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Care
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Economics
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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. 

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3 min read

University turmoil makes the case for chaplains

Creating space, offering time, across cultures.
A cup of coffee is offered across a table to a hand that is hesitant.
Priscilla Du Preez 🇨🇦 on Unsplash.

As the university sector convulses, what’s the point of their chaplains? 

The university chaplains fulfil a role which calls for a unique set of skills, including pastoral imagination, flexibility, and creativity as they respond to various, often unpredicted, challenges. Chaplains occupy a place between highly professional Students Services colleagues at the university - think counsellors, experts on emigration and finances, and local parishes representing diverse theological viewpoints.  

Every year, while meeting and greeting international students, one of the earliest tasks for the chaplains is to explain their role, as in non-European languages and cultures there is no equivalent of a “chaplain”. Are the chaplains sort of “spiritual gurus”, “life coaches”, “champions of wellbeing”? What is the real difference for the students and the staff in a secular academic institution, between approaching a chaplain and a professional counsellor?   

In addition to all these initial questions that a student might ask, other observers question the role of chaplains in a secular academic institution, for being counterproductive. Why provide and finance a chaplain without any measurable outcomes of his or her work? Whether it is counting confirmations, ensuring Christian faith and values as clearly pronounced, or/and conducting regular acts of worship for the students and staff? 

Looking at my daily engagement with the international, diverse community of the students and the staff, there are at least three areas of presence (rather being than doing, adapting famous Gabriel Marcel’s distinction), which illuminate this unique type of vocation.  

First, currently British universities are going through a very painful, dramatic time of saving money and redundancies. Chaplaincy is becoming a visible space for emotional support to those who are worried about their immediate future. Students and staff are going through a period of uncertainly, if not confusion, so chaplaincy holds the unique space on the campus to show empathy to those who cry, and to offer time for those who need to speak about their pain.  

Secondly, chaplaincy has the privilege of being very creative in the ways of engaging with the local academic community. The memorial services for the students and the staff who died recently are not the formal funerals: yet they allow the participants to speak, play the music, show videos about the departed.  There is a real celebration of life, brings consolation to academic colleagues, families and relatives.  

Thirdly, unlike other professional services, only chaplaincy is able to show the generosity of time to anyone who comes through the door. That’s because those  individuals are welcome as the ‘image’ of God. The rest about that individual is accidental, he or she finds ‘home away of home’ in the space of chaplaincy, because through the eyes of Christian faith: he or she is precious and unique. 

What about proclaiming the message about Jesus Christ? There is a story about St Francis of Assis who said to his brothers, while approaching an Italian city: “now we will proclaim the Gospel to all who live in this city”. After that he and his companion marched through the streets in silence. When they left the city, one of his brothers, rather surprised by lack of preaching, asked: “Francis, when did we proclaim the Good News?”. “Our way of walking was the proclamation of our faith”. The way how we greet, spend time with students, talk, joke and pray – reflects that proclamation.     

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