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On 12 January 2023, the House of Lords is scheduled to consider the following question for short debate:

Lord Sikka (Labour) to ask His Majesty’s Government what assessment they have made of the paper by the Journal of Epidemiology and Community Health ‘Bearing the burden of austerity: How do changing mortality rates in the UK compare between men and women?

1. What are the recent trends in UK life expectancy?

In February 2020, the University College London Institute of Health Equity published ‘Health equity in England: The Marmot Review 10 years on’. The report stated that, since 2010, the improvement in UK life expectancy for both men and women had slowed dramatically. The report also noted life expectancy had fallen in some of the most deprived areas of the country. In the same year, the Office for National Statistics (ONS) confirmed that life expectancy at birth in the UK for both men and women had slowed since 2011 when compared with previous decades.

The most recent figures from the ONS indicated UK life expectancy at birth was 79.0 years for males and 82.9 years for females during the period from 2018 to 2020. These figures again confirmed the overall trend that improvements in life expectancy at birth for both males and females were slowing. Since the period from 2010 to 2012, improvements for each two-year reporting period had declined when compared with the previous non-overlapping period, with the exception of 2017 to 2019. The trend for life expectancy since birth for both males and females over the last four decades is provided in the graph below:

Life expectancy at birth for males and females, UK, between 1980 to 1982 and 2018 to 2020, using ONS data
Figure 1. Life expectancy at birth for males and females, UK, between 1980 to 1982 and 2018 to 2020

Source: Office for National Statistics, ‘National life tables: life expectancy in the UK: 2018 to 2020’, 23 September 2021, Figure 1

In January 2021, the House of Lords Science and Technology Committee published a report entitled ‘Ageing: Science, technology and healthy living’. The report looked at both trends in life expectancy in general and ‘healthy life expectancy’. Healthy life expectancy is defined by the ONS as an estimate of the number of years lived in ‘very good’ or ‘good’ general health, based on how individuals perceive their health. It found that, while inequalities existed both in terms of life expectancy and healthy life expectancy, inequalities were greater for healthy life expectancy. The committee recommended the government and government agencies, including NHS England and Public Health England, should prioritise addressing these health inequalities. Further information on this report and the government’s response is provided in the House of Lords Library briefing, ‘Science and Technology Committee report—Ageing: Science, technology and healthy living’ (11 October 2021).

2. What does the Journal of Epidemiology and Community Health article say?

The paper referred to in the title of Lord Sikka’s question for short debate is based on research led by the Glasgow Centre for Population Health and the University of Glasgow, published in October 2022. The authors of the report argued there was a “considerable body of evidence” that the austerity policies pursued by the UK government since 2010 were the main cause of the decline in the rate at which life expectancy has increased. The study characterised austerity as policies that lead to a reduction in spending on social security and public services. The authors of the study also argued the impact of austerity had disproportionately affected women in the UK because they are more likely to be dependent on social security and social services.

The paper cites several previous studies in support of these arguments, including a literature review published by the European Journal of Public Health, entitled ‘Austerity and health: the impact in the UK and Europe’ (October 2017). This study argued that austerity negatively impacted health by causing increased unemployment, poverty and homelessness. It also argued that austerity policies had a negative impact on healthcare services as a result of reduced funding. It concluded that the impact of these policies was greatest on people who were already vulnerable, such as those with precarious employment or housing or with existing health problems. It also said austerity was associated with worsening mental health, resulting in an increased risk of suicide.

Taking these arguments as their starting point, researchers at the Glasgow Centre for Population Health and the University of Glasgow sought to establish whether the health impact of austerity had been worse for women than men in terms of changes to life expectancy. The study compared the number of deaths that occurred in Scotland, England and Wales between 2012 and 2019 with previous trends, using data going back to 1981. The paper concluded that it remained unclear whether the changes to life expectancy since 2011 had affected men and women differently. However, it said there was some evidence that women’s mortality rates had worsened to a greater degree than men’s mortality rates in more deprived areas of Great Britain.

Although the paper found inconclusive evidence that austerity had had a worse impact on women’s life expectancy, it did claim that the austerity policies pursued by the UK government had had an “immensely damaging” impact on life expectancy overall. It said approximately 335,000 additional deaths had occurred between 2012 and 2019 compared with what had been previously been predicted. It also said the change in these trends was greater for people living in the 20% most deprived areas in England, Scotland and Wales.

3. What has the government said about the issue?

On 17 December 2020, Lord Rooker (Labour) asked the government what its assessment was of the ONS figures for UK life expectancy published in September 2020. In his supplementary question, Lord Rooker noted that the figures also showed a fall in life expectancy for women in the most deprived areas of the country.

The then parliamentary undersecretary of state at the Department of Health and Social Care, Lord Bethell, acknowledged the rate of improvement in overall life expectancy had stalled. He said the government was taking action to improve public health, as outlined in the green paper on prevention, published in July 2019. This included a commitment to reduce the differences in health outcomes for the richest and poorest in the UK. Further information on this green paper is provided in the House of Commons Library briefing ‘Opposition day debate: health inequalities’ (2 March 2020).

Several members asked what the government’s analysis was for this slower rate of growth. For example, Lord Davies of Brixton (Labour) asked the government whether it accepted that austerity policies since 2010 was a significant cause. This argument was rejected by Lord Bethell. Lord Kirkhope of Harrogate (Conservative) asked the government what it thought the explanation was for this change, querying whether it might be the result of a change in the methodology used to assess life expectancy or a result of changing social habits among the population. Lord Bethell said the reasons for the change were complex and that he could not give an answer that addressed every element of this problem. However, he said behaviour was a factor, noting the high levels of obesity in the UK.

4. Is the government continuing to pursue austerity policies?

In his 2022 autumn statement, Chancellor of the Exchequer Jeremy Hunt said that the UK faced significant economic challenges, including higher levels of government debt. He said the government would pursue policies intended to consolidate the public finances, through increased taxation and reduced public spending. Further information on the 2022 autumn statement is provided in the House of Lords Library briefing, ‘Autumn statement 2022: Key announcements and analysis’ (25 November 2022).

Prior to the autumn statement, the shadow chancellor, Rachel Reeves, said that Mr Hunt intended to pursue a policy which amounted to “austerity 2.0”. She argued the government should be doing more to create a fairer tax system instead. In his House of Commons speech on the day of the autumn statement, Mr Hunt rejected the claim the government was pursuing the same policies as those of the 2010–15 parliament. He said spending during the current parliament would rise by 3% per year. However, he also defended the record of previous Conservative chancellors. He argued that the last 12 years had seen the UK economy grow at a faster rate than Germany, France, Italy or Japan. He also said the UK had seen the lowest unemployment during this period for nearly 50 years.

The study by the Glasgow Centre for Population Health and the University of Glasgow was also raised in the House of Commons during this debate. The then SNP shadow treasury spokesperson, Alison Thewliss, said the study proved the policies pursued by former Conservative chancellors had led to 330,000 excess deaths. She argued that the policies outlined in the autumn statement would have a similarly negative impact on life expectancy. Mr Hunt did not specifically address these comments. However, the study was also referred to by Amy Callaghan (SNP MP for East Dunbartonshire) who argued the Chancellor should remove the cap on benefits. Mr Hunt responded to this point by arguing the government was “doing everything that [it] can” to help people on benefits, including providing support to address increases in the cost of living and increasing the national living wage for those in work.

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Cover image by Tim Mossholder on Pexels