Austerity: Life Expectancy

Ian Paisley Excerpts

Wednesday 18th April 2018 Westminster Hall

[Louise Haigh]

My right hon. Friend is absolutely right: these are long-term issues, which need addressing. They are all the more heartbreaking because we have seen decades of progress, and we all assumed that that would only go in one direction; little did any of us imagine that we would see a rise in infant mortality in the sixth-richest country in the world. These figures are, quite frankly, inexcusable.

On social care, care homes in deprived communities often no longer receive enough to cover the costs of care, which inevitably compromises the quality that they are able to provide. For those in such communities who cannot afford private care homes, that reduction of quality, and in some cases the lack of any available residential care at all, has had a punishing effect.

All Members present will have received casework regarding those still in their homes in the community who rely on care packages. Their care is simply unacceptable, relying on care workers who are paid far too little and who often do upward of 25 care visits every single day. There is not a chance, even by unsustainably drawing on the boundless good will of those care workers, that visits could last for 30 minutes, as defined by official guidance. It is beyond the realms of possibility. Those millions of hours of lost contact time for the 470,000 vulnerable—predominantly elderly—people who use home care will have undoubtedly compromised their long-term care and support needs and the management of multiple conditions.

It perhaps should not be a surprise that the rise in mortality and the fall in life expectancy came from precisely that cohort—older women living alone in poorer areas. In many senses, they were the early-warning sign of the deeply troubling trend in increasing mortality. This cohort, more reliant than any other on a functioning, effective, compassionate state providing quality support, have been badly let down in recent years. It should be a source of national shame that elderly women in some of the most deprived areas of our country are living in isolation, not properly cared for, and are losing their lives because the state has not supported them. However, it is not just that cohort of women. Some 7% of the extra deaths in 2016-17 were of people aged between 20 and 60. Almost 2,000 more younger men and 1,000 more younger women have died than would have if progress had not stalled.

I am sure that the Minister cannot look at the evidence presented here today, or at the research undertaken over the past two years, and not want to take steps to tackle those shocking statistics and to prevent those lives from being cut short. It is therefore critical that Ministers and the Government take seriously the fall in life expectancy and the evidence behind the growth in mortality. Up to now, Public Health England has regrettably tried to attribute it to the greater prevalence of flu. However, as Loopstra noted in her report:

“If Public Health England’s attribution of rising mortality to cold weather and flu is correct, then it should lead to an elevation of mortality in regional swathes across the nation. However…trends have varied considerably across local authorities, with no apparent geographic patterning consistent with regional outbreaks.”

The rise in unexpected mortality and the concurrent fall in life expectancy represents a significant moment in the history of public health in this country, yet the Department of Health has so far rejected the call from public health professionals for an inquiry into the sharp rise in deaths. I repeat that call today, and ask the Minister to look very seriously at the evidence presented on the link between life expectancy and austerity.

I will end on the words of Danny Dorling and Stuart Gietel-Basten, who have undertaken so much of the research in this area:

“demography is not destiny. Projections are not predictions. There is no preordained inevitability that a million years of life need be lost…but only through politics comes the power to make the changes that are now so urgently needed.”

The Minister has that power in her hands, and there can be no more pressing question for her than to ask why the citizens of our country are dying sooner than they should. I hope she leaves no stone unturned in pursuit of that answer.

[Ian Paisley (in the Chair)]

I do not intend to put a formal time limit on speeches. However, there are two Opposition spokespersons as well as the Minister, and I would like to start calling the Opposition spokespersons just after the hour, so if Members could speak for about five minutes each, that would be helpful.

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[Chris Ruane]

I am afraid that I must move on, because I have been getting eyes from the Chair and I do not want to upset Mr Paisley.

The Government have said that the situation is a blip because of flu or the cold weather. The Department of Health has seemed to downplay fears about life expectancy, pointing out that smoking rates have gone down and cancer rates have gone down, but that is all the more reason to be worried. If those indicators are going down and life expectancy is going down, what is causing that? Those are good indicators, but there are some bad outcomes for certain people in certain areas.

A report by Professor Martin McKee, whom I had the pleasure of meeting yesterday, notes that the most recent period

“has seen one of the greatest slowdowns in the rate of improvement”

in life expectancy

“for both sexes since the 1890s”.

The relative data on life expectancy today is comparable to a time before workers’ rights, advancements in medicine and technology, and the welfare state. That slowdown, as reported by the Office for National Statistics last July, shows that the increases in the previous period, before 2010, meant that for every five years that a woman was living, she could expect to live one year extra. Now it is the case that for every 10 years that a woman is living, she can expect to live one year extra. The rate has been halved.

Let me add to those figures some of my own, which I received through parliamentary questions that I tabled in January. Between 2009-11 and 2014-16, 19.8% and 20.3% of local authorities reported a decline for females at birth and at 65-plus respectively. There are certain areas of the country, certain demographics and certain genders—women—who are feeling this the most. That is no surprise, because 80% of the austerity cuts made since 2010 have fallen on the shoulders of women. The link between life expectancy and cuts to social care budgets has already been highlighted.

The hon. Member for South West Bedfordshire mentioned Scotland. I do not want to stick up for the Scots: they can do a good job themselves, especially the hon. Member for Central Ayrshire (Dr Whitford), with her medical background. However, there are national and regional variations within the United Kingdom. If we look at local authorities in England, we see that 22% of them have seen a decrease in life expectancy.

[Ian Paisley (in the Chair)]

Order. Could the hon. Gentleman draw his remarks to a conclusion?

[Chris Ruane]

In Wales and Northern Ireland the figure is 18%. In Scotland it is only 6.2%. In the north-east of England, 27% of local authorities have seen a decrease in life expectancy. There are regional differences. What we can draw from that is that where there has been devolution and kinder, gentler Administrations, there has been a less sharp decline.

Hope is a powerful motivator in the way we make decisions. Messages of hope won historic victories for my party in 1945 and 1997 and denied the current Government their majority last year. What the Conservatives proposed at the last election, after seven years of austerity, was another 10 years of austerity. There is learned helplessness out there. People are sick and tired, and they are dying because there is no hope. They have lost income—£2,000 for most people and £5,000 for teachers. Austerity is biting, not just in medicine but in social care, and affecting mental health and physical health. In the short time I have left, Mr Paisley, it is worth noting—

[Ian Paisley (in the Chair)]

Very little time.

[Chris Ruane]

There is very little time, so I will draw my comments to a close by saying that Professor Martin McKee and other academics, from Oxford and other universities, want the Health Committee to have an inquiry on this issue. It is complex. I have mentioned some of the causes, and other MPs, from both sides of the Chamber, have mentioned some of the other causes of the decline in life expectancy. It is a complex mix of issues and deserves an inquiry by the Health Committee.

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[Mrs Hodgson]

It is not rubbish. Professor Sir Michael Marmot warned:

“If we don’t spend appropriately on social care, if we don’t spend appropriately on health care, the quality of life will get worse for older people and maybe the length of life, too”.

Sadly, we have seen this across the board. Despite the growing pressure on our health and social care service, the Government are responsible for spending cuts across our NHS, social care and public health services. While demand continues to increase, the Government have taken away vital funding, which could close the life expectancy gap.

Since local authorities became responsible for public health budgets in 2015, it is estimated by the King’s Fund that, on a like-for-like basis, public health spending will have fallen by 5.2%. That follows a £200 million in-year cut to public health spending in 2015-16. Further real-term cuts are to come, averaging between 3.9% each year between 2016-17 and 2020-21. On the ground, that means cuts to spending on tackling drug misuse among adults of more than £22 million compared with last year and smoking cessation services cut by almost £16 million. Spending to tackle obesity, which the hon. Member for South West Bedfordshire mentioned as a cause of shorter life expectancy, has also fallen by 18.5% between 2015-16 and 2016-17 and further cuts are in the pipeline. These are vital services for local communities and could benefit their health and lifestyle, but sadly they continue to be cut due to lack of funding.

How does the Minister expect to close the life expectancy gap without investing properly in vital public health services? An ounce of prevention is better than a pound of cure. The Government must invest in public health and prevention services, as that could play a significant role in closing the life expectancy gap that we are discussing.

When the Prime Minister made her first speech on the steps of Downing Street—the Minister is nodding, because she knows the quote—she said:

“if you are born poor, you will die on average nine years earlier than others.”

We were all pleased that the Prime Minister highlighted that issue, but I have been left disappointed with her Government’s lack of response to tackle it. We on this side of the House are committed to ensuring that our health and care system is properly funded, so that all children are given the best possible start in life and older people are treated with the respect and dignity that they deserve. I hope that the Minister will clearly outline what the Government will do to close the life expectancy gap.

[Ian Paisley (in the Chair)]

Before I call the Minister, I thank all hon. Members for complying so obediently with the timing that I requested.