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

One flag two nations: the view from Leicester

Raising the national flag won’t secure the future for our grandchildren
A suburban English street with St George's Cross flags on lamposts.
Mtaylor848, CC BY-SA 4.0, via Wikimedia Commons

I was in the local pub the other week and overheard a conversation at the bar prompted by Operation Raise the Colours, the campaign group that advocates for the Union flag and the St George’s Cross to be hung in public places.  

Striking was the opinion of one man who repeatedly stated that he was not a fascist or a racist but supported anti-immigration policies and the deportation of migrants and asylum seekers for the sake of his young granddaughter. It was a lack of hope for her future, he kept asserting, that meant politicians needed to take a more aggressive stance against people arriving in this country hoping to live here. He therefore supported the raising of the St George’s Cross as a sign of the national identity he hoped his granddaughter would grow up to experience. 

In the last hundred years the St George’s Cross has been a sign of Empire, military might, hooliganism, English Nationalism, xenophobia, fascism, and other violent and oppressive worldviews. It meant for many who did not want to be associated with these things that they could never raise or recognise the flag at all.  

But there has also been some reclamation of our national symbols. Cool Britannia and Britpop under New Labour saw a new pride in the Union flag; England’s football team under Gareth Southgate and the ‘proper’ English Lionesses were successful, articulate, and diverse under the Cross of St George. It's why even now it’s hard to discern whether someone with a Cross of St George stuck to their house endorses Tommy Robinson, or whether they’re showing their support for the England women’s rugby team, who are swept all opposition before them whilst cavorting in pink cowboy hats and redefining all kinds of feminine stereotypes. 

These myriad options for painting identities onto national colours seems particularly clear in Leicester, where I live and work. We live in the outer suburbs, meaning two miles in one direction, humans are outnumbered by sheep, and two miles in the other is the incredibly diverse edge of the city.  

Leicester famously has the most diverse street in the UK, Narborough Road, where people from many nations live and work, generally in relative harmony. Skills are shared: help with government forms for those without good English are informally bartered for meals, haircuts, or produce. Christians, Jews, Muslims, Sikhs, Hindus and many other faiths worship within close proximity. It seems a place symbolic of one kind of England: diverse, tolerant, enriching the lives of one another by the sharing of culture and skills.  

It’s easy to point to recent riots between Hindu and Muslim populations in the north of the city as proof of the opposite. Nevertheless, having worked in a diverse city centre church and visited schools and hospitals where many cultures and faiths study and work together, there are large pockets of the city that do generously manage to embody this vision. Faith leaders are overwhelmingly committed to mutual tolerance and respect. 

I know many people in the county also wish for this version of England, but it has been striking to see how many villages surrounding the city have joined in with Operation Raise the Colours. Its anti-immigration message provides a clear-cut visual contrast. In the city there are no St George’s Crosses but innumerable signs of inter-culturalism brought by immigrants, asylum seekers and refugees. It is the first city in the UK where being white British does not put you in the majority. In the county, these flags seem to state that these signs are not welcome. That to ‘Unite the Nation’ is to expel those different to us. That the only culture available is the one they want to equivocate with the St George: white, British, suspicious of outsiders.  

Both of these contexts seem to be fully fleshed out alternatives for the future of England. Who do we want to be? Tolerant, inter-cultural, diverse? Or exclusive, suspicious, nativist? The guy in the pub was staking his hope for the future on one of these alternatives, and I’m sure he’s not unique. There will be others who are fully devoted to the opposite: a diverse and welcoming state of which Leicester appears an imperfect harbinger. 

It’s important to note that a fair reading of the Bible cannot help to highlight the theme of welcoming foreigners, perhaps particularly those who are not able to contribute financially. The Israelite faith of the Old Testament specifically commands farmers to leave a border of crop unharvested for such struggling migrants.  

One of the most beloved stories of the Jewish scriptures is that of Ruth, an Edomite woman who comes destitute to Israel and finds provision in the righteous life of Boaz, who has left such a border of crop for her to glean. Eventually they marry, and their offspring is blessed by God: including King David and Jesus Christ. I do believe that welcoming foreigners, and particularly those who have been affected by poverty or war is just. Any form of Christianity which puts nation before those different to us or those who suffer is a false one. 

But, just as I believe that man in the pub is wrong for putting his hope in the tightening of borders, anybody who puts their hope in any philosophy or system a flag can represent is mistaken. Liberal policies towards immigration and open hearts towards those who must seek asylum or refuge will always fail and fade. Neither England represented by the city and county of Leicester can or will last a millennia, let alone an eternity. Neither can guarantee a better future for our descendants. 

Jesus spoke of a Kingdom without flags, without an army, and without borders. One in which all tribes and tongues will be welcomed as the foreigners we are to the Holy God. One which is already recreating the Earth to be a place without death, enmity, and suffering and one day will bring this work to fulfilment. This Kingdom of God is the only political entity in which hope can be securely placed because it keeps its promises and never passes away. Our political parties, national identities, and nation states may be more or less like the Kingdom of God but they are never secure foundations for our future.  

If I were braver, I might have broached this reality with the man at the bar. I might have suggested he makes an error in placing hope for the future generations of his family in a particular understanding of the national flag. I could have invited him to see the truer potential for hope in a Kingdom which is not directly seen but nevertheless is more real and secure, and discussed with him about what that means for our temporal reality. And challenged him to see past the flag to a Kingdom which will provide for his granddaughter without measure. 

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