Health And Social Care Cuts Linked To Excess Deaths

[Kromovaracun]

http://bmjopen.bmj.com/content/7/11/e017722

A peer-reviewed paper published in British Medical Journal Open has concluded that spending constraints in health and social care introduced since 2010 have directly affected the UK's mortality rate, causing an estimated 120,000 excess deaths in the last 7 years. They state this research corroborates other recent research which has also identified a specific increase in the UK's mortality rate since 2010:

http://journals.sagepub.com/doi/10.1177/0141076817693599

If these findings are reflective of reality, and cuts in public spending are the cause, are the excess deaths worth the benefits of austerity?

[Sqad]

Kromo.......I will be honest...I read that report qt least 3 times and even so couldn't understand one bloody word of it.
We need someone like Jim, to make some sense and hopefully put it into simpler terms.....terms that we can ALL understand.
If the mortality rates have increased, then this is serious as the UK has always been down the league table in cancer survival and cardio vascular disease.......way before 2012, although i thought that there were signs of improvement, but apparently not.

[ToraToraTora]

I can help there sqad. Has giving less free money to work shy scum caused death? the answer is no.

[ToraToraTora]

if you want to live longer get yourself a dog!
http://www.bbc.co.uk/news/health-42009932

[jim360]

I'm still busy reading the paper, and will try to report back after that if I have anything meaningful to say (which is itself doubtful).

However, TTT, I will point out that the paper(s) specifically focus on a possible increase in mortality rate over the age of 75. So "work-shy scum" has nothing to do with it. At all.

Maybe, for once on your life, you could read something before you dismiss it, or before you endorse it wholeheartedly?

[ToraToraTora]

ok Jim, the OP relates this to austerity so the question is a flawed premise to start with.

[Kromovaracun]

Actually, the paper in question links it to austerity - specifically to cuts in public expenditure on health and social care which have taken place since 2010.

[New Judge]

"If these findings are reflective of reality,..."

They're not.

Apart from that there is no "austerity" in the UK, least of all in the health service. What there is a distinct lack of is the willingness to see the NHS operate in a properly efficient manner. The waste and inefficiency is incredible and is available for all to see. It is not lack of money that causes the NHS to be less effective than it should be.

[Kromovaracun]

//From 2001/2002 to 2009/2010, the average annual increase in real PEH per capita was 3.82%. Between 2010/2011 and 2014/2015, the average annual increase was 0.41% (online supplementary figure S1). Planned real PEH spending to 2020/2021 is forecasted to increase at an average of 0.72% per year, based on published information up to 2016. Real PES per capita experienced an average annual increase of 2.20% between 2001/2002 and 2009/2010, while between 2010/2011 and 2014/2015 it decreased by 1.57% annually.//

Surely that implies a significant cut in spending, New Judge?

I mean, you might argue that 0.4% is still too high an increase (though I believe it was below inflation, though I may be wrong). But it's still a demonstrable cut.

[jim360]

I managed to get through the first two papers -- which, incidentally, date back to February, so maybe it's a little surprising to see them in news now as opposed to then. They were, I think, reported on in various media outlets at the time.

I'm not sure how persuasive they are, or should be. It's not difficult to find passages scattered in both papers that make it easy to imagine at least some amount of politics driving the conclusions reached. For example, there's this passage at the end of the second paper:

"Yet, despite claims by some current cabinet ministers that leaving the EU would generate an extra £350 million per week for the NHS, the government reportedly has no plans to increase funding."

Now, I'd happen to agree that Johnson in particular seems determined to repeat this claim, writing in the Telegraph a couple of months ago: "Once we have settled our accounts, we will take back control of roughly £350m per week. It would be a fine thing, as many of us have pointed out, if a lot of that money went on the NHS..."

But the main point is that including such a line in the paper does come across as very politically motivated, and I wonder how easy it is to separate the analysis from the politics. Such is always the problem with statistics. Numbers don't lie, but the people reading them may do.

I would also like to see the full critiques from someone called Jones and another person called Eugene Milne, both of which -- along with the authors' reply -- are blocked behind a wall I can't seem to get past even through the university. But Milne (http://journals.sagepub.com/doi/full/10.1177/0141076817703881 ) notes, and I concur, that "the visual appearance of a rise [in mortality rate since 2010] is heavily dependent on the 2015 data point."

So, I don't know. If the reported trend continues for a few more years, then it's hard to argue against the idea that something has changed very recently such that older people are at greater risk of death than previously. But it's tricky to know what to attribute that cause to. Despite what NJ says, austerity has actually been a thing for the last few years, so it certainly *could* be a knock-on effect of government policy. But I don't think the papers are definitive enough on this.

To be fair, the authors are careful not to state any definitive conclusions either.

[Mamyalynne]

^ link

http://journals.sagepub.com/doi/full/10.1177/0141076817703881

[jim360]

thanks Mamya.

I found this discussion in the Economist from March, also related to the paper:

https://www.economist.com/news/britain/21718939-2015-saw-biggest-annual-leap-deaths-50-years-britains-long-falling-death-rate-has

[Theland]

I believe 90 Tory M.P.'s have signed a netter to the P.M. Demanding emergency funding for the N.H.S. Fat chance from these heartless people.

[Old_Geezer]

If there were claims by some current cabinet ministers that leaving the EU would generate an extra £350 million per week for the NHS I'd suspect they must have been mainly from the ranks of remainer MPs; since that was the group claiming, despite the evidence to the contrary, that the leaver bus said that. Anyone stating that it would be fine if a lot of that subscription went to the NHS is simply stating their personal point of view. Nothing wrong with that. "A lot" isn't "all". And one might consider no one has left yet anyway; so it's hardly relevant.

[Old_Geezer]

I think it's obvious that austerity measures lead to less money to do what's desired and inevitably worse results across the board. It'd be naive to think that there wouldn't be a rise in the death rate at hospitals as a result. IMO most of the time, investing to kick start the economy is the better solution; but unless previous governments, of all persuasions, have had the sense to put sufficient of our wealth away for a rainy day during the better times, then there are hard borrowing decisions to be made instead. The political right prefers to avoid that by telling us that we are all in this together and we have to put up with austerity no matter what the less well off have to endure.

[ToraToraTora]

the NHS is not under funded, it needs running efficiently.

[Zacs-Master]

And people need to start respecting it.

[Kromovaracun]

I am noticing that none of the people citing "efficiency" as the fundamental problem have produced any evidence whatsoever other than their own opinions.

[Sqad]

Kromo....your point is well taken, but from a personal point of view, I would have great difficulty in accepting ANY statistical analysis that emanates from the NHS and unless one has worked in this institution then one doesn't realise the waste and inefficiency that prevails.
Yes....in agree that this is anecdotal evidence...but ignore it at your cost.

Jim...yes! yes! but i got the impression that this was all about Nursing homes with increasing death rates, not hospitals, but i may well be wrong.

Both Labour AND Tories agreed that austerity was necessary,the only difference being the rate of change...Tories wanted it quickly and Labour wanted a slower approach.

[Kromovaracun]

Also I am interested to know, given that austerity having a human cost is at the very least plausible if not proved beyond dispute, if further research *did* show a decisive link between excess death and cutting public spending on health/social care, whether austerity would be still be worth it for people who view it as necessary.

[Sqad]

Kromo....what you are asking, I think, is would i pay more income tax if it could be proved that it would reduce the death rate...........I would think hard and say NO.....I wouldn't pay more tax.