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
Mental Health
Politics
4 min read

Why reducing the voting age is a mistake

Adolescence should be a safe space to be a bit daft

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

A band and audience are back lit against a stage.
Let it out.
Kylie Paz on Unsplash

The haunting book of Ecclesiastes carries these memorable words:  

For everything there is a season, and a time for every matter under heaven: 

a time to be born and a time to die, 

a time to weep, and a time to laugh 

a time to keep silence, and a time to speak 

They came to mind recently when reading of the UK government’s plan to reduce the minimum voting age to 16. Now I understand why this government might want to do this. Lowering the voting age has proved popular in other places such as Scotland. Some well brought up 16-year-olds are mature beyond their years, show an interest in politics, and are smart, articulate people. And, of course, younger people tend to be more inclined to vote for left-leaning parties like Labour. It makes electoral sense.  

But does it make generational sense?  

Adolescence is a time when we try out being grown-up for a while. Mid-teenagers are no longer children, but they are not yet fully adult. They are in the process of spreading their wings, most of them still at school, living at home under their parents’ roofs, not yet fully responsible for their own time, income, life choices and so on. They can’t legally buy alcohol, fireworks or drive a car. Yet they can buy a pet or a lottery ticket. It’s a kind of middling time, not one thing nor the other.  

And rightly so. Adolescence is a time for a certain controlled irresponsibility. We all look back with embarrassment on things we did in our teenage years. A few years ago, I watched a cricketer called Ollie Robinson make his debut for England at Lords. The best day of his life turned into the worst when some journalist desperate for a story dug up some semi-racist tweets he had posted several years before as a teenager. Some say he has never recovered, as he struggled with the media attention into his life, and has not played international cricket for over two years. We all said stupid things when we were 16 and that should be expected and forgiven as what they were – immature posturing, attempts to work out who we are in the big world, testing the water of the adult world before we dive in. Adolescence should be a safe space to be a bit daft, to get some things wrong and some things right. Hopefully we learn from our mistakes and our successes and grow up a bit through them.  

The attempt to make 16-years olds politically responsible seems to encroach upon that safe space. It risks skewing an important stage of growing up. And this seems to be a modern trend. 

Teenage years are a vital period enabling us to grow into mature adults, learning to become responsible over time. 

In the past, 21 was the age when people legally became adults, being given the ‘key to the door’, trusted to come in and out of the house independently of parents. Yet that has shifted within living memory. The legal age of adulthood was reduced to 18 in 1969. 

Jonathan Haidt recently complained that we are seeing “the complete rewiring of childhood.”  The childhood of mammals, he claimed, involves rough and tumble play, chasing games, activities that develop adult skills. In recent times, he says, we have put into the pockets of children and young teenagers, a video arcade, a porn theatre, a gambling casino, and access to every TV station. The result of indiscriminate access to smartphones has been the loss of what we recognise as childhood and its replacement by gazing at screens all day long. 

This shift to the voting age is also part of the drift to politicise everything. Everything becomes political, from your artistic tastes, to gender differences, to the food you eat, to family relationships. If politics is everything then surely everyone affected by it must vote? Yet politics has its limits. Politicians can only do so much. They can try to fix the economy, close loopholes that let harmful behaviour flourish, organise life a little better for most of us. They cannot fix the human heart, get us to love our neighbours or teach us gratitude, humility, faith, or what to worship – the most important choice of our lives. 

Not everything is political, but everything is spiritual. Everything moulds us in some way, shaping us into the people we become over time, like plasticene in the hands of a child. Teenage years are a vital period enabling us to grow into mature adults, learning to become responsible over time, being given leeway to develop our moral senses and to work out our opinions as we encounter the wider world.  

There is indeed a time to be born, and a time to die; a time to choose, and a time to play; a time to be an adult and a time to be child. Perhaps we should respect the times and seasons of life a little better, letting teenagers be teenagers and not expecting them to become adult too quickly. Most will hopefully have many years to vote if they live long healthy lives. The distinctions of time and the delicate, slow process of maturity need to be respected. We erode them at our peril.  

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