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6 min read

How to pick an economic approach that really adds up

Assessing doughnut economics, Paul Williams asks what’s the economy for and who does it really serve?

Paul Williams, the CEO of Bible Society, worked for over a decade in business in London and then as an academic theologian in Canada.

a round table with empty chairs is seen from above. An orange is the only item on it.
Meina Yin on Unsplash.

“Anyone can see that our economic system is broken.”

This is the conclusion of Kate Raworth, author of Doughnut Economics, and her assessment has garnered positive endorsements from figures as diverse as George Monbiot, Andrew Marr and Sir David Attenborough. 

Yet to judge by the discussion surrounding the Chancellor’s Autumn Statement, our political class is not included in this broad perspective that Raworth claims. In what is widely understood as the early skirmishes of an election campaign, anticipating the moment when the country’s voters have another opportunity to indicate the direction of travel they hope for, the focus is on who will be better or worse off by this or that tax cut or benefit change. If anything is broken it is not the economic system but something like ‘the government’s economic management’ (Labour) or ‘public sector productivity’ (Conservative).  

If you are worried, as Raworth is, by “relentless financial crises,” “extreme inequalities in wealth” and “remorseless pressure on the environment” then it seems that both the government and the opposition believe that the solution is more economic growth, albeit with some barely discernible differences in fiscal and regulatory policy. 

Our contemporary political discourse is dominated, regardless of party, by the mainstream economic paradigm in which the market generates economic growth and the state functions to keep things on track by taxing and redistributing some of the surplus to those who for whatever reason didn’t do as well as others in the process. It also provides some additional incentives to business and other organisations to act in the public interest, for instance by subsidising green energy or taxing fossil fuels. Both parties, it seems, support this approach. The difference between them concerns how best the state manages the economy to get the most out of it, how the resulting surplus is distributed, and what kind of further incentives are needed. 

Visualising doughnut economics

An economics diagram in the shape of a doughnut.
Source: Doughnut Economics Action Lab.

For Raworth, on the other hand, the first thing to ditch is the assumption that economic growth is the right goal to pursue. The ‘doughnut’ of doughnut economics is an alternative to GDP as a measure of progress. It name is derived from the visual depiction of the idea of an economy that operates in the space within two limits – ensuring the human rights of each person on the one hand, and staying within the means of the planet on the other. This concept refuses to conceptualise the economy as a closed system in distinction from the social and environmental systems on which it depends.  

Raworth also wants to shift the emphasis away from the individual rational chooser of economic theory toward a more social understanding of human flourishing. And in direct contrast to the mainstream paradigm sketched above, in which the market’s job is to deliver economic wealth and the state’s job is to worry about distribution and regulation, Raworth wants an economic system designed from the outset to ensure a more equal distribution and to actively regenerate the environment. 

The economic system itself is like an engine that can be put to whatever purpose you want. It generates wealth and wealth can be put to all kinds of uses, good or bad. 

How might we evaluate this? Nobody disagrees that financial crises, extreme inequality and environmental damage occur and are bad. A good number of mainstream economists find Raworth’s aims laudable and worth pursuing, because we do need a better measure of success and improved models of human behaviour and ways to incorporate and limit externalities like carbon emissions. Yet they also find her analysis of economics a caricature, as many of the developments in economics over the last few decades seem to be ignored. 

For her harshest critics, Raworth fails to give due credit to our current economic system for the incredible reduction in global poverty that it has already enabled, provides very little by way of actionable policy ideas, and is full of erudite but wishful thinking. 

Yet the popularity of Doughnut Economics reflects a deep sense amongst many of us (some mainstream economists included) that something is seriously wrong, alongside an instinctive identification with the kind of values and changes that Raworth seeks. 

 The vital question is: what is our economy for? If we can get a better sense of what purpose we want the economy to serve, it may prove easier to identify whether it is achieving that, or is in some sense ‘broken.’  

But to ask this question is immediately to step away from the mainstream paradigm that dominates our public discourse in framing the economy. For mainstream economics, questions of purpose are ethical questions and those questions are explicitly left to the actors within the economic system and the state acting on their behalf. The economic system itself is like an engine that can be put to whatever purpose you want. It generates wealth and wealth can be put to all kinds of uses, good or bad. 

These ancient texts suggest that our mainstream paradigm is seriously adrift if it imagines that our economic system is morally neutral.

For many people the idea that the economy itself can be separated from ethical questions will automatically raise an alarm. Certainly, for Christians it ought to. The Bible firmly resists the idea that wealth and its generation is morally neutral. Even the most superficial reading of the Scripture alerts to the inherently spiritual and moral quality of economic activity. Fruitful work is part of what it means to be made in the image of God in the garden of Eden. The product of work is offered to God in worship. The Law is full of commands to deal justly, use fair weights and measures, consider health and safety in the building of a house, and give yourself, your family and your animals a rest (to name but a few). Jesus tells us that you cannot serve both God and money. The pictures of the New Creation in both Old and New Testaments include economic imagery – The Old Testament book of Micah envisions an end to war with everyone living “under their own vine and fig tree” (a vision of peace and economic flourishing) and the New Testament book of Revelation depicts the product of human work being offered up in worship before the throne of God.  

Overall the Bible sees the economic, social and environmental dimensions of life as interwoven and interconnected. Take the Sabbath, for instance. It is not only workers who get (or are commanded to take) a Sabbath once a week. The command extends to the whole community - and even to animals. Every seven years, the Sabbath Year provides a rest for the land and for those struggling with debt – the land must be fallow and allowed to regenerate, and all outstanding debts cancelled. Sabbath and Jubilee are deeply intertwined (the Jubilee was effectively a sabbath of sabbaths, taking place after seven sabbath years) and the Jubilee was the theological paradigm chosen by Jesus to explain his own mission and ministry. Quoting the prophet Isaiah, he said:  

“The Spirit of the Lord is on me, because he has anointed me to proclaim good news to the poor. He has sent me to proclaim freedom for the captives, recovery of sight for the blind, to set the oppressed free, to proclaim the year of the Lord’s favour.” 

These ancient texts suggest that our mainstream paradigm is seriously adrift if it imagines that our economic system is morally neutral. And Raworth is closely aligned with the biblical vision insofar as she insists on the importance of an economy that exists not for its own sake, in some independent sphere, but explicitly to enable people, communities and creation to flourish together.  We need to ask what our economy is for. And this is as good an answer as you might find.  

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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 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.