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. 

Snippet
Care
Change
Justice
4 min read

Four things I’ve learnt from working with prisoners

Here’s why I care about the incarcerated

Daniel is the regional director, Asia Pacific, for Prison Fellowship International.

Female prisoners hug their children who have climbed across a table to them.
Prisoners hug their children during a visit.
PFI.org.

It was my mother who first sparked my curiosity about engaging with prisoners. As a volunteer prison counsellor, she held bi-weekly meetings with incarcerated individuals, listening to their stories, struggles, and moments of hope. Over family dinners, she would share the situations these people found themselves in and how counseling was breaking through the emotional walls they had built around themselves. 

However, for most of my life, such a prison ministry was never something I considered pursuing – certainly not as my career. I’m a Christian and a verse from the Bible had guided me through life: 

“For I was hungry, and you gave me something to eat, I was thirsty, and you gave me something to drink…I was in prison, and you came to visit me.”  

The last part of that verse was the one I had often skipped over. 

Four years ago, this verse resurfaced in my life and this time, it wouldn’t let go. I was convicted of how I, and much of society, including the church, have often overlooked this desperate need within our communities.  

That conviction led me to work at Prison Fellowship International (PFI). I work alongside others who believe in redemption and grace for those the world has forgotten.  

PFI is a movement of more than 120 partner prison ministries worldwide working to restore the lives of those impacted by crime. It does that by sharing the Christian Gospel and God’s love with prisoners and protecting their children from increased risks of trafficking, child labor or following in their parent’s footsteps.  

As I’ve walked this road, I’ve realized why caring about prisoners matters. It’s not just a good deed, but a vital part of caring for the least and forgotten in our society. Here are four truths that have shaped my thinking. 

Compassion looks past the crime to the person 

In a world that often defines people by their worst mistakes, compassion calls us to look deeper. Many individuals behind bars have been shaped by lives of poverty, trauma and injustice who made poor decisions. In places like Sri Lanka and Nepal, I’ve encountered people imprisoned for stealing food to provide for their families living in desperate poverty. These stories reveal a wider context of inequality, where systemic injustices and lack of access to healthcare, education, or employment drive people towards choices they might not otherwise make.  

While I do not excuse nor diminish the harm caused by crime, we must hold space for both justice and mercy. We must choose to see beyond someone's crime and into their heart to recognize their humanity and believe in the possibility of restoration – for them as an individual, for the victim and for our communities as a whole.  

Families are the silent, forgotten victims 

When someone goes to prison, it’s not only the individual who suffers; their families, especially children, often quietly bear the weight of that loss. I recently met 11-year-old Su Lin in Cambodia. Her dad is imprisoned, and her mother left the family in the care of their grandmother. When the burden of caring for them became too great, Su Lin’s brothers were put up for adoption. She doesn’t know if or when she’ll see her father again or whether her mum will ever return. 

Her story is heartbreaking, but just one of millions. Around the world, children of prisoners are shunned by their community for crimes they did not commit and left isolated in cycles of poverty, trauma and often, generational crime.  

Daily, I have the privilege of working with PFI’s network to support children like Su Lin, but so many more slip through the cracks. When we forget prisoners, we also abandon their families, the silent victims who deserve care, hope, dignity, and a chance at a brighter future. 

True justice restores, not just punishes 

I’ve seen first-hand how forgiveness, accountability, and a path to restoration can heal not just prisoners, but entire communities. In the Solomon Islands, a culture deeply rooted in a strong, connected community, this type of redemption is being lived out.  

There, before prisoners are eligible for parole, they are invited to participate in Sycamore Tree Project, a PFI program that aims to foster healing and reconciliation through restorative efforts. When all parties are ready, local religious leaders facilitate a reconciliation meeting between the offender and victim, often joined by their families and community leaders. These difficult yet grace-filled conversations lead to healing, accountability, and forgiveness. 

Our findings have been powerful: reoffending rates in these communities have dropped dramatically. This is what radical reconciliation looks like – messy and challenging, but life-changing. 

Faith calls us to love the forgotten

At the heart of faith is a call to love those whom the world has cast aside, including those behind bars, so often labelled unworthy and left behind. With many correctional systems still prioritizing punitive justice, I believe we are called to deeply reckon with how we can advocate for grace in a society focused on punishment. 

Prisoners are not beyond hope. Their families are not invisible. Their futures are not sealed. Together, we can bring light into the darkest places in our communities and societies. In doing so, we discover the depth of true, lasting justice and mercy.    

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