Table of Contents
The Healthcare Mission of the Church
Catholic Healthcare: Bridging Quality and Accessibility at Scale
Centralisation does not mean taking over hospitals
Introduction
Last week’s post examined subsidiarity-integrated centralisation and Catholic education, arguing that, beyond canonical oversight, Catholic educational institutions need not be under a single administrative authority. Instead, selected resources, infrastructure, expertise and services can be aggregated across institutions to create a Catholic educational network, while preserving institutional autonomy.
Today’s post applies the same principle to Catholic healthcare, which is often primary and occasionally secondary. It focuses on how Catholic hospitals and healthcare centres can coordinate their resources to improve the quality, accessibility, and sustainability of Catholic healthcare while preserving the autonomy of individual health institutions.
Unlike Catholic schools, there is no codified definition of a Catholic hospital. However, in light of canon 803 §1 on Catholic schools, one can describe a Catholic hospital as a healthcare institution under the control of the competent ecclesiastical authority or a public ecclesiastical juridical person, or one that the ecclesiastical authority recognises as Catholic through a written document. This means that hospitals owned and operated by Catholics, even if they are priests or religious, which are not under the control of the competent ecclesiastical authority, are not Catholic hospitals.
The Healthcare Mission of the Church
Healthcare was an integral part of Jesus’ holistic mission of saving the body and soul (John 10:10). He healed the sick and also focused on preventive care, such as when he told his disciples to rest after completing a mission (Mark 6:30-31). In the early Church, the elders were invited to pray for the sick so that they might be healed (James 5:14-15).
Hence, the Church has always considered caring for the sick “an integral part of her mission,” consistently combining it with preaching the Gospel. Consequently, it has established many religious institutions aimed at “fostering, organising, improving, and increasing help to the sick” (Dolentium hominum, 1). On 13 May 1992, Pope John Paul II established the World Day for the Sick to be celebrated annually on 11 February, the memorial of Our Lady of Lourdes. The purpose of the day is
To raise awareness among the People of God and, consequently, the many Catholic health institutions and civil society itself, of the need to ensure the best care for the sick; to help those who are sick to valorise, on a human and above all on a supernatural level, suffering; to involve dioceses, Christian communities and religious families in a particular way in healthcare pastoral care; to encourage the increasingly valuable commitment of volunteering; to recall the importance of the spiritual and moral training of health workers and, finally, to better understand the importance of religious assistance to the sick by diocesan and regular priests, as well as by those who live and work alongside those who suffer (“Letter to Cardinal Fiorenzo Angelini, President of the Pontifical Council for Pastoral Care for Healthcare Professionals, for the Institution of the World Day of the Sick.” 13 May 1992).
Catholic Healthcare: Bridging Quality and Accessibility at Scale
Quality healthcare is very expensive. Yet one of the strengths of Catholic healthcare in Nigeria is serving communities that otherwise would not have access to quality healthcare.
Catholic hospitals and health centres often serve people not merely according to their ability to pay but in line with the Church’s mission. In collaboration with Catholic hospitals, several priests and religious organise annual free medical services for poorer communities and families, as well as providing overall subsidised healthcare. Some also organise privately. Some foreign charities also partner with Catholic hospitals to achieve this same purpose. This creates an asymmetric pastoral model in which the primary beneficiaries of healthcare are not necessarily the principal providers of the resources required to sustain it.
However, despite this success, there is still great room for improvement. One observes that some Catholic hospitals have modern equipment, sufficient personnel, and regular patient volumes, while others struggle to maintain basic infrastructure, procure medical supplies, or attract qualified healthcare professionals.
Reasons for these differences include geographical location, population, economic conditions, the institution’s age, security, the availability of healthcare professionals, and the types of healthcare services provided. Moreover, another important reason is that Catholic healthcare in Nigeria is currently fragmented, as Catholic hospitals and health centres operate largely as independent units.
In response, several dioceses are now training priests as medical doctors and pharmacists to ensure that diocesan hospitals are properly staffed and managed, and to reduce recurrent expenditure. This training is a form of anticipatory subsidisation of wages. Here, a diocese trains a priest to work in its hospitals at a lower wage, since he will receive a reduced salary and benefit from accommodation in the rectory.
Yet this solves only part of the problem: fragmentation is ultimately expensive and undermines overall improvement because, when institutions operate largely in isolation, they lose opportunities for coordination, shared resources, and institutional leverage. The effect is that a small diocesan hospital pays higher prices for medical supplies because it buys in smaller quantities, while a large diocesan hospital receives discounts because it buys in larger quantities. Aggregating their demands would have helped both hospitals negotiate better prices. Moreover, one hospital may have specialised equipment that is underutilised, while another hospital within the same diocese may lack access to such equipment. Furthermore, in a fragmented system, the diocese lacks data, which is indispensable in healthcare infrastructure.
This is where subsidiarity-integrated centralisation becomes relevant.
Centralisation does not mean taking over hospitals
The proposal for subsidiarity-integrated centralisation is not to place all Catholic healthcare institutions under a single administrative authority, as this would undermine the principle of subsidiarity. Moreover, such an arrangement is not opportune given the diversity of Catholic healthcare institutions, their different circumstances, and the authorities responsible for them.
Instead, the question is: what areas can Catholic healthcare institutions create value by aggregating their resources to promote pastoral fruitfulness?
In 1985, Pope John Paul II called for greater collaboration of all Catholic bodies engaged in health and healthcare, and consequently established the Pontifical Commission for the Pastoral Care of Health Care Workers, to serve as a coordinating body for all Catholic institutions, religious, and lay, involved in pastoral care of the sick (Dolentium Hominum, 4,6). In a speech to the International Federation of Catholic Hospitals the same year, he praised the collaboration and cooperation among Catholic healthcare institutions (“Address to Participants in the Congress of Catholic Hospitals,” 30 December 1985, n.1). With the apostolic letter, Humanam Progressionem, Pope Francis merged the pontifical commission with others to form the new Dicastery for Promoting Integral Human Development in 2016.
For instance, in a diocese, diocesan hospitals can pool procurement of medicines, medical and laboratory equipment, and other commonly used resources. Collective purchasing would help negotiate better prices without taking away decision-making from individual hospitals. The diocese could also negotiate common maintenance agreements for medical equipment, generators, information technology systems, and other infrastructure, thereby reducing recurrent expenditure.
Furthermore, subsidiarity-integrated centralisation can create value in expertise and in the use and management of consultants because a network of hospitals can collectively retain one consultant rather than an individual hospital. Moreover, a hospital network makes it easier to provide referrals and specialist services across the network.
The financial gains are reinvested to further improve hospital standards, retain qualified staff, and enhance overall healthcare. In addition, networking the hospitals makes it easier to integrate into national or private health insurance schemes for people within a diocese.
Data as Health Infrastructure
Data is an essential infrastructure for subsidiarity-integrated centralisation and indispensable to health management. Some central coordination helps with data management in hospitals. It makes it easier for the bishop to assess the capacity of the diocesan healthcare network, including the number of hospital beds and intensive care units, their locations, patient volumes, available specialists, diagnostic capabilities, equipment, staffing levels, and financial sustainability.
It also makes it easier for the bishop to evaluate whether the diocese needs a new hospital, whether to suppress or merge some existing health centres, or whether to expand them. Based on this data, it is easier to direct funds objectively to a particular hospital that serves a rural, poor community, even if the hospital is not financially sustainable given its income. Such hospitals still retain huge pastoral value. This data is necessary for engagement with government and private stakeholders, as well as potential supporters of healthcare in the diocese.
Centralised data also reveals patterns that individual institutions may not easily see, as it is easier to identify common illnesses or healthcare challenges in the area. Since 2020, priests of the Catholic Diocese of Okigwe, through a volunteer initiative, Priests Volunteer Health Group, Okigwe, have published an annual statistical report on the causes of death of Okigwe diocesan priests dating back to 1981, when the diocese was created. Through annual data collection and analysis, it tracks the illnesses that deceased priests in the diocese suffered from, the average age at death and the annual mortality rate, and integrates this with data from previous years, thereby producing a veritable report for health analysis for the healthcare of priests of the diocese. The report has been vital to health initiatives among priests of the diocese.
Change of Orientation
One of the advantages of subsidiarity-integrated centralisation is a change of orientation on how one thinks about ecclesial resources. Here, instead of viewing another Catholic hospital as a competitor, one sees it as a collaborator and enabler in advancing the Church’s healthcare mission.
Hence, the questions go beyond what a particular hospital has to what the Catholic or diocesan healthcare network has. Instead of asking what an individual hospital can achieve with its own resources, one focuses on what the Catholic healthcare network can achieve collectively. Here, healthcare becomes a continuous pastoral pathway to the Church’s salvific mission, since only the living can praise God (Isaiah 38:19).
Conclusion
The purpose of subsidiarity-integrated centralisation in Catholic healthcare is not to centralise healthcare administration. This contradicts the subsidiarity principle. Instead, the goal is to build a Catholic healthcare ecosystem in which, beyond canonical oversight, Catholic hospitals and health centres are not isolated units but are connected through data, expertise, procurement, and resources. This helps the Church to understand its healthcare capacity more accurately, identify gaps in healthcare provision, strengthen hospitals serving disadvantaged communities, and make better use of her resources.
May God continue to help us🙏🏾
K’ọdị🙋🏾♂️
