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
Community
Easter
2 min read

A day without water tapped into the best of us

In a crisis, community seeps through our walls.

Imogen is a writer, mum, and priest on a new housing development in the South-West of England. 

On a doorstep a man hands a bottle of water to another man.

Recently on our housing development we experienced a surprising addition to our lives. Due to a pretty major error, a main water pipe was hit by a digger… this resulted in 24 hours of no running water for our entire estate and the local school while the pipe was repaired. 

24 hours is a long time. In our house, water consumption over that time looks something like this: 

  • 1 dishwasher cycle 
  • 1-2 clothes wash cycles 
  • 2 loads of dish washing up 
  • 2 boys in a bath 
  • 2 showers 
  • 10-15 toilet trips 
  • various hand washing, plant watering, child play etc. 
  • 4-6 bowls of boiled pasta/rice 
  • 8-10 cold water drinks 
  • 20+ cups of tea 

Let me tell you, 24 unexpected hours without water was a challenge. But it also got me thinking. 

It got me thinking about privilege. In the UK, access to clean water is not a daily conscious consideration, it is assumed. We assume that we will have water when we turn on the kitchen tap, when we flush the toilet, and when we run a bath. We assume that the water out of the taps will be clean and safe. This is not the case for everyone. Around the world, one in four people do not have access to safe drinking water. Access to water is a universal human right, but in reality access to water shows our privilege. 

It also got me thinking about simplicity. Lent is a time for reflection and often in the Christian tradition it is a time for fasting. In previous years, I have fasted from multiple things: coffee, chocolate, Instagram, and this year Vinted and meat. But I have never fasted from clean, running water. There were many household chores and to-do list items that I simply couldn’t do because we didn’t have water. As with other fasting attempts, I hope that this unexpected space led me to prayer. There was a temporary, reflective simplicity to the absence of water. 

And it got me thinking about community. Crises bring out the worst and best in humanity. Though I could tell you a couple of horror stories, instead let me tell you about the heroes. Tessa, Tom, Marjay, Sarah, Vineeth, Megan, Danny. These heroes went out of their way to buy and distribute water across the development, to monitor and communicate updates from the water company, to offer support with boilers. Several houses had bottled water piled outside their homes for anyone who had run out. We had multiple unexpected water deliveries and neighbours checking in. Our community thrived as we struggled without water. In a crisis, community seeps through our insulated walls and isolated lives. In a crisis, community swells and surges showing that there is indeed good in this world. 

I’m glad we’ve got our water back. But I’m also glad for all the thinking. 

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