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
Development
Justice
Music
5 min read

Millions of people are still cold, hungry and naked – will you be there?

The call to justice that echoes from Trafalgar Square to primary schools

Pete Moorey is a campaigner for Christian Aid.

A school choir sings in an ornate abbey setting
Twyford School Choir sings in Westminster Abbey.
Dean & Chapter of Westminster.

I’m getting close to my 50th birthday, so I’m prone to nostalgia. My mind wanders back forty years to my primary school days in the early 1980s in a village in Sussex.  

Once or twice a week, we’d have school assembly. This included singing hymns. Not something that a shy seven-year-old would usually enjoy. But, in fact, we belted out a series of classics with gusto, accompanied by an almost proficient teacher on an almost tuned piano. 

To Be A Pilgrim with its lyrics about fighting giants. All Things Bright And Beautiful and those purple headed mountains. And then our favourite When I Needed A Neighbour with the opportunity to scream out the words “I was cold, I was NAKED!” at top volume, cheekily looking at your classmates as you asked, “Were you there?” 

The thing about those hymns was that the lyrics stuck. Not just now, decades on, but even back then. And so when a teacher in assembly started to talk to the school about the famine in Ethiopia or the hurricane in the Caribbean, you began to think “Is that my neighbour?”  And when your church encouraged you to deliver envelopes door to door to raise money for Christian Aid Week, you asked yourself “Was I there?” 

Of course that was the intention of those songs. The story of When I Needed A Neighbour is bound up with the history of social justice movements in the UK and in particular the organisation I work for, Christian Aid. 

Christian Aid was founded in 1945 by the British and Irish churches, who felt convicted to do something to tackle the refugee crisis and poverty sweeping across Europe following the Second World War. 

By the late 1950s, it was running Christian Aid Week - a big charity appeal to tackle global poverty long before Live Aid or Comic Relief. And as Christian Aid reached its twentieth anniversary in 1965, this annual fundraiser was a big deal. 

Such a big deal in fact, it decided to launch the fundraiser in Trafalgar Square by running a Beat & Folk Festival. You can find an old newsreel of the occasion on YouTube. Nelson’s Column is surrounded by thousands of young people listening to the Christian equivalent of Peter, Paul and Mary and getting fired up about global injustice. 

For the occasion, the then Christian Aid area secretary for London, Brian Frost, decided that a new song needed to be written. And so he approached the modern hymn writer of the moment, Sydney Carter. Two years early, Sydney had written his most famous hymn Lord of the Dance

Brian was of that era when Christians were at the heart of the anti-apartheid movement and committed to ecumenical action. And so combining this passion for social justice and the folk song mastery of Carter - When I Needed A Neighbour was born.  

As Christian Aid marks its 80th anniversary, we revisited this classic. When you watch the newsreel of an early performance in 1965, you quickly realise its folk credentials. It’s not just the fact that it’s being sung by marvellously hirsute men, it’s also there in the folk melody, guitar accompaniment and sung refrains.  

A year later Sydney Carter would record an EP that included Lord of the Dance which featured the folk royalty of Martin Carthy on guitar. For folk aficionados, you’ll know him as one of the English folk music greats - married to the incredible Norma Watterson and father to Eliza Carthy. For those less familiar with the genre, he was also an important inspiration for Paul Simon and Bob Dylan - yes, him off A Complete Unknown. 

There’s no evidence that Martin appeared on When I Needed A Neighbour but I think his involvement a year later confirms that the song sits firmly in the Sixties folk music boom. To young ears, it would have been hip. To older ears, perhaps scandalous.  

How do you reimagine such a classic as When I Needed a Neighbour, 60 years on from its birth - and now 80 years into Christian Aid’s history? Especially at a time when we witness our global neighbours in Gaza, Sudan, Ukraine, the DRC, and more wondering if - in the face of conflict and humanitarian disaster - anyone is there. 

We started with the lyrics. In 1965, Sydney Carter captured something of the simplicity of the issue at hand. People are cold, hungry and in need of shelter. And there’s something that each and every one of us can do, in our common humanity, no matter who we are, whatever our creed, ethnicity or background. 

Within a few years of the song being written however, Christian Aid had a lightbulb moment - it wasn’t enough for us to respond to emergencies around the world. Not enough also to work with communities on long term economic development. No, if are to live out God’s call to act justly and to love mercy, then we needed to be part of movements tackling the unjust structures and systems that result in poverty and inequality around the world. 

And so in returning to When I Needed A Neighbour and working with hymn writer Ally Barrett, we have now written new words that act as a call to each and every one of us to be a neighbour by speaking out for justice. This is something that Christian Aid has done throughout our history, calling for action to drop the debt in the 1990s or as one of the first development organisations campaigning for climate justice in the 2000s. 

This week we marked our 80th anniversary at Westminster Abbey by recommitting ourselves to God’s call for justice. And this included the Kingdom Choir (who famously sang at Harry and Megan’s wedding) and the Sacred Choir from Twyford Church of England school in London performing a gospel-tinged version of When I Needed A Neighbour

My hope is that, 60 years on, the song will still carry resonance. In an age when conflicts rage, the climate crisis runs riot and inequality is rife, isn’t it time to answer When I Needed A Neighbour’s call again? 

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