THE NHS is spending millions of pounds a year on running chaplaincy services which offer spiritual care and religious support to patients.
Health boards collectively spend about £3.7m a year on the internal departments, including paying salaries of full-time "generic" NHS chaplains who are tasked with providing support to all who ask for it.
In addition, the NHS has made payments of almost £600,000 to churches to attend to the religious needs of individual patients in the past three years, figures obtained by The Herald under Freedom of Information laws revealed.
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More than 85% of spending on the external bodies went to the Roman Catholic Church, largely in exchange for priests to come in to hospitals and perform sacraments such as the last rites, which NHS chaplains are not able to carry out.
Scotland's largest health board, NHS Greater Glasgow and Clyde, said its in-house chaplaincy department was allocated a budget of £632,665 in 2013/14, with the service "providing non-denominational support to our 38,000 staff and all our patients".
It also pays £75,000 per year to the Archdiocese of Glasgow and the Diocese of Paisley in exchange for "on-call" priests, "to provide the Sacramental ministry that Roman Catholic patients and families expect".
It previously also paid money to the Church of Scotland and the Episcopal Church, before the arrangements ended after March 2012.
Spencer Fildes, chairman of the Scottish Secular Society, called for payments to external churches to be scrapped and for budgets for internal chaplaincy services to be re-examined urgently.
"We believe chaplaincy services are essential, but we don't support their funding by the NHS," he said. "The cost of £3.7m a year is quite astonishing, particularly when frontline services are being cut and there's a desperate need for more healthcare professionals across the country.
"I would urge the NHS to engage with religious bodies with a view to drastically reducing the cost or removing it completely from the budget. It's absurd that such money should be spent without evidence of benefit."
The Catholic Church said the payments it received, which were made to dioceses rather than individuals, were expenses for priests and the cash it was paid paled in comparison to the overall chaplaincy service budgets. However, Mr Fildes accused the Church of "draining the NHS of badly needed funds".
He said: "As the Church affirms that, for believers as a whole, such sacraments are necessary for salvation, surely the financial burden of performing such sacraments lie with the church itself."
Nine of Scotland's 14 health boards have made payments to churches since April 2011, while the remainder, including NHS Highland, which covers the largest geographical area of any of the organisations, paid nothing.
The spending on spiritual care follows updated guidance issued to health boards by the Scottish Government in 2009 which states that the NHS, rather than churches, had responsibility for providing a spiritual care service.
Previous guidelines, finalised in 2002, ordered health boards to set up spiritual care committees, appoint managers of the service and "spiritual caregivers".
While NHS spiritual care employees are expected to "deliver and facilitate spiritual and religious care as appropriate" across the board, faith specific chaplains are not generally direct NHS employees.
NHS Greater Glasgow and Clyde said the "vast majority of the work NHS chaplains do with patients, carers and staff is non-religious in nature", with chaplains mainly "attending to the spiritual and emotional needs of those on a journey of injury, illness or loss."
Other external religious organisations to receive payments from the NHS in recent years include the Episcopal Church, which received £43,000 from three health boards since 2011/12. NHS Tayside, which provided the number of pastoral calls made in exchange for £72,000, paid on average £6.31 for every call from a Catholic priest compared to £163.90 for every visit from a member of the Episcopal Church. NHS Tayside was the only health board to make a payment to a Buddhist religious organisation, paying £81.60 in return for 20 pastoral calls last autumn. NHS Lanarkshire, which paid £77,500 to the Diocese of Motherwell for a denominational chaplain at its three acute hospitals in the period, said the arrangement would be reviewed to "ensure equity".
Humanist Society Scotland chief executive Douglas McLellan said: "We do chaplaincy as part of our vocation and it's disappointing that others see it as a way of raising funds".
A spokesman for the Catholic Church in Scotland defended the organisation against claims it was exploiting the health service, saying it "does not charge the NHS anything" but that the health service "has always provided expenses for those religious bodies which have acted in a chaplaincy role in hospital".
In Lothian, he said, 50% of calls for spiritual care services come from Catholics but only 5% of the spiritual care budget was set aside for members of the religion.
The spokesman added: "The vast majority of spending on spiritual care in the NHS is not on reimbursing the expenses of visiting pastors, of the various denominations and religions, but on full time salaried spiritual care co-ordinators paid for by the NHS even though they cannot offer spiritual care to all patients as is evidenced by the calls which other clergy still respond to.
"The Church does not raise funds from the NHS. Priests freely respond to sick calls whenever they receive them, they are not paid for such services. The cost is a small part of the overall amount spent by the NHS on the provision of spiritual care."