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
Community
Nationalism
5 min read

I protested against the Unite The Kingdom protest

The need to see one another

Thomas is a writer exploring the intersection of faith, politics, and social justice.

CCTV footage show two rival protests divided by a line of riot police.
CCTV image of the rival protests on Whitehall.
Met Police.

I don’t know why I was so concerned about the horses. I kept noticing them swaying through the sea of shivering bodies. I was so drawn to them that I tried to take a photo, a rare occurrence for me, but I was too far away. The horses riders, dressed in full riot gear, were being pelted with beer bottles. Maybe the horses were getting hit too, but it felt like they were recoiling on behalf of their riders. 

In front of the horses, engulfing Trafalgar Square, were tens of thousands of “Unite the Kingdom” protestors. From what I could see, they were predominantly white men. Many of them were dancing and waving flags, but a sizeable contingent was furious, drunk, and insisted on attacking any unfortunate police officer in their way. 

Behind the horses, lining the streets of Whitehall, were five thousand counter-protestors, including me. Unlike our opposite numbers in Trafalgar Square, we were trapped, surrounded on every side by St George’s flags, Union Jacks, and, oddly, some Georgian flags too. Maybe the shop had sold out. To my right, I could see the counter-protestors defiantly dancing. To me left, I could see a group chanting “Nazi scum, off our streets” whilst swearing towards the St George’s flags. 

There in the middle, I found myself feeling a curious mixture of discomfort, sadness, and anger. Uncomfortable because I’d been trapped for four hours, stuck on a continuous cycle of rinse and drain. Sad, because I knew that much of the “Unite the Kingdom” violence was built on misinformation and the scapegoating of refugees, a group I know well, and because this fog of violence blew over the counter-protestors as they hurled insults towards the St George’s flags. And angry, because figures like Elon Musk were using their extraordinary wealth and influence to spread fear and lies: “Whether you choose violence or not, violence is coming to you. You either fight back or you die. You either fight back or you die. And that’s the truth. It’s only a matter of time till that happens to towns and villages. It will spread. And no one will have any peace.” Over the years, I have spent many hundreds, if not thousands, of hours with refugees and asylum seekers, both in my home and at my church. I had experienced no violence. In that moment, I was surrounded by “leftists”, socialists, and trade unionists, and the only violence I was experiencing was from the glint of beer bottles raining down on the police two hundred meters away. 

I was grateful for the interruption of an elderly lady asking if she could get past. I’d been asked a number of questions throughout the day, primarily because I was one of a group of four Christians holding signs like “Jesus was a refugee”, “love thy neighbour”, and “I was a stranger and you welcomed me”. At the start of the protest, an older lady and a young man joined our circle. The young man asked “I’m glad to see there are some Christians here. What do you think of Christian nationalism? Your religion doesn’t feel much like Jesus?” He was a brave Saudi Arabian refugee with a bright smile, earnestly questioning the fractures in my community of faith. Taken aback by the poignancy of the question, I fumbled a response before being rescued by one of my friends. 

Protest signs written on cardboard.
Tommy's protest signs before the rain.

 

After a while, the older lady started speaking. “Sorry for interrupting. I used to be a Roman Catholic, but I’ve lost my faith. On days like this though, I always want to pray. I don’t feel much hope for the church. A while ago, I went into a catholic church. I asked if the church could do anything about the divisions in our community and the anger at refugees. The priest shrugged and said no. I’m glad you’re here.” Her short, staccato sentences mirrored the tension of the day. I told her about how our church serves refugees, how I struggle with the anger of days like today, and how some of us have forgotten that the bible tells us to welcome the stranger dozens of times. As they walked away, I felt touched by the honesty both the young and old had gifted to four strangers, and I was glad to be carrying our smalls signs of hope. 

The megaphone brought the present back into view with another question. “Could everyone please get ready to leave up the left of Trafalgar Square?” it said. The police had cleared a path for us to leave, the sea of flags artificially parted by riot gear. We were escorted to Green Park tube station, at which point we turned off towards Oxford Street. My wife remarked at how quickly normality returned. I was devastated by the day, but felt too tired to weep. I wasn’t quite the same Tommy that I’d been that morning. The man who shares my name, and the chaos he wrought on my city, had turned a dial in me a little further than it had been turned before. 

I knew that I would have more days like this. In the midst of my discomfort, sadness, hope, and fear, I knew that I was supposed to be there, holding my soggy “Jesus was a refugee” sign, shivering in my damp clothes, and praying under my breath. I knew that I needed to gather other reluctant protestors alongside me, holding their own soggy signs and praying their own prayers. 

And I also knew that there was a better way to carry this fragile message of unity in our increasingly fragile land and increasingly fragile time. As a half-British, half-South African man, I’ve had the privilege of growing up with the stories of the anti-apartheid movement, stories which steward the hard-earned truth that defiant, tenacious, persistent love is the only antidote to hatred, misinformation and fear. As Desmond Tutu once said, “when we can accept both our humanity and the perpetrator’s we can write a new story”. Saturday left me feeling that we desperately need a new story, and that requires us to look beyond the swaying horses and see one another clearly. 

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