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
Ethics
Freedom
War & peace
4 min read

There’s light and darkness in journalism’s truth game

“There’s your truth, there’s my truth and there’s the truth.”

George is a visiting fellow at the London School of Economics and an Anglican priest.

A church altar holds commemorative frames of killed journalists
The Journalists’ Altar.

The Journalists’ Altar at St Bride’s church, on London’s Fleet Street, bears the Perspex tombstones of reporters and their colleagues who have died in wars and conflicts around the globe, in the act of bringing news to us.  

This solemn memorial is joined by new ‘stones’s for Anas al-Sharif and his four-man crew from Qatar-based al-Jazeera, who were killed in a targeted strike on their tents at the gates of the Al-Shifa hospital in eastern Gaza City. 

It was worth checking that they’re included on the altar, as there’s the sneaking suspicion that someone might have decided that honouring them in this way would be inappropriate or even inflammatory. The Israel Defence Forces (IDF), who killed them, would certainly take this view, having described al-Sharif, one of the few television correspondents bravely to have remained in northern Gaza, as a “terrorist” who “posed as a journalist.” 

Journalist rights groups, such as the Committee to Protect Journalists (CPJ), as well as, unsurprisingly, Al Jazeera itself counter that this is baseless. The CPJ adds “there is no justification for [the] killing.” 

Of course there isn’t. Al Jazeera is pro-Arab and consequently pro-Islam and, therefore, anti-Israel. Al-Sharif may have had links with Hamas in the past, but he and his colleagues were demonstrably non-combatant. If we start killing journalists who are biased against us, we’re entering very dark moral territory indeed. 

I worked for The Observer when it was owned by conglomorate Lonrho and it promoted proprietor Tiny Rowland’s best interests in Africa and in his battle with Mohammed Al-Fayed for ownership of Harrods. News Corporation’s titles aren’t famous for exposing and criticising the activities and opinions of the Murdoch family. 

It might be a stretch for even their fiercest critics to suggest that Rowland or the Murdochs had committed acts of terrorism, but the point is that journalism, good or bad, is never truly independent. That al-Sharif and his friends had associations with Hamas is largely irrelevant. Indeed, journalists must have contacts with the dark side.  

If we’re at risk for our allegiances, then it’s not just us but freedom itself that is under threat. Imagine if we could be arrested for sympathising with supporters of Palestine Action, currently a proscribed terrorist organisation in the UK. That, worryingly, begins not to sound too farfetched. 

Journalism, when it works properly, shines as a light in the world’s darkness, revealing what’s really going on. It’s what makes it a less trivial professional activity than many other walks of life. The Journalists’ Altar bears testament to that.  

The light shining in darkness is central to the Christian tradition, revealed in the prose poetry of the opening sequence to John’s gospel (a line of which appears on the Journalists’ Altar). It is inextinguishable, exists only because darkness exists and is revealed in the human capacity for love, the triumph of hope over despair and lives led self-sacrificially. 

That’s way too much freight for humble old journalism to carry. But it is true that journalism shines a light in human affairs, the better to reveal what lies in the darkness so that we can examine it. In that endeavour, it shares an interest in truth 

A late and lamented Observer desk editor of mine once told me dolefully, when I wailed that lawyers were preventing a story I knew to be true, that “there’s your truth, there’s my truth and there’s the truth.” I don’t think he meant to mark the difference between subjective and an objective, absolute truth, but he did define the truth game that we’re in. 

As it took Gaza’s territory, Israel’s government long ago ceded its moral ground – quite an achievement given the scale of the atrocities committed by Hamas on Israel’s people on 7 October 2023. It simply cannot afford to allow the light of what is true to shine in the darkness of Gaza. So, it bans foreign correspondents from reporting from within the Strip. 

“Democracy dies in darkness” has been the slogan of The Washington Post since 2017, a line it lifted from its Watergate heritage. There’s been a fair bit of chortling and downright rage at this conceit since its newish proprietor, Jeff Bezos of Amazon, declined to allow the Post to back the Democrat candidate against Donald Trump at the last US election (those pesky owners again). 

But it’s not really democracy that dies in the dark. It’s just that we can’t see in the dark. We need light to do that. Journalism, for all its weaknesses and absurdities, provides some of that light. Israel, Gaza and the deaths of five Al Jazeera journalists show that it’s a light that isn’t inextinguishable. That’s more than a worry. 

Al Jazeera’s anchor Tamer Almisshal nailed it: “Israel, by killing and targeting our correspondents and team in Gaza, they want to kill the truth.” Our democracies need to ensure that doesn’t happen. 

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