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
Church and state
Comment
Community
Trauma
5 min read

After Southport: how to communicate amid tragedy, rumour, and riot

Handling the media in the aftermath brings dread, discretion and dignity

Stuart is communications director for the Diocese of Liverpool.

A media pack await a press conference in a street.
Media covering the Southport attacks.
The Emperor of Byzantium, CC BY-SA 4.0, via Wikimedia Commons.

Working from home in the quiet town of Ormskirk, about four miles from Southport, the first I noticed was a cacophony of sirens accompanied by our local Facebook groups buzzing with speculation over what it was this time. The news started breaking. An incident in Southport, vague details at first but enough to start that feeling of unease.  

Then the phone call and email. The local vicar and one of our Archdeacons seeking advice as inevitably the media would be looking for comment. I’ve taken a similar call many times over the 20 years I have worked with the church. It sets a mix of contradictory emotions. Selfishly you can’t help thinking there goes my plans for the day before you are sharply brought up to the knowledge that the reason for this is a tragedy for others.  

Southport brought out a further emotion. When I was a student, I lived for a year close to the location of the stabbings. 30 years on and the suburban area I knew was seemingly unchanged. Yet everything was different. 

The role of the press officer at this point involves navigating a tricky balance. You have a job to do, the journalists you deal with have a job to do. You are constantly fielding phone calls, jotting messages juggling time slots. You have a relentless barrage of people putting interview requests in and you want to ensure the right voices are heard and that those who represent aren’t worn out by interview upon interview. 

Then you remember what caused the story in the first place. You think of the emergency services working hard to support those in need. Above all you think of the victims and the families – at that time not knowing how many or how serious. And the sense of gloom deepens as the rumours of how serious the situation spreads before you get word of a police conference fearing the worst before the worst gets confirmed. 

At these times the mood amongst the media teams always feels strange. Acutely aware of the pain of the situation and sympathetic to what’s happened they can’t escape the job they have to do. I have seen this over many years mainly through the management of the press pens outside funerals at Liverpool Cathedral and churches across the region. You get to know some of the pack well, mainly and somewhat grimly reuniting at the next tragedy. They are massively co-operative with a strong sense of camaraderie, yet you can feel the pressure coming down to them from their news and picture desks. So, a sharing of resources and support occurs underpinned by a hint of journalistic competition.  

The press officer’s role here is to feed the machine. It’s hungry. They have time to fill and very often, particularly so close to when the event happened, everyone is more speculative than informed. The machine needs feeding whatever and the church voice can be a calm voice of authority speaking the anxieties and wishes of the local community. However, we don’t want to be rent-a-voice, we are not helpful if we seem to be trying to grandstand over someone else’s grief. We need to show the compassion and love that our faith and Christian values teach us. 

That became critically important on the second night when things turned ugly and the story was hijacked by rioting right wing mobs. Having been to the peaceful and respectful vigil on the afternoon I drove back past the scene of the stabbings on my way home. You could smell the tension in the air as people were converging on the streets exuding a purpose that did not seem like the sorrow from earlier that day. 

The media aftermath for the church was then to support the efforts showing the community rebuilding whilst also calling for harmony, standing shoulder to shoulder with representatives from all faiths. 

And on to the funerals. 

There are many patterns to organising press coverage at a funeral. Usually, we need a pen to marshal the cameras in a way that enables them to get the pictures they need whilst maintaining a respectful, sympathetic distance. It feels there is a nigh on obligatory picture of the service order, my hand featuring in many of these shots. There is a lot of standing and waiting, clarifying the minutia of the service so the reporters can tell the story and capture the atmosphere.  

Yet for me each funeral is different as I try to ensure the family’s wishes predominate. Southport was a case in point. Of the two funerals in Anglican churches (one victim was from a Roman Catholic family) one family wanted no coverage and my role was simply to make sure that wish was honoured. The other saw cameras in and around church and a full suite of reporters so we work hard with them to ensure respect. Mostly that involves a combination of setting consistent fair rules and supplying enough for them to tell the story. Journalists can cope with told they can’t do something provided their rivals are getting the same message. Lose the consistency you lose the pack as I experience outside Ken Dodd’s funeral when I had to scream at the press pack to get back in their pen before the cortege arrived.  
I see this as a ministry. I have learnt techniques over the years, witnessed fights in graveyards, stood soaking waiting for the funeral to end and the coffin to leave so I can relax. Doing this is a privilege which spills over into the funerals I conduct as a priest. As do the learnings from those funerals that, in turn, inform my ministry. Get it right it becomes a fitting, respectful and dignified way for the wider community to say goodbye to a victim. 

Then when it’s done we move on. The press pack to the next day’s story myself to the tasks from the routine job that I had to ditch. That’s easier for us. But the families and loved ones can’t easily move on from their pain and grief. 

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