Article
Care
Comment
Economics
Ethics
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. 

Article
Comment
Digital
Football
Sport
1 min read

Fed up with today’s football? Blame this passion killer

How the beautiful game became boring

Sam Tomlin is a Salvation Army officer, leading a local church in Liverpool where he lives with his wife and children.

An AI image of apathetic football players being watched by dis-spirited fans.
Nick Jones/Midjourney AI.

The football season has begun. And with it, the usual rigmarole of adverts, fantasy football and over-priced shirts. But this season has a slightly different feel to it. Perhaps it is the obscene - and record - amount of money that was spent in the transfer window (benefitting the biggest clubs), or the sour taste of the Isak saga between Newcastle and Liverpool.

Or maybe there is just a malaise with the game that has been growing for years and is now perceptible just below the surface. Friends and family tell me they have lost interest in football, echoing the words of former Chelsea and England player John Terry who recently made headlines by lambasting the state of the modern game as ‘boring’ . The tendency for one team to defend while a more technically gifted and drilled team tries to break them down means ‘You don't see many shots,’ according to Terry. 

His thoughts reminded me of comments made by pundit Gary Neville a couple of months ago after a dull 0-0 draw between Manchester United and Manchester City: 

‘This robotic nature of not leaving our positions, being micro-managed within an inch of our lives, not having any freedom to take a risk to go and try and win a football match is becoming an illness in the game'. 

Neville and Terry are referring to the style of play inaugurated by Manchester City manager Pep Guardiola who has undoubtedly revolutionized how football is played in the last decade. The style is geared towards complete control and domination, ironing out any potential errors and minimising risk. It is statistics and data driven, with managers and coaching staff constantly looking at iPads during matches and clubs employing data analysts. 

This strategy has of course been wildly successful for Man City in recent years. I don’t think these former players are contesting these remarkable achievements or that this style of football can’t be inspiring and entertaining when executed by players at the top of their game. But because it has become such a dominant way of playing, worse players and teams feel that they have no option but to mimic it. The result is often a boring game with neither team willing to take risks as they are desperate to keep possession. Just look at popular memes comparing wingers from 20 years ago putting crosses in the box compared to simply passing backwards.

Liam Manning, the former manager of my team, Bristol City, very much models himself on this data-driven Guardiola style. Tellingly, one of his catchphrases in interviews refers to ‘taking the passion out of the game’. By this he means ensuring that players keep cool heads and stick to the game plan - but I wonder if he inadvertently betrays the philosophy Neville and Tarry rail against: it is passionless, soulless and mechanical, less open to moments of surprise and unexpected brilliance. 

To put my cards on the table, I agree wholeheartedly with Neville. Modern football in my estimation has changed beyond recognition even from the 90s when I grew up. While I cannot deny that some of this has been for the better – stadia safety and decrease in hooliganism for instance – I lament the introduction of VAR and its flawed search for objectivity, the replacement of stadia rooted in the heart of the communities which gave rise to them with soulless bowls located outside of town and the expense that often prices poorer fans out of the game. 

Are Neville, Terry and I just hopeless Luddites longing for a past that would inevitably pass away, or is there a deeper philosophical point to all of this? Perhaps. The French Christian thinker Jacques Ellul (1912-1994) critiqued modernity’s propensity to seek ever more efficiency no matter the cost. The French word he gave to this was ‘technique.’ While this is often translated simply as ‘technology,’ it is wider and deeper than this. He describes it as ‘the totality of methods rationally arrived at and having absolute efficiency (for a given stage of development) in every field of activity.’ 

In a ‘technological society,’ efficiency rather than creativity, beauty or freedom becomes the norm. It is not hard to see this all around us as we scan our shopping on machines to minimise time-consuming personal interaction, use our pocket computers to organise our lives and dominate our attention all the while we do not know our neighbours’ names. Most Western institutions, the systems of business, politics and morality (and perhaps now football?) have been consumed by this system. 

Technique, according to Ellul, is not any one person or group’s fault, but develops its own internal and de-humanising logic which will never reach its goal as it searches forever greater efficiency:  

‘proceeding at its own tempo, technique analyses its objects so that it can reconstitute them; in the case of man, it has analyzed him and synthesized a hitherto unknown being.’  

But the spiritual consequence of technique is a flattened and banal account of human life, desacralizing the world. ‘Technique denies mystery a priori. The mysterious is merely that which has not yet been technicized… Nothing belongs any longer to the realm of god or the supernatural. The individual who lives in the technical milieu knows very well that there is nothing sacred anywhere… He therefore transfers his sense of the sacred to the very thing which has destroyed its former object: to technique itself.’  

There is a clear parallel here with the principalities and powers the Apostle Paul warns against in the Bible: ‘For we wrestle not against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this world, against spiritual wickedness in high places.’ 

What is the antidote to technique in football and elsewhere in life? It is tempting to collapse into a fatalism assuming the march of technical and de-humanising efficiency is unstoppable. Ellul acknowledges the potency of technique but suggests that the greatest weapons against its totalising control are both an awareness and consciousness of its methods and consequently a certain conception of freedom which will willingly not conform to its pattern. ‘Freedom is completely without meaning unless it is related to necessity, unless it represents a victory over necessity… We must not think of the problem in terms of a choice between being determined and being free. We must look at it dialectally, and say that man is indeed determined, but that it is open to him to overcome necessity, and that this act is freedom.’ 

In footballing terms this might be seen in an enigmatic figure like Khvicha Kvaratskhelia who seems to belong to another era and whose national team Georgia lit up Euro 2024 with their fearless and free flowing play, or by supporters applauding players who take greater risks even if they do not come off. In life in general this might be expressed through consciously avoiding the ‘necessity’ of efficiency: like choosing to do things more slowly like queueing at a supermarket checkout rather than using the automated machine, or walking to rather than driving where possible.  

For Ellul and Christians, however, the ultimate liberation from enslaving systems comes in the form of a God revealed in Jesus Christ, who lives a life wholly free from such slavery and takes upon himself the debt and weight enslaved humans hope to escape on their own. As Paul puts in another one of his letters: ‘It is for freedom that Christ has set us free. Stand firm then, and do not let yourselves be burdened again by the yoke of slavery.’ 

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