All over the world, governments are slashing health care spending in the name of promoting “efficiency” and “cost savings,” on the grounds that there is “no money.” The reality, however, is that these cuts have as their direct outcome the early deaths of masses of people—collateral damage for the further enrichment of the financial oligarchy.
A study of the terrible impact of spending cuts of more than £100 billion in the UK alone, with the loss of more than 1 million jobs, provides an indication of the worldwide impact of the ongoing destruction of health care and essential services.
A joint report by Oxford and Cambridge Universities and the University of London (UCL) finds that savage cuts to the UK National Health Service (NHS) and Social Care provision could result in nearly 200,000 “excess” deaths by the end of 2020 in England.
“The effects of health and social care spending constraints on mortality in England: a time trend analysis,” published in the British Medical Journal, BMJOpen, estimates 45,000 extra deaths have occurred between 2009 and 2014 and predicts a further 152,141 deaths from 2015 to 2020—a staggering 100 a day.
The research links increasing mortality rates to the cuts to health and social care spending, first begun under a Labour government, then continued by successive Conservative governments to pay for the £1 trillion bailout of the banks after the 2008 global financial collapse.
“From 2001 to 2010,” it states, “the absolute number of deaths in England decreased by an average of 0.77% per year. From 2011 to 2014, the number of deaths increased by an average of 0.87% per year.”
Older people account for most additional deaths. Though the overall number of deaths in hospital fell in the period studied, this masks the fact that the elderly and frail are being pushed out of hospital and are dying needlessly in their own homes or in care homes. A combination of factors is responsible, including cuts to spending on social care, and a shortage of hospital and community nurses.
Total local authority spending on social care for older people decreased by £1.57 billion in just six years to 2016, leading to the closure of 95 care homes. The study associated each per capita £10 decrease in social care spending with five extra care home deaths per 100,000 of the population.
Spending on social care in England fell by 1.19 percent a year between 2010-2014, despite the projected increase in the number of 85-year-olds in the population—testimony to the historical legacy of the NHS, which for decades has been free at the point of need.
Patients are being discharged from hospital before they have properly recovered because of the pressure to free up beds. Elderly people with multiple health problems are callously referred to as “bed blockers.” The report notes, “Emergency medicine departments (A&E) saw 900,000 (4.6%) more attendances in 2015/2016 compared with the previous year, and 4% more emergency hospital admissions. Over the past two years, the number of elderly patients waiting over 12 hours in A&E [Accident and Emergency] has trebled, and there has been a 31% increase in delayed hospital discharges.”
Between 2010 and 2012 “nurse numbers dropped by approximately 6,000, which... translates to approximately 10% of expected deaths for that period.” There are currently 24,000 nursing vacancies due to years of pay restraint and cuts to training places. Since the abolition of bursaries, nursing applications are down by 20 percent. Britain’s planned exit from the European Union will make things even worse as a third of nursing applicants have come from the EU.
To close the mortality gap, the report concludes that the NHS budget would need to be increased by £6.3 billion each year to 2021, a total of £25.2 billion. Instead, in last week’s budget, Chancellor Phillip Hammond announced a derisory extra £2.8 billion for the NHS. In its post budget analysis, the Institute for Fiscal Studies forecasts declining productivity, growth and earnings every year until 2022. It says that the NHS is facing the “tightest funding constraints since the 1980s.” With annual spending growth of 4 percent before the financial crisis falling to the present 1 percent, and an aging population, the NHS is stretched to breaking point.
The BMJOpen report does not consider different mortality rates in reference to regional or class differences. However, it points out that “social care is means tested and privately delivered; factors that may influence access and quality.”
Since 2010, the NHS has been deliberately run down, with the £20 billion of cuts planned by the Labour government under Gordon Brown imposed by the incoming Conservative/Liberal Democrat coalition. A further £26 billion in “efficiency savings” is to be imposed by 2021, with the British Red Cross warning of a “humanitarian crisis.”
Labour and its allies in the trade union bureaucracy continue to collude in the destruction of health and social care in local authorities throughout the UK. Just weeks after the election of Jeremy Corbyn as party leader in 2015, he and Shadow Chancellor John McDonnell instructed Labour councils to continue to impose austerity and refrain from setting “illegal” budgets.
One of the BMJOpen study’s co-authors, Professor Lawrence King of the Applied Health Research Unit at Cambridge University, said, “It is now very clear that austerity does not promote growth or reduce deficits—it is bad economics, but good class politics. This study shows it is also a public health disaster. It is not an exaggeration to call it economic murder.”
The term echoes what Friedrich Engels, the co-founder of scientific socialism, described in his 1845 work, The Condition of the Working Class in England, condemning the British ruling class for “social murder” due to the fetid water supplies, cramped housing and disease that afflicted working-class districts.
Faced with the damning study by reputable academics from some of the UK’s top universities, the government issued the usual counter of political bias—the same response made to an earlier Oxford University research report published by the Journal of the Royal Society of Medicine showing that there were 30,000 “excess deaths” in 2015 compared to the previous year—the biggest leap in more than 70 years.