Beyond wealth and wellbeing: how nations flourish

As GDP data is increasingly scrutinised, Ryan Gilfeather asks how to measure the true health and wealth of a nation.

Ryan Gilfeather

Ryan Gilfeather explores social issues through the lens of philosophy, theology, and history. He is a Research Associate at the Joseph Centre for Dignified Work.

Two women sit behind a press conference desk against a backdrop, one listens as the other speaks and gestures.

A recent International Monetary Fund press conference on the world economic outlook.

IMF.

Discussions of GDP loom large in our current age. As we live under the shadow of the threat of a recession in the UK, ministers and commentators anxiously follow our country’s Gross Domestic Product, to see whether we are on the right track. Measuring the total value of goods and services produced in a country, this figure is a litmus test for the health of an economy. Crucially, many policymakers and leaders in government believe this figure reveals the health of a nation.

As we will see, not all agree. Opponents rightly highlight that an increase in GDP does not necessarily mean that ordinary citizens live better lives. There are good reasons to share this opposition from a Christian perspective. However, ultimately, the Christian tradition highlights a very different way to measure the health of a society.

In 2020 The Carnegie UK Trust, a think tank campaigning for greater welfare for all, published a new measure for social progress: GDWe (Gross Domestic Wellbeing). In brief, they gathered and processed ONS (Office for National Statistics) data on a variety of domains in life, giving them a single figure on a 10-point scale to rate well-being. These domains included personal well-being, relationships, health, vocational activities, living environments, personal finances, the economy, education and skills, governance, and the environment. When they plotted GDP against GDWe from 2013-9, they revealed that the two do not always line up. As GDP steadily increased from 2016, overall welfare in society dipped. From 2013-9 GDP increased by 10.34 per cent and GDWe only 5.19 per cent. Hence, measuring GDP does not necessarily reveal whether life is getting better for ordinary.

Economic resources are not useless... However, they are not sufficient unto themselves for us to live full and good lives.

This attempt to shift the conversation about social progress from predominantly centring GDP is commendable. The Bible does not legislate on whether to use GDP or GDWe. However, scriptures within it repeatedly decouple economic wealth from flourishing. For example, in the gospel of Matthew, Jesus says the following:

Do not store up for yourselves treasures on earth, where moth and rust consume and where thieves break in and steal, but store up for yourselves treasures in heaven, where neither moth nor rust consumes and where thieves do not break in and steal. For where your treasure is, there your heart will be also.

In life, we can either focus our efforts on attaining wealth or fostering our relationship with God. Only the latter will lead us to flourish. Economic resources are not useless; they are necessary for us to thrive in certain conditions. However, they are not sufficient unto themselves for us to live full and good lives. Furthermore, when wealth becomes the focus of our hearts and minds, our lives will be hollow and fractured. GDWe is a good measure, insofar as it acknowledges that economic flourishing is not the same as a good quality of life, and it attempts to shed light on the latter. However, the Christian tradition highlights a different framework altogether to grasp the health of a society.

Gregory of Nyssa, a fourth-century theologian and bishop, frames wellbeing as a human being reflecting the image of God to the greatest of their ability. The book of Genesis says that God made us all in His image. Gregory argues that this means that we can become like God in certain ways. God is the fullness of all good things, such as love, justice, peace, joy, and courage. Consequently, Gregory argues that when we act in good ways, we begin to share those characteristics, which in turn leads us to act well in the future. For example, if I defend someone who is under attack, I will become more courageous, and more likely to repeat the same action in the future. The more we reflect the image of God, by acting well and taking on His characteristics, the more we will flourish as individuals. In this vision of human flourishing, Gregory brings together an Aristotelian account of virtue, with a Christian understanding of people as the image of God.

This framework for the well-being of an individual also provides a good barometer for the health of a society. All of these actions and characteristics are building blocks for a healthy society. So long as we have a good sense of how to act appropriately with love, justice, peace, joy and courage, then our actions will build up our common life together. They benefit all, rather than one. They are not zero-sum actions. Accordingly, a society made up of individuals who are acting well and reflecting the image of God would be very healthy indeed.

As a measure of a society, we should ask whether it leads citizens away from virtuous actions and characteristics. For example, between 2019 and 2021, gun murders in the USA rose by 45%. Earlier this year, journalist John Burn-Murdoch argued this rise is partly due to decaying public trust in that country. This tells us that a culture marked by fear of others can lead some of its citizens to commit terrible actions and live lives full of violence. GDP may rise during this time, as may other markers of welfare. However, to see the whole picture we need also consider how societal forces are leading citizens away from flourishing in their reflection of the image of God. Then, we should go about addressing these malignant forces.

In times of adversity... individuals in societies marked by high levels of trust are more satisfied with their lives and act more benevolently.

At the same time, we should also consider how a society enables its citizens to reflect the image of God. Societies with high levels of social trust create space for a variety of positive actions and characteristics. The World Happiness Report studies people’s sense of life satisfaction worldwide. It routinely finds that in times of adversity, like the Great Recession in 2008 or the COVID pandemic, individuals in societies marked by high levels of trust are more satisfied with their lives and act more benevolently than others. Again, these social forces are not the same as GDP, yet they have a significant ability to shape the extent to which citizens can reflect the image of God, and thereby flourish.

In my work for the Joseph Centre for Dignified Work, I am particularly concerned with low-wage workers’ pay and conditions. As I have argued elsewhere, low pay leads to some workers needing to take on two or more jobs. They, consequently, have no time to see their children, nourish their faith, or participate in community institutions. It is clear, therefore, that the widespread pattern of paying below the Real Living Wage (£11.94 p/h in London, £10.90 elsewhere), hinders people in their expression of love for God, family and neighbour. Pay and conditions are but one further example, amongst many, of how societal forces can hinder or help our flourishing in the reflection of the image of God.

Needless to say, GDP and GDWe are still useful and necessary tools. However, they do not tell the full story. GDP only describes the progress of the economy as a whole, and GDWe can only describe the quality of an average person’s life. In contrast, when we set a goal that each citizen should reflect the image of God, we can begin to explore how societal forces enable or squeeze out this aim. With this greater knowledge in mind, we can strive for progress in our nation by fostering good structures and stamping out bad ones, so that all may reflect the image of God to the greatest of their ability.

Article

Care

Comment

Economics

Ethics

2 December 2024

4 min read

NHS: How far do we go to feed the sacred system?

Balancing safeguards and economic expediencies after the assisted dying vote.

Callum Elwood

Callum is a pastor, based on a barge, in London's Docklands.

A patient eye view of six surgeons looking down.

National Cancer Institute via Unsplash.

“Die cheaply, protect the NHS” It sounds extreme, but it could become an unspoken policy. With MPs voting on 29th November to advance the assisted dying bill, Britain stands at a crossroads. Framed as a compassionate choice for the terminally ill, the bill raises profound ethical, societal, and economic concerns. In a nation where the NHS holds near-sacred status, this legislation risks leading us to a grim reality: lives sacrificed to sustain an overstretched healthcare system.

The passage of this legislation demands vigilance. To avoid human lives being sacrificed at the altar of an insatiable healthcare system, we must confront the potential dangers of assisted dying becoming an economic expedient cloaked in compassion.

The NHS has been part of British identity since its founding, offering universal care, free at the point of use. To be clear, this is a good thing—extraordinary levels of medical care are accessible to all, regardless of income. When my wife needed medical intervention while in labour, the NHS ensured we were not left with an unpayable bill.

Yet the NHS is more than a healthcare system; it has become a cultural icon. During the COVID-19 pandemic, it was elevated to near-religious status with weekly clapping, rainbow posters, and public declarations of loyalty. To criticise or call for reform often invites accusations of cruelty or inhumanity. A 2020 Ipsos MORI poll found that 74 per cent of Britons cited the NHS as a source of pride, more than any other institution.

However, the NHS’s demands continue to grow: waiting lists stretch ever longer, staff are overworked and underpaid, and funding is perpetually under strain. Like any idol, it demands sacrifices to sustain its appetite. In this context, the introduction of assisted dying legislation raises troubling questions about how far society might go to feed this sacred system.

Supporters of the Assisted Dying Bill argue that it will remain limited to exceptional cases, governed by strict safeguards. However, international evidence suggests otherwise.

In Belgium, the number of euthanasia cases rose by 267 per cent in less than a decade, with 2,656 cases in 2019 compared to 954 in 2010. Increasingly, these cases involve patients with psychiatric disorders or non-terminal illnesses. Canada has seen similar trends since legalising medical assistance in dying (MAiD) in 2016. By 2021, over 10,000 people had opted for MAiD, with eligibility expanding to include individuals with disabilities, mental health conditions, and even financial hardships.

The argument for safeguards is hardly reassuring, history shows they are often eroded over time. In Belgium and Canada, assisted dying has evolved from a last resort for the terminally ill to an option offered to the vulnerable and struggling. This raises an urgent question: how do we ensure Britain doesn’t follow this trajectory?

The NHS is under immense strain. With limited resources and growing demand, the temptation to frame assisted dying as an economic solution is real. While supporters present the legislation as compassionate, the potential for financial incentives to influence its application cannot be ignored.

Healthcare systems exist to uphold human dignity, not reduce life to an economic equation.

Consider a scenario: you are diagnosed with a complex, long-term, ultimately terminal illness. Option one involves intricate surgery, a lengthy hospital stay, and gruelling physiotherapy. The risks are high, the recovery tough, life not significantly lengthened, and the costs significant. Opting for this could be perceived as selfish—haven’t you heard how overstretched the NHS is? Don’t you care about real emergencies? Option two offers a "dignified" exit: assisted dying. It spares NHS resources and relieves your family of the burden of prolonged care. What starts as a choice may soon feel like an obligation for the vulnerable, elderly, or disabled—those who might already feel they are a financial or emotional burden.

This economic argument is unspoken but undeniable. When a system is stretched to breaking point, compassion risks becoming a convenient cloak for expedience.

The Assisted Dying Bill marks a critical moment for Britain. If passed into law, as now seems inevitable, it could redefine not only how we view healthcare but how we value life itself. To prevent this legislation from becoming a slippery slope, we must remain vigilant against the erosion of safeguards and the pressure of economic incentives.

At the same time, we must reassess our relationship with the NHS. It must no longer occupy a place of unquestioning reverence. Instead, we should view it with a balance of admiration and accountability. Reforming the NHS isn’t about dismantling it but ensuring it serves its true purpose: to protect life, not demand it.

Healthcare systems exist to uphold human dignity, not reduce life to an economic equation. If we continue to treat the NHS as sacred, the costs—moral, spiritual, and human—will become unbearable.

This moment requires courage: the courage to confront economic realities without compromising our moral foundations. As a society, we must advocate for policies that prioritise care, defend the vulnerable, and resist the reduction of life to an equation. Sacrifices will always be necessary in a healthcare system, but they must be sacrifices of commitment to care, not lives surrendered to convenience.

The path forward demands thoughtful reform and a collective reimagining of our values. If we value dignity and compassion, we must ensure that they remain more than rhetoric—they must be the principles that guide our every decision.