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
Leading
Politics
1 min read

Covid inquiry: Johnson, Cummings, and the cost of refusing to grieve

The report exposes mistakes, but our real challenge is learning how to face loss without denial

Jonah Horne is a priest, living and working in Devon.

Boris Johnson sits, giving evidence to an inquiry.
Boris Johnson giving evidence to the inquiry.
UK Covid-19 Inquiry.

I distinctly remember the sheer confusion of January to March 2020. Should we flee our flat in London? Should we cancel the lease on our workspace? Will I be able to continue breakfast with my friend on Thursday mornings? I ignorantly scoffed that a lockdown could conceivably take place and then, stood devastatingly corrected only a few months later. However, the UK Covid-19 Inquiry reveals that this ignorance induced confusion was not restricted to the personal level but instead enacted on a national stage. 

What’s glaringly obvious as you read the recommendations is that the government acted too slowly and too indecisively. If the initial restrictions been introduced sooner, say in January or February, the first lockdown “might have been shorter or not necessary at all.” This, the report suggests, could have saved approximately 23,000 lives. Brenda Doherty, of the Covid-19 Bereaved Families for Justice group, believes her mother could have been one of these. Instead, she and her sister stood by her graveside in March 2020 as her family members waited a few metres back sectioned off by red tape. The report and accompanying evidence call for sombre reading. 

In response, those in charge at the time have understandably launched an attack in their own defence. Boris Johnson has labelled the inquiry "totally muddled,” which ironically sounds like the informal conclusion of his leadership in the report. Similarly, Dominic Cummings has hurled a 2,000-word response into the social media stratosphere, which feels almost as long as the 800-page paper itself. 

What seems glaringly obvious about both men’s responses is the very thing Brenda Doherty displays with such elegance: grief. There is, in these men’s retorts, a stunning omission of any sense of responsibility or indeed any willingness to admit defeat. And what frightens me most, as we look towards the future, is our refusal to grieve over the things of the past. The threat on Europe from Russia is growing. AI’s disruption on our workforce seems to be being enthusiastically brushed aside. And another, potentially much more violent, pandemic is unsettlingly likely. 

However, in the face of these disruptive forces grief is a remarkably generative power. Without grief we remain, much like Johnson and Cummings, frozen in time. Immovable in our ineptitude and ignorance. Grief, I’d argue, is the very thing that enables us to recognise our shortcomings and, when mixed with hope, energises us towards a future which lies on the other side of sorrow. Yet, when we exist in a place of fragility, the idea of imagining that life lies beyond my incompetency, if only I grieve it, is frightening. Devastatingly though, for us humans, this may be the only way to learn and move forward.  

Our future and redemption is undeniably bound up in our ability to grieve. Grief is inherently futural. By grieving our ineptitude, we inevitably witness to the places that require growth, mercy and grace. When we fail to grieve, we remain frozen in time—precariously hiding behind the illusion of our infallibility. This is a deeply fragile state. From this position, any assault or critique on our mistakes becomes a personal attack rather than invitation to redemption. We find ourselves lashing out in fear, terrified of being exposed. Johnson and Cummings embody this predicament to a tee.  

This situation however is not unique to the Covid iquiry and our late-prime minister’s response. Another character who lashes out in fear is St Peter, one of Jesus’s friends and disciples. There is a rather poetic story that illustrated this at the end of John’s gospel in the New Testament. One of Jesus’s friends Peter rejects him as he’s taken to be murdered. Peter attacks a guard, cuts his ear off and Jesus famously disarms him and heals the man. Moments later, Jesus is taken, Peter flees and we find him standing in a courtyard, by a fire and where claims not to know his friend and master Jesus. To make matters worse, he rejects him not once, but three times. However, when Jesus returns from the grave, he meets Peter again, at a fireside on a beach, and asks him “do you love me?” Not once but three times. The thing that I think is particularly remarkable about this meeting is that Jesus recognises Peter’s future in bound up in the redemption of his past mistakes. Jesus takes Peter to the place of failure, a fireside, and gives him an opportunity to declare his allegiance and love for him, the same amount of times he had rejected him. He reminded him of his wound to heal him for his future.  

If we are to take seriously our response to the Covid-19 inquiry, we must take responsibility for our errors. Not begrudgingly but with a grace filled grief. Our future, one that is filled with hope, does not come to us without a confession of past errors. Instead, a hopeful future may only come to us when we confess, recognise and grieve our mistakes. Indeed, to freely grieve over my failures is to grieve believing in life beyond my defeat. 

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