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. 

Interview
Care
Change
Community
Masculinity
5 min read

There’s a simple solution to society’s lost boys

Mentoring the fatherless helps and heals

Belle is the staff writer at Seen & Unseen and co-host of its Re-enchanting podcast.

A teenager slumped against a sofa plays a video game
Zach Wear on Unsplash .

What if nearly every major social pathology could be halted upstream? What if there was evidence to suggest that they commonly flow from one singular factor? What would we do – would we sit back and wait for the State to intervene, pointing to where we know the problem is beginning? Or would we wade up that stream ourselves, and start damning up the current?  

Richard Kay and Robert Mansel Lewis have chosen the latter option. They are the founders of Chapter2, a charity that offers mentoring for boys aged seven to 16. And they have identified fatherlessness as the factor that is linked to many major social pathologies to be found in Western society today. 

Earlier this year, the Centre for Social Justice brought out a report called Lost Boys. It found that2.5 million children in the UK do not live with a father figure, and that just under half of young Britons grow up with one biological parent, more often than not their mother.; 

Back in 2013, the numbers were strikingly higher in low-income areas, with 65 per cent of children aged 12–16 in the bottom 20 per cent of income households not living with both birth parents – this was 26 per cent higher than in better-off households. What’s more, when children were aged three, the chance of them being in the bottom income quintile was 21 per cent if their parents were married, and a massive 81 per cent if they were in lone-parent families.  

So, we can already see a clear line drawn between fatherlessness and poverty,. Chapter2 (informed by the work of psychologist, Stephen Baskerville) also point out that fatherlessness is linked to alcohol abuse, drug abuse, truancy in school, incarceration, and mental health difficulties – all among young boys, in particular.  

There’s a smorgasbord of factors and influences that are making it increasingly complex to be a ‘healthy’ and ‘happy’ man right now. “You don’t even need to put the word ‘toxic’ in front of ‘masculinity’ anymore, Kay points out. “It’s just assumed. If we need to ask what healthy masculinity is, people really don’t know.” 

As I’m writing this, I’m sitting in a coffee shop with ‘boys will be... what we teach them to be’ emblazoned on the side of it. It feels as though multiple destructive forces are making a beeline for young men right now, and we’re panicking. We’re manically trying to halt a fast and violent flow - but what if we waded upstream? 

That’s what Kay and his colleagues are trying to do. The charity’s mission is to  

bring good men into the lives of young boys who are living without a father. These men – all volunteers (?) - are committed to being there for the long term (two years, minimum) and to build a trusted friendship. That’s it: the beginning, middle, and end of the mission.  

I was struck by the radical simplicity of it. Young boys get referred to Chapter2 through social services, schools, and by family members or guardians – they told me that referrals have never been something they’ve had to work hard to gather. Which is pretty heart breaking in itself. 

The reality is, the fatherlessness crisis isn’t going to be solved by State-led intervention, and nor should it be. The solution lies in community living as it should do. It can be helped by the smashing down of hyper-individualism and the dismantling of our obsession with the nuclear family. It can be eased by reminding ourselves that it really does take a village to raise a child. Oh, and that we’re the village. When we spoke, Kay talked about his initial reluctance to found a charity that does this work, weary that it somehow relieves us all of our responsibility to live wide-open lives. Chapter2 is working toward a world in which the mentoring of young, fatherless, boys is normal, not a last resort.  

I like that. 

The longevity of Chapter2’s goal is pretty counter-cultural, isn’t it? We’re a commitment-phobic-culture. That’s pretty anti-love-your-neighbour, right? But the only way to respond to the wound of abandonment is by showing up – relentlessly, consistently, self-sacrificially. It’s the art of staying – come what may.  

I was told that this takes the boys a little getting used to; that Kay and Mansel Lewis warn the men they’re training that there will come a point when the boys will try and push them away, assuming they’ll leave sooner or later and feeling more comfortable having that happen on their own terms. It’s a symptom of the abandonment wound, I guess. But the men stay, and the boys begin to trust them.  

And here’s the other biggie for Chapter2: there’s no agenda. No goals. No solutions. No fixing. Just presence - consistent presence.  

Again, I was struck by how foreign that must feel to the boys. Everybody else in their life needs and wants something from them – better school attendance, better behaviour at home, less trouble with the police – and rightly so. But the Chapter2 mentors are only interested in the boys’ company and trust. They’re not trying to fix them, they’re just trying to know them – if there are no measurable changes, they’ll still show up. Zero conditions.  

The poet, rapper, author, and pastor, Joshua Luke Smith, often talks about a father as being someone who will  

‘bind up your wounds and catch you when you fall’,  

because that that’s what every young man needs – someone to care enough to do those two things. Because hurt people tend to hurt people. So, wounds need to be bound before they become ‘an excuse to wound others’. Again, it’s all very upstream, don’t you think? It’s very Chapter2-esque.  

One Chapter2 mentor recently received a Father’s Day card from a boy he’d built up a relationship with. Another young boy who’d been arrested twenty or so times in twelve months eventually realised, thanks to his mentor, that it’s not worth getting into trouble. His mentor, he said, ‘is someone he can trust, he’s consistent and he knows he cares about him’.  

This is community living as it ought to. Is this also the solution to the pandemic of fatherlessness?  

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