Recently I was struck by a quote from geographer Danny Dorling on the fact that, in 2020, the UK recorded the highest number of excess deaths since the Second World War.
“All these excess death calculations that are being made, we’re comparing ourselves in 2020 with five truly awful years,” said Dorling last month, “whereas other countries are comparing themselves with the best years they’ve ever had.”
Excess deaths are defined as deaths above what could be expected based on an average of the previous five years. Because of Covid-19, there were nearly 85,000 excess deaths last year. In the first three months of 2021, there were over 32,000 excess deaths.
However, the problem in using excess deaths in the UK as an indicator of the unprecedented nature of the Covid pandemic is that, because of the political choice of austerity, between 2014 and 2019 – the previous five years – excess deaths were already rising. There were, for example, over 32,000 excess deaths in 2015, over 20,000 excess deaths in 2016 and 2017 and over 22,000 excess deaths in 2018.
In other words, because of the preceding “five truly awful years”, the huge rise in excess deaths in 2020 and 2021 was less pronounced than it would otherwise have been. In yet other words, the true extent of the present human catastrophe overseen Conservatives has been masked by the previous human catastrophe overseen by the Conservatives. You might call that ironic.
Lifting the veil
This can happen because a veil of denialism still surrounds austerity. With Covid, the bare facts are generally accepted even if the reasons for the enormous death toll – at the time of writing the sixth highest in the world – are blotted out. Austerity does not even have that chink of light. A cheer-leading consensus has blinded a rational acceptance of its effects. The entire political class was in cahoots – though austerity was carried out by the Conservative-Lib Dem coalition, the pre-Corbyn Labour opposition voiced its support from the sidelines.
Austerity was largely implemented through swingeing cuts to benefits and central government funding to local authorities. A combination of the popular and the invisible.
The ground for the former was prepared by a massive, and effective, propaganda campaign, portraying benefit claimants – especially allegedly sick claimants – as scroungers living off the naive generosity of the taxpayer. In addition to direct cuts in benefits – the benefits cap and freeze – there was a huge increase in the sanctioning (the withdrawal of all financial support) of claimants. Over a million sanctions were imposed in 2013, a 345% rise on their 2001-2008 average (they had been introduced by the previous Labour government).
Local authorities, however, bore the brunt. The central government grant to local councils was cut by 49%. Given that most local government spending (around 60%) goes on social care, this is where the axe fell, with palpable consequences for mortality rates. In 2014, there were a million fewer social care visits to the elderly than there had been five years before.
There is nothing painless about cuts; they don’t just eradicate ‘waste’. “ … the more cuts there have been to public health, social services and benefits – particularly for people in old age – the more earlier deaths there have been in the UK,” says Dorling. “Cuts that prevent visits by social workers to elderly people reduce their chances of being found after a fall. Cuts that make it harder to rehouse someone who is currently in a hospital bed back into the community result in hospital beds not being available for others.”
All this was compounded by what was happening to the NHS. Though formally “protected” from austerity, between 2010 and 2015 health spending rose by an average of 0.5% compared to an annual uprating of 4% since 1950.
In 2017, a study published in the British Medical Journal found that the post-2010 squeeze on public finances was linked to around 120,000 excess deaths in England alone, with the over 60s and care home residents most affected. The researchers estimated there were more than 45,000 excess deaths between 2010 and 2014 and over 152,000 people could die between 2015 and 2020 unless the “mortality gap” was closed by more funding.
Mind the gap
But such was the size of the mortality gap, it was starting to eat into life expectancy. In autumn 2017, the Office for National Statistics (ONS) revised its predictions for life expectancy for both women and men, cutting the estimate for both by about a year – an estimate that had been made just two years previously. Life expectancy was flatlining. After rising consistently for decade after decade, it was now barely creeping upwards. During David Cameron’s time in office it rose by a month a year for men and by just two weeks for women. By contrast, in the 1940s and early 1950s life expectancy rose by a year every three years and accelerated again in the 1970s and ‘80s.
This means, explains Dorling, “that 110 years of improving life expectancy in the UK are now officially over. The implications for this are huge and the reasons the statistics were revised is a tragedy on an enormous scale.”
The evidence kept accruing. In February 2020, the Marmot Review, an investigation into health inequalities originally commissioned by the Brown government, found that overall life expectancy had failed to increase for a decade and had actually declined for the poorest 10% of women. The author, Michael Marmot, blamed austerity for taking a “significant toll” on the nation’s health and being responsible for “flatlining life expectancy”.
And the pension industry believes life expectancy is actually falling. In 2018, The Institute and Faculty of Actuaries cut adult life expectancy by six months in what it said was “a trend as opposed to a blip”. In March 2019, Continuous Mortality Investigation, a company owned by the Institute and Faculty of Actuaries, found that the life expectancy of men and women aged 65 had fallen by five months from 2017. According to one group of analysts, the main reason was that deaths in 2018 were “particularly high”.
However, there is a silver lining. In 2017 the Financial Times had reported that the “sharp slowdown” in life expectancy could wipe £310 billion from the deficits of large companies’ final salary pension schemes.
In an irony typical of this economic system, deteriorating public health is actually good for the financial health of big firms.
At present, official life expectancy is stalling, as opposed to actually declining as it is in the US, but further revisions are not unlikely.
For whom the bell tolls
Changes in life expectancy such as these are momentous. Besides the human cost, they signal that something very significant is happening to an economic and social system. The collapse of the Soviet Union was preceded by rising mortality and declining health spending. In 1976, a French demographer – widely ignored at the time – correctly predicted the demise of the Soviet system on the basis of rising infant mortality figures. Coincidentally, since 2014 infant mortality has started increasing in England.
But despite our free institutions and allegedly adversarial media, stagnating life expectancy here and now has created nothing more than a faint murmur. The ONS’s downward revisions referred to earlier were buried in an appendix to a press release. The BBC can claim that Covid “has undone the progress made in the last decade or so” and ignore the pre-Covid rise in excess deaths (that its own graphs show!). Matt Hancock can pontificate about adding five years to life expectancy through healthy eating.
Nothing is being suppressed. All the information contradicting official complacency can be readily collated (I just have). But in the absence of mass exposure and repetition – the secret of news becoming received wisdom – the truth about austerity and life expectancy reaches, at best, a minority who want to hear about it.
And far from the damage being repaired, austerity – as enshrined by Rishi Sunak’s last budget – will continue. With the evidence about the effect of austerity in 2010s now clear, the government is responding by upping the dose.
Meanwhile, the land of make believe strides on, brimming with absolutely unwarranted self-confidence.
