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The contrast between the papacies of Pope Francis and Pope Benedict has echoes of one of the great theological debates of the past century, between the German Jesuit Karl Rahner and the Swiss Jesuit – until he left the Society of Jesus in 1950 – Hans Urs von Balthasar. The issues are still at the heart of modern Catholicism, as it strives to read the signs of the times.

In one of the defining scenes of the Oscar-nominated film The Two Popes, Ratzinger and Bergoglio (to give them their original surnames) discuss how humanity encounters the divine. In an exchange that theologians who know them both have described as realistic, the actor playing Ratzinger (Anthony Hopkins) declares: “God does not change.” Bergoglio (Jonathan Pryce) counters: “Yes he does, he moves towards us.” Ratzinger quotes John 14:6, “I am the way, the truth, and the life” and asks, “Where should we find him if he is always moving?” Bergoglio: “On the journey?” Ratzinger: “Oh … This is your ego talking. You think you know better.” That last line does not do justice to the real Ratzinger’s gentleness and courtesy, but probably captures what he is thinking.

Ratzinger, whom some regard as formidable a theologian as Rahner and Balthasar, held fast to the position that the Church stood outside history, judging the world by the Gospel and by its inheritance of doctrinal truth. Balthasar would have agreed. Rahner saw the grace of God already at work in the world, and the Holy Spirit flowing freely among every generation of humankind – “God moving towards us”. It is on that basis that he invented the concept – which he is later said to have somewhat regretted – of the “anonymous Christian”. This is the unbaptised person of goodwill who is open to the transcendent, and whose good deeds flow from the grace of God though he or she does not (yet) know it.

Balthasar was scathing about the anonymous Christian idea, because it painted fallen humanity in too rosy a colour. Rowan Williams discusses the Rahner-Balthasar dispute in an essay originally published in 1982 and reproduced in Wrestling with Angels; he shares Balthasar’s misgivings. “For Balthasar,” Williams writes, “dialogue with the world is so much more complex a matter than it sometimes seems to be for Rahner; because the world is not a world of well-meaning agnostics but of totalitarian nightmares, of nuclear arsenals, labour camps and torture chambers ... Balthasar’s harsh clearsightedness is an important disturbance of any assumptions about easy humanist convergences in our world.”

These nightmares and torture chambers stand as a corrective nuance to the optimism of the opening words of Vatican II’’s Gaudium et spes: “The joys and the hopes, the griefs and the anxieties of the men of this age, especially those who are poor or in any way afflicted, these are the joys and hopes, the griefs and anxieties of the followers of Christ.” Up to a point, Lord Copper. Some of the “men of this age” are instruments of evil, and their anxieties diabolical. And that is why the Rahner/Balthasar debate, the dialogue between Benedict and Francis, is something the Church needs constantly to ponder – without one side demonising the other. For they were both right. Humankind is simultaneously both redeemed and fallen.



If the National Health Service had a motto, it could well be semper reformanda. Politicians are endlessly calling for reforms and announcing their delivery. This very week, as emergency calls to the ambulance service take longer than ever to respond to, and long queues of ambulances stand outside hospitals, the newly established network of Integrated Care Boards breaks surface across England with the publication online of “organograms”. In the House of Commons this week, the Health Secretary hailed this as heralding a solution to the crisis.

Yet “integration” is the very opposite of what is happening. Hospitals are unable to cope with the demand for beds for sick patients, because they have too many patients waiting for discharge who no longer need treatment but still need care. Many of them need places in residential care homes.

They will have to wade through a bureaucratic swamp to get there. Residential homes are short of staff, money and beds, and they are not integrated into anything. They are independent, uncoordinated and unsubsidised. A few are run by charities or non-profit enterprises; the rest exist to provide a return for their investors. Local authorities pay fees for those residents who qualify, at rates far below cost, so other residents, so-called self-funders, are charged more to provide an unofficial cross-subsidy. The government’s squeezing of local government funding in the name of austerity – and of “shrinking the state” – has forced local authorities in turn to squeeze the privately-owned residential care sector.

This is private sector anarchy, with no strategy or policy behind it except to let market forces match supply with demand, which they manifestly fail to do. Indeed, the latest government initiative to try to relieve the pressure on the NHS is a tacit admission of this failure. Hospital trusts are to be encouraged to block-buy beds in residential homes that have vacancies – which very few do – failing which they can discharge patients into hotels.

Yet residential home managements accept no responsibility whatever for ambulance queues outside A&E departments, and why should they? The duties they recognise are to their existing residents, their staff and their owners. Pay rates are low; there are about 150,000 vacancies in the sector. The residential care sector has “market failure” written all over it.

If hospital trusts are forced to block-buy beds in private residential homes, it would be logical, and foster the elusive goal of “integration”, to let them own the homes outright. And where necessary build new ones. The old Thatcherite mantra “private good, public bad” has surely long passed its sell-by date. Ambulance queues are the clincher. Has either the government or the opposition the foresight and the courage to say so?

2 | THE TABLET | 14 JANUARY 2023

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