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
Comment
Development
War & peace
3 min read

South Sudan is on the brink, but it can pull back

The UK can join local peacemakers in preventing a new civil war.

James Wani is Christian Aid’s South Sudan’s Country Director.

A Sudanese woman walks across the ashes of a burnt out street market.
A burnt-out market place in South Sudan.
Christian Aid.

It’s been two years since Sudan slid into a brutal power struggle between the army and its former ally, the paramilitary Rapid Support Forces (RSF). Despite its size and savagery, blink and you might miss it as the world media remains mesmerised by the White House tariffs.  

Sudan’s people have suffered on a scale that’s almost impossible to take in. It is the world's biggest humanitarian crisis. More than 12.5 million people have been forced from their homes. Some estimates suggest up to 150,000 people had been killed so far in the conflict.  

The ensuing chaos has spilled into neighbouring countries like South Sudan where I live. Over the last year almost a million refugees and returnees have crossed the border to escape horrific war crimes, violence and rape. 

Neither are they escaping into a land of peace and stability. Resources are stretched as South Sudan grapples with long-standing challenges like floods and droughts from climate change and our own fragile peace process.  

Those crossing from the north have added a crisis on top of the existing crises. Nine million people here need humanitarian assistance - three quarters of South Sudan’s population.  

Christian Aid and its local partners are doing what they can to support this huge influx from Sudan by providing cash, emergency supplies and access to water and sanitation to more than 100,000 people.   

But even these attempts at relief might be short-lived. Fears are growing that South Sudan may follow Sudan and topple into civil war. 400,000 people died over five years in the last one. Ominous signs are there for a renewed conflict.  

Late last year in Juba there was an outbreak of violence between the President’s military forces and armed groups connected to the former head of the National Security Agency. The country’s first ever elections keep on being postponed. Tensions escalated in February. An unelected Reconstituted Transitional National Assembly was not called back from recess to discuss this.  

Now the country's First Vice-President Riek Machar is under house arrest. South Sudan's President Salva Kiir accused Machar of stirring up a new revolt. Last month, the US ordered all its non-emergency staff in South Sudan to leave as fighting broke out in one part of the country.  

Just this month, the UN mission’s plane was shot down, killing staff and a wounded armed forces general, allegedly by groups allied to the Vice-President. Uganda has sent its army to support the President and airstrikes on civilian areas and opposition compounds in four states are now nearing the capital.   

South Sudan might be on the brink, but this isn’t a doctrine of despair. The country can pull back.  

Christian Aid doesn’t just provide humanitarian support - we are in the business of hope. by working hand in hand with local activists, like the South Sudan Council of Churches (SSCC), to help the country’s government establish and implement the 2018 peace agreement.   

Respected church leaders have, and are, playing a key role in building trust and confidence:  brokering peace deals at local level, undertaking shuttle diplomacy in South Sudan’s states, talking to armed groups to urge them to get behind the peace agreement and to the President and Vice-President to return to honouring their agreement. The new elected head of SSCC, Rev. Tut Kony Nyang Kon, said their role was to bring the country around a unity of purpose.   

He said South Sudan’s leaders need to present a reinvigorated plan for free and fair elections in two years to reassure people, rally the peacemakers and deter those who may see an opportunity to undermine the peace gains made so far.  

But they need diplomatic support too.   

The UK, along with the USA and Norway, is part of the influential “Troika” that must make a serious diplomatic investment in the national and international peace processes to ensure that the existing peace agreement holds and deter other states from providing financial or military support that can fuel conflict and violence.  

The UK government needs to show it means what it says when it promised the UN Security Council last November that it would champion the protection of civilians and double aid for those fleeing the conflict in Sudan.  

2025 should be a leadership moment for the UK and the international community to increase support for the region and get behind South Sudan’s peacemakers to avoid another catastrophic conflict in Africa.