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
Character
Comment
Education
Fun & play
5 min read

Is your child school ready?

What really matters as a child develops
A teacher looks on as a young child concentrates on writing.
Department for Education.

In the coming weeks, those little critters will start to emerge, easily identified by their autumn plumage of coloured sweatshirts and oversized backpacks. Anxious parents and caregivers can be spotted, shepherding their young along paths and pavements, casting worried glances left and right at the pelican crossings. Listen carefully and you may hear the squeak of uncomfortable new shoes and juveniles complaining about the wearing of a coat, as adults of the species re-establish social bonds with cries of, “Back to school already, I can’t believe how fast it’s gone!”   

As they congregate upon the tarmac staging ground, some will be taking part in this ritual for the very first time. Neophytes who have maintained social bonds throughout the pre-school years might be seen to greet their fellows cordially, “Did you have a good summer? Can Flo make it to Izzy’s party?” Others will stand alone, scanning the playground for a half-remembered face from the bygone days of antenatal classes. That was only five years ago, but it feels like a millennium. The faces are changed; everyone looks more…tired. 

The world has been turned upside down in those past five years. It’s been said so often that it is almost trite, but nonetheless true: nothing prepares you for becoming a parent. In the UK, new parents increasingly raise their children without the immediate support of extended family, coupled with the tyrannous expectation that one will retain one’s employment rank and contribution to the labour market alongside this new and 24/7 full time job of looking after baby. The Key Performance Indicators of parenting are ambitious. Deliverables for the first five years include toilet training, instilling speech and language skills, establishing basic recognition of 26 alphabetical characters (including the child’s ability to recognise the alphabetical sequence that spells their own name) and ensuring the recognition of and (ideally) ability to correctly sequence numbers 1 to 20.  If your child can do all of this by the age of 5, whilst also learning not to punch, kick or bite other children, not to eat food off the ground, and not to stick rocks up their nose, then congratulations! Your child is school ready

It may comfort some readers to know that very few 5-year-olds manage to hit absolutely all of these milestones. As the education secretary, Bridget Phillipson, commented recently – parenting is too hard. She is working to establish a new iteration of Labour’s ‘Sure Start’ programme (rebranded as ‘Family Hubs’) to offer parents more support in the community. As part of her rationale she states, “When one in four children are leaving primary school without having reached a good level of reading, then something’s gone seriously wrong in those early years that has to go beyond the school gate.”  

Whilst I’m keen to see more support for new families – I’m intrigued by this particular rationale for it. Ability to read well by a certain age seems an unlikely metric by which to measure whether a child has had a positive experience of childhood; it appears indicative of what autism-researcher Anne McGuire calls “The normative time of childhood,” in which the success is measured against an imagined future of economically productive years. By this metric, if a child learns to read at a prodigiously young age this is taken as an indicator that they will enter the workforce with greater velocity than their peers, essentially that they will have “more future-yet-to-be-realized” than those around them. McGuire writes, “In a neoliberal regime where ‘time is money’, the child is figured as ‘time-rich’ and so represents a good investment opportunity indeed.”  

McGuire’s analysis is piercingly accurate of how we often talk about our children, despite knowing all too well that it represents a fallacy. There are multitudinous stories of adults who have gone on to make staggering contributions to human flourishing, despite being placed (literally or figuratively) under the dunce’s cap at school. But even without focusing on those who go on to excel, those who attract fame, fortune, or both, we don’t have to look far to find cause to re-evaluate what it means for a child to be school ready.  

My son’s year group recently finished their own primary school journey, and a quick glance through some of the leavers’ books reveals that children are very good at valuing each other for what is here in the present, without recourse to an imagined economic future. As children wrote goodbye messages for each other they said things like,

“Thank you for always having such good ideas for games to play.”

“You helped me on my first day when I got lost.”

“You’re a great house captain and you always help the teacher.”

No one was particularly keen to predict fame and fortune for the future of their friends, and there was an understandable indifference towards academic milestones. As a literary corpus, the leavers’ books were testament to the old adage that people will not remember you for what you say or do but will remember you for how you make them feel.  

One the subject of childhood, Jesus once said something that defies easy explanation. He was out, teaching in the open air, surrounded by crowds of adults including important religious leaders and wealthy individuals who wanted to ask complex and deep theological questions, but in the midst of it all there were parents bringing their children, elbowing their way to the front of the crowd to ask Jesus to pray for their little ones. When some of Jesus’ followers tried to usher the children away, Jesus said, “Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these.” The precise meaning of this utterance has eluded thinkers and theologians for centuries – what exactly is it about childhood that Jesus was alluding to?  

I wonder if it is something about the capacity of children to live in the immediate, and therefore to value what really matters – justice, kindness and friendship. In primary school, yes it helps in some ways for children to arrive aged 5 with a certain command of the alphabet and the ability to finish the day wearing the same set of underwear that they arrived in. But perhaps what matters more is children arriving ready to enter the fray of friendships – being kind, being helpers, having the self-confidence to know that they have something to give to the learning community that they are joining, whatever their learning speed might be. Such things are gloriously untethered to economic potential or a future-yet-to-be-realized, but they are closely tethered to a child’s understanding of themselves as a valuable and important person. If Labour’s intention to offer new parents more help in the community goes some way towards communicating to our pre-school children that they have that have – and will always have – value, regardless of what they will or won’t attain to academically or economically, then it will help many more children reach the milestone of being school ready.  

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