attack. I.e. the prevention of attacks is more important than what goes on after the attack. Note too that it is possible that survival after attacks has only a little to do with improvements in the treatment of heart attacks (after they have occurred) and more to do with hearts getting stronger (from preventive activities prior to the attack).

Of course the decline in the number of attacks may be partly due to improvements in the drugs given to people at high risk of an attack (statins for raised blood cholesterol, anti-hypertensives for raised blood pressure, etc) and even improved forms of surgical treatment (such a ‘stents’) for people who have serious heart disease but given these drugs and new forms of surgical treatment came into use only over the last decade or so – long after the decline in deaths began (around 1980) it seems unlikely that they have made a major contribution (see too Simon Capewell’s findings mentioned above) This leaves us with lifestyle change as the mostly likely main cause of the fall in heart attack deaths (again see Simon Capewell’s findings). The decline in smoking is probably the most important lifestyle change but improvements in diet such as the switch from animal fat to vegetable fat which began about the time heart attack deaths began to fall, may also have contributed.

Whether the Health Service (much as I love it) has had anything much to do with these lifestyle changes seems unlikely. The switch from animal fat to vegetable fat was largely due to the increasing availability of cheap vegetable oil (sun-flower, rape seed, etc.) due to agriculture subsidies under the Common Agriculture Policy etc. When did your doctor last talk to you about saturated fat and did you head his/her advice?

Interpretation of the results of papers is, in the end, value driven. My interpretation of the results of our paper (which I am not sure is even entirely shared by my co-authors) is that it means that prevention is better than cure. This interpretation is – like Andy Burnham’s –based, not just on the findings of the paper – but on speculation. Though I do have some empirical support from other research such as that of Simon Capewell and his colleagues. I also have some logic to support my case. It is value driven: because I am a preventionist rather than a treatist.

The problem with the media coverage of our paper – from my (preventionst) point of view was that it got hijacked by too many treatists. OK perhaps I should feel grateful for the amount of coverage our paper got and that at least prevention sometimes got a mention. (The paper does to some extent speak for itself without the need for too much interpretation.)

Several people have congratulated me on the extent of the media coverage for the paper. But I really do not care about coverage. All publicity is not good publicity in my book. I am sorry that the coverage didn’t do more to help Andy Burnham’s cause - hat the NHS isn’t broke so why fix it - or mine that ‘prevention is better than cure’. In saying this I should say that I am not blaming anyone but myself.

'Thou shalt love thyself as thy neighbour?'

Sermon on Romans 12: 1-21, St Matthew's, 14th January 2012 (but changed quite a lot).

Today’s epistle reading – from Paul’s letter to the Romans – is partly about gifts and talents but also partly about how we should behave as Christians. I thought today I would focus on the idea that comes up again and again in Paul’s writings, and is in Jesus’ parables too, that whilst undoubtedly we human beings have weaknesses we also have strengths – gifts in other words - and how we are going to discern what these are.

My focusing on this theme in the epistle reading is partly motivated by reading Karen Armstrong’s Twelve Steps to a Compassionate Life. In this book Karen Armstrong challenges us to be more compassionate and sets out a twelve step programme for how to achieve this. After learning about compassion (Step 1) and looking at the world (Step 2) Step 3 is entitled ‘Compassion for yourself.’ Significantly this comes before ‘Compassion for others’ (Step 4).

Of course compassion for ourselves is important and something we regularly forget to practice. In our service just now I reminded you of Jesus’ summary of the law: Firstly ‘The Lord our God is one Lord and thou shalt love the Lord thy God with all they mind and with all thy strength’ and Secondly ‘Thou shalt love thy neighbour as thyself’. Now we all tend, to forget the second half of this Second Commandment. We are not only to love others but we are to love ourselves.

Now I think compassion for ourselves requires looking for and finding the good in ourselves rather than just the bad. In fact it would seem somehow perverse to love what we see as bad in ourselves – although I am not sure that it is always easy to tell what is good and what is bad and often the two are inextricably mixed. If we are courageous we may be reckless, if we are honest we are may be rude, etc. etc. But let’s leave that for a moment

Karen Armstrong tells a story about a friend – the Rabbi Albert Friedlander – who had grown up in Nazi Germany and as a child was bewildered and distressed by the vicious anti-Jewish propaganda that he heard from every quarter. One night when he was about eight years old he couldn’t sleep and so made a list of all his good qualities. He told himself firmly that he was not what the Nazis said, that he had talents and special gifts of heart and mind which he enumerated to himself one by one. Finally he vowed that if he survived he would use those qualities to build a better world. Karen Armstrong notes that this was an extraordinary insight for a child of eight in such circumstances, but she says that Albert Friedlander – in later life – was one of the kindest people she had ever met.

The commandment that thou shalt love thy neighbour as thyself is related to what is sometimes known as the Golden Rule i.e. ’Do unto others as you would have them do unto you’. Jesus commands his disciples to follow this rule when, for example, in the Sermon on the Mount, he says ‘So whatever you wish that men would do to you, do so to them, for this is the law and the prophets (Matthew 7:12).

Now the Golden Rule also presumes self-knowledge – you need to know what you wish men would do to you to be able to do the same for them. It requires us to know ourselves. And in particular we need to know what we need. Some of us find this really rather difficult. When my wife asks me whether I would like some breakfast I know whether I am hungry or not. So far so good. But if I am hungry and she asks me what I would like then things start to get difficult.

Should I have just a slice of toast as I am trying to lose weight? Or should I say a bacon sandwich which I know I will enjoy but has lots of calories or should I compromise with some porridge. I just don’t know. But what I do know is that I like my wife offering to make breakfast for me – even if I don’t actually need any breakfast. It is a fairly safe bet that she would like it if I were offer to make breakfast for her. In part I know this because I know myself.

We do know our basic needs - for food for love – and because we know this we can respond to one another’s needs. We can love our neighbours as ourselves. Love seems to me – at heart – about responding to one another’s needs. Paul says as much when he talks in this passage about how members of the Roman church should behave towards one another e.g. verse 10 suggests that they ‘should outdo one another in showing honor’. This is because Paul knows that in Roman society ‘honor’ is a big deal. Romans got stressed if they felt that people were dishonouring them or their family. Their need for honor was great. To respond to this need was to ‘love one another with brotherly affection.’

But beyond our general needs we may not know our specific needs. It is – I admit – conceivable that someone else – someone who really knows and loves me – my wife perhaps – might know – better than I know myself – what I should have for breakfast. We do not know our specific needs because we are not honest with ourselves about our strengths and weaknesses.

Paul tells the Roman Christians ‘I bid everyone one of you not think of himself more highly than he ought to think, but to think with sober judgement, each according to the measure of faith which God has assigned him.’ But my problem is not I think – thinking more highly of myself than I ought – though perhaps I am a bit guilty of that – but of thinking of myself with sober judgement and coming to a conclusion about who I am. I do not think I could –very easily - do what Albert Friedlander did as a child: enumerate my talents and gifts – my strengths in other words.

The flip side of recognising one’s strengths is to recognise one’s weaknesses. I certainly cannot easily enumerate my weaknesses. This is even harder than enumerating my strengths. But I do think the attempt is worthwhile. We do this in general terms in most of our acts of worship and we will shortly say a prayer of confession today. But although it is relatively easy I think to acknowledge that, we – in general - commit ‘manifold sins and wickednesses…by thought, word and deed’ it is much harder to admit what these are in detail even to ourselves and certainly to others.

But confessing our sins and weaknesses is not the subject of this sermon: it is identifying our strengths. This is surely the part of ourselves which we present to God at the end of our service, in the prayer of oblation, when we offer ‘ourselves, our sours and bodies, to be a reasonable, holy and lively sacrifice’. After all we can hardly offer our manifold sins and wickednesses to be such a sacrifice can we?

Note that Paul starts this section of his letter on gifts and Christian living with the words ‘I beseech you therefore, brethren, by the mercies of God, that ye present you bodies a living sacrifice, holy, acceptable unto God, which is your reasonable service’. The words are obviously the origin of the prayer.

So how are we to identify our strengths? I think that what Paul suggests rather helpfully here in Romans is that we can begin to identify our gifts in the context of our relationships with others. Here he talks about this context as the ‘body of Christ’.

He’s just been talking about presenting our individual bodies as a living sacrifice. Here is another sort of body – a corporate rather than an individual body - and it is only within this body – the body of Christ -that presenting our individual body makes sense. He urges his readers ‘Having gifts that differ according to the grace given to us let us use them’ –try them out – in the context of - and for the benefit of - that corporate body to which we belong.

So if we are a prophet we must prophecy, if we are good at serving people we must serve, if we are a teacher we must teach, if we are a car mechanic we must mend cars, only then will the body that we are all part of function properly. Note too that Paul talks about gifts –here at least- as mainly things we do rather than things we are but I think we can see gifts as both character traits and skills.

What is this body of Christ of which we are members and hence ‘individually members one of another’? Those who heard Paul’s letter for the first time would have been wrong to assume that it meant just their little church. It meant at least all the Christians in Roman and beyond.

It seems to me significant that Paul – in this passage – moves seamlessly on from his exhortations to use our gifts to further exhortations about how we are to use these gifts i.e. in a loving fashion. It is no good being good at giving aid to others if we don’t do this with zeal and it’s no good if we have a talent for mercy but aren’t cheerful about it.

This discernment – and more importantly - use of our gifts are primarily acts of love: a response to others needs. Do we first need to love ourselves before we can love one another, as the order of Karen Armstrong’s Twelve Steps to a Compassionate Live would seem to suggest and indeed the commandment to ‘Love our neighbours as ourselves’ implies? Perhaps not: if discernment of our gifts is in the using of them in the service of others.

So loving ourselves is hard. Even knowing ourselves, what we truly need and who we are, including our good qualities, is difficult. Perhaps self-knowledge is not absolutely essential for if we are to love ourselves. We are commanded to love ourselves but only in the context of loving others and not for its own sake.

Why I am no longer a Minister in Secular Employment

This is an edited version of a talk I gave to Churches Together in Earley and East Reading on the 13th October 2011. It is also incorporates material from a farewell editorial I wrote for the journal Ministers-at-Work which can be found here.


First a brief word about who I am. I am Mike Rayner, Director of the British Heart Foundation Health Promotion Research Group at the University of Oxford and have been so for over 15 years. I am also an ordained priest in the Church of England and Assistant Curate at St Matthew’s Church, Oxford. I have been a member of the congregation of St Matthew's for over 30 years but the Assistant Curate for only four. I’ll be telling you more about myself over the course of this talk.

In this talk I will suggest that all Christians have a ministry where they work. And we all work – whether we think it or not – and whether we are paid to do so or not. So in that sense we are all ministers at work. But I also want to suggest that some people should be recognised by the Church as having a special ministry where they work – even if that work is not paid by the Church. They should be ordained in other words.

Then having convinced you of that I want to go one step further and suggest that ministry is something we can do when we are not working - for the Church or anyone else. I want to suggest that all of us are 'called' - to have a vocation - to be ministers in all of our lives – both working and non-working. I want to suggest that this should be called Whole Life Ministry - WLM for short. I will also suggest some people should be ordained to be WLMs and I will also try and explain my reasons for this.

But before I really get going I want to talk briefly about four descriptions (used in the Church of England) for ministers who have a ministry, at least in part, outside of the parish in which they live. These terms are Non-Stipendiary Minister (NSM), Self-Supporting Minister (SSM), Minister in Secular Employment (MSE) and Worker Priest.

So first we have that absolutely horrible description ‘Non-Stipendiary Ministry’. This is a horrible term because who want to be defined by what they are not. It implies that non-stipendiary ministers are somehow deficient relative to stipendiary minsters: that they don’t have a stipend and are therefore second class.

Slightly preferable to my mind is ‘Self-Supporting Ministry’: which is coming to replace the term Non-Stipendiary Ministry. But even this term isn’t particularly helpful. What on earth is self-supporting? I am not self-supported and I wonder how many people are. I am supported by the University of Oxford who pay my salary. Self-Supporting Ministry also implies that that person’s ministry is done in their unpaid time – as voluntary work presumably. But I for one see my ministry as being done just as much during the time I am paid to work as in the rest of my time.

The description of my ministry that I have preferred until recently is ‘Ministry in Secular Employment’. I am currently on the ‘management’ committee of an organisation called CHRISM – Christians in Secular Ministry. In fact, until recently, I have been the Editor of its Journal called Minsters-at-Work.

CHRISM - according to its website is the - national association ‘for all Christians who see their secular employment as their primary Christian ministry and for those who support that vision. CHRISM has around 200 members, an Annual Meeting, a journal, tries to set up local branches, etc. Its members are therefore generally NSM/SSMs who see themselves as MSEs. Most members are ordained but not all by any means.

Now I have increasing come to dislike this term MSE. This is primarily because I do not see my employment as secular. To me it is sacred. I have always thought of myself as having a vocation to the work I do. Whether I have always responded in the way God would have had me respond in response to his call I cannot be sure but I hope that I have tried to listen to what he was calling me to do. So a brief description of that aspect of my calling: to paid employment.

I’m not going to run through my cv but at the moment I work full time for the University of Oxford in the Department of Public Health. I am the director of a research group there. The funding for my salary comes from the British Heart Foundation and the research we carry out is into issues such as food labelling, food advertising to children, food taxes, etc.

We aim to do research which has an impact on Government policy – in that we are quite unusual for a university-based research group – but we have had some success in this regard. For example some people credit us with inventing traffic-light labelling for foods and we played a part in writing the current legislation around the tv advertising of junk foods to children. In all of this I see a sacred dimension.

My job for me is part of my ministry. What I do day-to-day – manage staff, write papers, apply for grants, go to meetings etc – I try to do for the glory of God, to help build the Kingdom of God, or however you like to put it. To this extent I am still a Minister Who is Employed by a Not-Overtly-Religious Organisation - the University of Oxford!

But before I explain more about how I see my current ministry and this thing I want to call Whole Life Ministry I want to deal with that fourth term ‘Worker Priest’. This term isn’t generally used in this country. I quite like it but most others don’t. It’s not considered appropriate for a variety of reasons. Firstly some (many?) of us - like me – who feel we have a ministry at work are not exactly workers but managers. ‘Manager Priest’ would be a better description for me rather than ‘Worker Priest’.

A second reason for avoiding the term – not a particularly good reason – is that the term ‘Worker Priest’ is associated with an initiative of the Roman Catholic Church in France, in the 1940s, to pay priests to be based as workers in factories and such like rather than in parishes. However many of these worker priests then got involved with the Trades Unions and were quickly called back to parishes by the Pope who effectively suppressed the movement in the 1950s. So ‘Worker Priest’ is distinctly non-Anglican and has a ‘pinkish tinge’ to boot.

Thirdly of course – whereas NSM, SSM, MSE can be applied to someone who is not ordained and if ordained either a deacon or a priest – the description Worker Priest can only reasonably be applied to someone who is ordained to the priesthood.

I am not going to apologise for spending so much time on words because words are important as John clearly thinks when he begins his gospel with the words ‘In the beginning was the word’. But now I want to try and explain more about how I currently see my ministry. I’ll start by explaining why I am ordained.

Now it is relatively easy to see why someone who has a ministry in the parish in which they live – whether they be stipendiary or non-stipendiary (or self-supporting) should be ordained. But why should some who sees their secular employment as their primary Christian ministry, as CHRISM members and I used to do, be ordained? This is always a difficult question. I guess my answer is: why not?

My own history here might be useful. Whilst I always felt I was called to the work I was doing I also from my late teens felt a calling to the priesthood which I tried to explain to various people at various times. Eventually in my late forties I found some people who thought I had such a vocation too and one of them – a bishop – ordained me (over four years ago now).

I have never, or hardly ever, seen my calling to be a paid employee of the Church of England and also I have never, or hardly ever, felt a calling to be in charge of a parish church. But does an ordained priest remain a priest does when he/she goes off to work for a Not-Overtly-Religious Organisation? Yes of course they do. But do they have a priestly role when they are working for that organisation. This is more difficult. I personally don’t have (much of) a sacramental ministry at work. For example I have never baptised a work-colleague’s baby nor have I celebrated the Eucharist at work. The first has never presented itself as an opportunity. I have never particularly felt the need for the second but I wouldn’t rule either out. I think my priestly ministry at work is primarily through blessing – but I would be hard pushed to explain this adequately.

But back to my ministry at work as opposed to my priesthood at work. One thing to say about this is that some like me see their actual work as their ministry. Others see their work as merely the vehicle for their ministry: the work place as just another possible setting for their ministry.

For people who see merely their work place as a setting for their ministry then various options are open. But here there is, perhaps, a temptation to replicate the things that you might conventionally see or do as ministry where you live in the place where you work. Classically people for example have sought to find and meet together with other Christians at work. Workplace Christian Unions are one expression of this. Taking this further Workplace Alpha courses have been run apparently successfully in some places. I’ve experimented with this sort of thing by, for example, running a series of meditation sessions at my work-place. I wouldn’t recommend this. It didn’t really work for me and the sessions were quite a lot of work for little – in my view –reward (though I am not sure all those who attended would agree.)

Of course preaching the gospel doesn’t need words as St Francis reminds us. Workplace ministry is as much about being as talking. And for me it is not just about whether or not you steal the odd paper-clips from your employer. I confess I do. It’s clearly much more than that. For one it’s much more about how I interact with my boss, those who work for me, my work-colleagues, my competitors at other universities, the civil servants and politicians I lobby, etc. etc. Actually everyone who works has these types of relationships.

At St Matthew’s we – at one point – set up a ‘Faith-at-work’ group – which attracted a lot of people for a while. And this is something I would recommend trying out, if you have a big enough congregation, and a few people who are prepared to set up such a group. One of the successful things our faith at work group did was spend a morning discussing relationships at work and how we could bring our faith to bear on sorting these out.

But for me – as I said earlier - it also matters what I do at work, not just how I do it. This is the famous question addressed by Luther who claimed that there is nothing un-Christian about being a hang-man if you hang people to the glory of God. In CHRISM meetings we argue quite a lot about whether some or indeed any jobs are incompatible with being a minister (ordained or otherwise). Prostitution at least seems to be ruled out by most people, hanging people, not by all.

But to finish I wanted to elaborate upon this idea that for all of us our ministry is surely not just done in one place or is neatly delineated from the rest our life. Over the past few years I have come to see my ministry as being in and through the whole of my life and not just or even mainly in or through my employment. And this is why I would no longer wish to call myself a Minister in Secular Employment and prefer to call myself a Whole Life Minister – not a particularly felicitous term but I can’t think of anything better.

In his important book, the ‘Stature of Waiting, W H Vanstone points out that for most of our lives we do no work: we receive rather than give, we wait. He notes that Jesus’ life can be divided into two halves: his active ministry and his passive ministry if you like where the turning point is the Garden of Gethsemane. Up to that point Jesus has been doing and acting. Rather breathlessly if you read Mark’s account. Then after the Garden of Gethsemane he is done to. Arrested, tried, tortured, killed. His passion is non-active. It is the paradigm for the waiting we must all do –particularly, but not exclusively, at the beginning at ends of our lives. Are we a lesser human being when we wait rather than do? Did Jesus not have a ministry while he was being arrested, tried, tortured, killed, done to? Of course he did. Reflecting on waiting is one reason why I think why we don’t just have a ministry while we are rushing about, at work, if you like, but also when we are just being.

Moreover I am not quite sure why I have to see my ministry as primarily in any particular activity or even non-activity. But if pressed to do so I would say that at this particular stage of my life my primary ministry is, for the moment at least, ‘in’ and through food and art! By primary I mean the aspect of my ministry I feel most passionate about.

Are food and art anything to do with my paid employment? Well the food is but the art isn’t.

As I said earlier food, or at least research into food, is what I am paid to ‘do’. And this has led to a developing interest in the connection between food and faith and giving sermons and talks and even organising a conference, on this issue. I have also begun to lead meditations around eating and making food. My latest experiment has been in running contemplative bread making sessions which seem to work quite well.

I find it interesting – but perhaps not surprising – that this ministry through food (sermons, contemplative bread making sessions) takes place not at my workplace (the University) but in churches or church halls but it clearly has a connection with my paid work.

And art? What is this about a ministry through art? Is that Ministry at Work No I am not employed as an artist. I have an amateur interest in art that’s ‘all’. I have always enjoyed going to art exhibitions but I cannot say art has been a particularly big thing in my life. Rather strangely (at least to me) I have found that I have developed an embryonic ministry ‘in’ art though a developing passion for giving ‘art sermons’. You can find further details elsewhere.

In some ways I have given up trying to define my ministry. I don’t want to be labelled. In particular I do not want to be labelled NSM/SSM or MSE. If you must, call me a WLM. Of course everyone of us has to work out for ourselves – in discussion with God - what shape our Whole Life Ministry should take but for me it has been though trying to make connections between my faith and the rest of my life – be it my paid employment, a rather undeveloped hobby, my relationships. It seems easier – more fruitful that way.

The questions remains: why does a WLM need to be ordained? The answer seems to be in reversing the question. Shouldn’t everyone who is ordained be a WLM? The answer to that question in clearly yes. There is no ‘time-off’ from ministry for anyone ordained or not. I suppose there is then the question of why anyone should or needs to be ordained at all. But that’s for another day.

I am bad at summarising but here are some take home messages. We all have a ministry. A ministry of all believers if you like. Some of us are lucky enough to be paid for it. Those who are paid by the Church have the roughest deal I feel. All of us work – at least for part of our lives - and for all of us our work is part of our ministry – an important part but not the only part. We all have to work out our ministry in fear and trembling.

Updated on the 9th June 2012

A note added on 3rd March 2018: 

This is where I originally had after the words: 'In all of this I see a sacred dimension,' the words: 'You may not believe that I have heard God aright but I think God is calling me to work towards the introduction of soft-drink taxes in this country'.  I removed these words from this 'blog' - not because I was embarrassed by them, or because I didn't believe them anymore - but because they were being used by the food industry and others e.g. here in their opposition to the sugary drinks industry tax (now to be introduced later this month).   

New Year resolutions: a type of prayer?

Sermon on Mark 1: 9-20 and Galatians 4: 4-7, St Matthew’s, Oxford, 1 January 2012




The theme today is ‘New beginnings’. It won’t have escaped your notice that this is New Year’s Day but you might not remember that is it at this time of the Church Year we celebrate the Baptism of Jesus. Now New Year is a time when traditionally we review our life and make New Year resolutions. And of course Jesus’ Baptism comes at the start of his ministry and so marks the beginning of a new phase in his life just as, in a minor way, the New Year represents a new beginning in ours.

In my sermon I want to give you some advice on New Year’s resolutions based on Mark’s account of the start of Jesus’ ministry that we heard for our Gospel reading just now. This is perhaps rather ambitious Even more ambitiously I want to link today’s Epistle reading from Paul’s letter to the Galatians to the theme of ‘New Beginnings’. I suspect that you might have forgotten what that said by now as it doesn’t make much sense out of context but it contains an important idea within it which related to our theme.

But first: New Year’s resolutions. Now New Year’s Day has not traditionally been regarded as a Christian festival but perhaps it is becoming so. Like those other previously secular festivals: Harvest Festival, Mother’s Day, etc. the Church should perhaps more enthusiatically embrace New Year’s Day as one of its own special days.

Of course New Year’s Day doesn’t come at the beginning of the Church’s Year which starts four Sundays before Christmas at the beginning of Advent but it does come just after Christmas and the celebration of Jesus’ birth. And a birth surely constitutes a fairly important beginning so January 1st feels like the beginning of the year and certainly more so than the end of November/early December.

New Years’ Day is also associated with those resolutions. You might not be planning on making any this year but what I have to say may still be relevant to you. After all reflecting on our lives and making changes in the light of those reflections is something Christians are enjoined to do. Paul’s letters are full of injunctions to the early Christians to think about what they have been doing and then move on, to mature, to be more-Christ-like.

Reflecting on our lives and making changes in the light of those reflections is surely also the essence of repentance: something Christians have traditionally done most of in Advent and Lent – in the preparation for the major festivals of Christmas and Easter, but there is no reason why we shouldn’t do it at the start of the year. The time between Christmas and New Year is a quiet time for many of us – and a much quieter, less busy time than say Advent. And we need a period of quiet in order to make sensible resolutions.

Now I think it is easy to sneer at New Year resolutions. Certainly other peoples’ resolutions are faintly comic. Here are the resolutions of someone called Bridget Jones for 1996:

Stop smoking

Stop drinking

Find inner poise

Go to the Gym three times a week

Don’t flirt with boss

Reduce thighs

Learn to love thighs

Forget about thighs

Stop making lists


Of course Bridget Jones wasn’t a real person but, according to Wikipedia, these resolutions aren’t very different to the most commonly made New Year’s resolutions. But I should say that the Wikipedia page on New Year’s resolutions looks distinctly dodgy and really the only useful thing it indicates is that there is a lack of reliable research on the subject. And this, I think, is because people are reluctant to talk very much about them or if they do only in a jokey sort of way.

One reason why we find Bridget Jones’s resolutions funny is because they resonate with our own desires. Don’t we all want to give up our addictions, life healthier less stressful lives, stop doing those things that – like Paul we do but do not want to do - find more inner poise? OK we may not be so obsessed by our thighs as Bridget but there is no doubt something else about our character which we earnestly desire to change. And there may be nothing wrong with these desires. Part of following Christ is wanting to be a better person.

We don’t generally express these desires – particularly not in public – and only reluctantly to people we trust because they are in part an acknowledgement of what we see as our personal imperfections, what we feel ashamed about in ourselves.

So perhaps we treat New Year’s resolutions too lightly. Perhaps they reflect what the Bible consistently teaches and what we know in our hearts that not all is right in our lives. And perhaps they stem from a deep-seated desire that things might be different.

The other thing that makes New Year resolutions a delicate and difficult subject is that we all know they are extremely difficult to keep. I have tried recently to see if I can find any evidence that people are more likely to give up smoking in January than in any other month of the year: evidence of a sort that at least one common type of New Year’s resolution works – but I cannot find any such evidence At the end of the year Bridget Jones writes in her diary: ‘Number of New Year’s resolutions kept 1. An excellent year’s progress.’

Moving swiftly from the start of the year 1996 for 30s something Bridget Jones’s to Mark’s description of the start of the new ministry for 30s something Jesus. There are quite a lot of contrasts as you might imagine.

A thing to note about Mark’s account: Mark - in his usual rather breathless style - actually describes four beginnings to Jesus’ ministry: First Jesus’ Baptism; secondly an extremely brief description – much shorter than in Matthew and Luke - of Jesus’ temptations by the Devil in the wilderness. This is such a brief a mention you might have missed it. Thirdly a short description of what Jesus first began to preach about at the start of his ministry - again much shorter than Matthew’s and Luke’s accounts. And finally Jesus’ calling of his first four disciples: Peter and Andrew, James and John

In other words Jesus doesn’t just resolve to change his life at some random point in his early 30s. He first marks the occasion with a baptismal ceremony, secondly he goes off by himself into the wilderness to contemplate his future, thirdly he connects his plans with what has gone before – what the prophets had foretold and what John the Baptist had recently been saying- and finally knowing that he cannot do all that he wants to do himself, co-opts some friends to help him.

So my advice about life changing resolutions based on this.

1. Make them on a special occasion. New Year’s Day may be such a day. It might also be appropriate to announce them – as Jesus did to the world when he allowed himself to be baptised by his cousin John.

2. Think about them before you make them. Go alone into the wilderness – like Jesus did – or at least to a quiet place where you can reflect on what you are going to resolve. But there you will encounter wild animals and angels – as Jesus did according to Mark. Of course wild animals is a metaphor for difficulties and angels a metaphor for assistance from God.

3. Don’t think you can just forget about the past – the past is what makes you what you are now. Jesus ministry only makes sense in the context of what his fore-runners, Moses, Elijah, Isaiah, John the Baptist had learnt from God. It was they who prepared the way for him. Similarly our resolutions have to make sense in the context of what has gone before.

4. Co-opt others to help you.

This all sounds like something you could find in many a self-help manual written by one of those TV psychologists but we know that making life-changing resolutions is not as simple as that. In particular we know –from experience that they are almost impossible to keep. The important word here is almost.

They are almost impossible to keep because of something called by psychologists, attitudinal ambivalence. When this is in operation – and it’s something which is much more common than we like to believe - we desire to behave in a different way to the way we usually behave but, for a variety of reasons, we are unable to make this change.

We might wish to be thinner but when confronted with that second mince pie we are unable to resist it. We know we should spend more time with our children but when asked by a work colleague to take on that extra piece of work we find it difficult to say no. Paul talks about this in his letter to the Romans where he explains: ‘I do not understand my own actions for I do not do what I want, but I do the very thing I hate‘ [7: 15].

And this is where our Epistle reading from Paul’s letter to the Galatians comes in and that important idea that it contains which bears upon our theme. This comes in Chapter 4 Verse 6 which says, ‘And because you are sons God sent the spirit of his son into our hearts, the spirit who calls out Abba, Father.’ This seems to me a completely remarkable verse with a completely remarkable idea. It has its parallel in Paul’s letter to the Romans. There he says: ‘When we cry Abba, Father it is the Spirit bearing witness with our spirits that we are children of God, and if children, then heirs of God and joint heirs with Christ.’ [8: 15-17]

Here Paul is developing one of his themes that somehow we Christians live in God and he in us. Jesus talks about this himself in his last words to the disciples where he prays: ‘The glory that thou hast given me I have given them, that they may become perfectly one even as we are one, I in them and thou in me.’ [John 17: 21-22] This mutual indwelling of Christ in us and us in Christ has an important ramification when it comes to prayer as Paul points out in Galatians 4:6 and Romans 8: 15. That is that when we say Abba, Father it is not we who are praying but God within us.

I recently gave a sermon here at an 8 o’clock communion service where I tackled the question of whether God could or would grant a prayer for fine weather at a church fete. I then posted this sermon on my blog and a friend of mine commented on it. He pointed out that I’d forgotten that true prayer is where God prays in us. And if this is the case the question of whether God can or cannot answer certain prayers becomes irrelevant.

Bridget Jones’ New Year resolutions read like a prayer. Here they are the first five again with ‘Let me’ before each one

Let me stop smoking

Let me stop drinking

Let me find inner poise

Let me go to the Gym three times a week

Let me not flirt with the boss


Aren’t all our life-changing resolutions really a prayer? Bridget Jones seems to direct this prayer at herself. So isn’t she bound to fail? What if she directed her requests at God rather than herself? Would she then see a transformation in her life? She too – as I did before my friend reminded me - might need reminding that prayers only work if it’s the Spirit of God who is making them.

Sermons are supposed to end with something to take away that we can apply. In this sermon I gave you the application in the middle where – to recap – I suggested we could look at how Jesus started his ministry and do what he did at the start of new phases in our life, such as the start of a new year. In brief I suggested you should (and not necessarily in this order): 1. Celebrate the occasion. 2. Go alone into the wilderness to plan any change. 3 Don’t forget about the past. 4. Co-opt others to help you.

But my more important message is that none of this is going to be any good without the Spirit of God within us.