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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
Economics
Nationalism
Politics
4 min read

Millions of children go hungry in a country that dares to call itself godly

The gospel of national greatness is less about grace and more about political grit

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

A sand drawing shows an unhappy child's face with the tide coming in from below
A sand drawing for a child poverty campaign.
Barnardos.

If anything, the UK – and more specifically England – is becoming a Christian country again. But not necessarily in a good way. The rise of Christian nationalism mirrors the American experience, with Christian symbols such as the cross weaponised against asylum seekers and the knuckle-draggers under them, marching as to war. 

But there are still many non-belligerents who would stake a claim to our Christian nationhood. Wiser counsels such as the historian Tom Holland. Or Danny Kruger MP, who spoke to a near-empty chamber in parliament recently, before defecting from the Conservatives to Reform UK, about a Christian restoration, envisioning a "re-founding of this nation on the teachings that Alfred made the basis of the common law of England." He may need to explain that slowly to Nigel Farage. 

But by what measure do we claim to be a Christian country? Here’s one: Child poverty. It’s very hard to make a case for a state being foundationally Christian in principle if significant numbers of its children go hungry. And the UK shamefully ranks among the worst of the world’s richest countries in this regard, with our children’s poverty rates rising by 20 per cent over the past decade – defined as those living in a household with less than 60 per cent of the national median income, so currently less than about £19,000 a year.  

That’s some 4.5 million living in poverty, or 9 in a typical classroom of 30. Unless action is taken the number will push five million by 2030. Anecdotal evidence from teachers is truly shocking. Children arrive hungry at school with empty lunchboxes to fill and feed family at home. The UK ranks below poorer countries such as Poland and Slovenia, which are currently cutting their child-poverty rates, and well ahead of other wealthy nations such as Finland and Denmark.  

It’s a national disgrace. Christologically, it also fails the minimum threshold for a nation that supposedly holds that the kingdom of heaven belongs to children. In damp and sub-standard housing this winter, lacking nutritious diet and prone to ill-health, heaven will have to wait for these British children. 

The same gospel tells us that the poor are always with us, which may make us resigned to it. But political complacency won’t do. If there is always relative poverty against great riches, then the true measure must be what we’re trying to do about it. The damning answer to that seems to be very little. 

It’s actually worse than that. The circumstance is one of our own deliberate, political making, exacerbated by the then chancellor George Osborne, who introduced the two-child benefit cap in 2017. That limited benefit payments for families claiming Child Tax Credit or Universal Credit for more than two children. It was part of Osborne’s pantomime wicked-squire act, as he repeatedly told us with a straight face that “we’re all in this together”. It was also borderline eugenics, because one of its effects was to limit the breeding of “lower orders”, the benefit cap disproportionately hitting the budgets of working and ethnic-minority families. 

With Osborne’s selective austerity and social-engineering drive long gone, it’s well past time for a Labour government to do something to rectify such social injustice. Current chancellor Rachel Reeves must abolish the two-child benefit cap in her November Budget. With other welfare cuts prevented by Labour’s summer backbench rebellion, the question inevitably squawked by right-wingers is how that will be paid for. 

 Opposition parties relish the prospect of Reeves welching on pre-election promises not to raise taxes on working families. And abolishing the two-child welfare cap could cost £3.5 billion a year. 

There are creative ways and means. Veteran chancellor and former prime minister Gordon Brown – the unsung hero of the 2008 worldwide financial meltdown, without whom we wouldn’t have an economy to do anything with – proposes fairly taxing the excess profits of the £11.5 billion gambling industry, which enjoys VAT exemptions and pays just 21 per cent tax, compared with 35-57 per cent in other industrialised  countries. And if more money is needed then remove some of the interest-rate subsidy enjoyed by commercial banks when they deposit money at the Bank of England. That is what social justice looks like (gambling also costs the NHS £1 billion-plus in harms, so it’s time for the industry to pay up). 

That points to some fiscal answers. There are other actions that must be taken this autumn, at political conferences and on any platform available to those with a public voice and conscience. It’s good to see Stephen Cottrell, Archbishop of York and stand-in primate of England in the absence of Canterbury, laying into the two-child limit and benefit cap. 

Both Cottrell and Brown tell heart-breaking stories of children’s poverty in the UK. We must fight it and ensure that Reeves’ forthcoming Budget does so. As the children’s commissioner for England, Dame Rachel de Souza said recently that millions of children are living in “almost Dickensian levels of poverty”. The irony is that in Dickens’ time we were called a Christian country. 

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