Austerity Fuelled a National Health CrisisCan We Afford Round Two?
With the Government getting ready for austerity 2.0, Sian Norris reflects on the impact previous cuts to local government had on public health
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The Government is set to make further cuts to public spending, with Chancellor Jeremy Hunt comprehensively ditching former Prime Minister Liz Truss’ September mini budget, ushering in an era of ‘austerity 2.0’.
Truss and former Chancellor Kwasi Kwarteng’s mini budget on 23 September ultimately led to the downfall of her short-lived government, with Hunt taking control and scrapping the plans on which she had built her mandate.
Now, as the UK prepares for its third Prime Minister in five months, Hunt is preparing a new financial plan to be announced on 31 October – and spending cuts and tax rises are expected to form part of his vision.
But while the nation braces for a second round of austerity, for many the impact of a decade of spending cuts is still being felt, while the cost of living crisis means millions of households are already struggling to make ends meet.
A new ‘mega-poll’ from the Trades Union Congress has found that one in seven people are skipping meals because they can’t afford to eat. Inflation is now at 10.1%, with food inflation reaching a 42-year high, at 14.6%.
Research published in the Journal of Epidemiology and Community Health found that more than 300,000 excess deaths in Britain can be attributed to spending cuts to public services and benefits linked to the austerity policies carried out between 2010 and 2019.
During the same time period, health inequalities widened and the life expectancy between those living in the most deprived and the wealthiest regions of the UK increased. Men in the most deprived areas can now expect to live 9.7 years fewer than men in the least deprived regions – 73.5 years compared to 83.2 years. Women living in the most deprived areas have a life expectancy of 78.3 years, while wealthy women can expect to live until their mid-80s (86.3 years).
‘Dysfunction in Poverty, House Insulation and EnergyPricing Existed Long Before Current Crisis’Adrian Goldberg
Part of the cause can be found in the way spending cuts are interconnected, with spending cuts to local authority budgets or squeezed education budgets having a knock-on effect to healthcare services.
Jeremy Hunt has said the Government must make “eye-watering cuts” to balance the nation’s books after his predecessor’s mini budget sent the economy into freefall. He has also asked ministers to “focus on areas which would not affect the service the public receives”.
Connecting Austerity and Health Outcomes
During the austerity years, local governments saw their budgets sliced, on average, in half, although the depth of the cuts and the impact differed from region to region. London local governments saw the core funding they receive from the Government reduced by 63% in real terms.
Day-to-day spending was cut, with cities feeling the knife more than rural areas, and the north facing the deepest cuts of all. Seven of the 10 cities that faced the largest spending cuts were in the north-east, north-west or Yorkshire; and on average northern cities saw a cut of 20% to their spending. This contrasted to a cut of 9% for cities in the east, south-east and south-west (excluding London).
The drive for ‘efficiency savings’ while protecting statutory services, led to funding cuts for services that have an impact on a population’s health. Take domestic abuse refuges, as one example, with one in six refuges closing between 2010 and 2016. The lack of a safety net left women vulnerable to multiple physical and mental health complications, which has a knock-on effect on frontline services such as hospitals and police.
Similarly, drug support services were cut during the austerity years: overall spending on drug and alcohol services was cut by 15%, with some councils cutting funding by 40% and only 10 councils in the country increasing funding on substance abuse support.
During the same period, drug-related deaths went up. Not only did the cuts to services which could have intervened before crisis point increase pressure on the NHS, it has led to more families mourning a loved one who might otherwise have received help.
Data from 2019 found that only half of local authorities offer all smokers support services for quitting, and 44% of local authorities no longer have a specialist stop smoking service open to all smokers in their area. Just over half (56%) were providing universal specialist service, while a further 9% offer specialist support to specific groups such as pregnant women and people with mental health conditions. Support and funding for measures to reduce youth smoking and promote quit attempts fell by 30% between 2014/15 and 2019.
As with cuts to drug and alcohol services, reducing support for smoking cessation services has a knock-on impact on the NHS and public health. In 2019/20 there were estimated to be 506,100 hospital admissions attributable to smoking – a 10% increase from 2009/10.
Even cuts to spending on green spaces, or communal spaces like libraries, can have an impact on health and wellbeing. English local authorities are spending almost £330 million less a year in real terms on parks and open spaces than a decade ago. This may sound insignificant but, if lockdowns taught us anything, it is how access to green spaces and community spaces is vital for our health.
It’s little wonder, then, that a study by University of Manchester health economists found that local government spending cuts are associated with worse multi-morbidity and health-related quality of life.
The health impacts of austerity have all taken place, too, in the context of real-term cuts to NHS funding between 2010-19: the annual increases to Government spending on health fell to less than 1% under 2010’s Coalition Government, before creeping up to just under 2% before 2019 – compared to 6% annual increases under Labour.
Councillor Andrew Western, Chair of the Local Government Association’s Resources Board, said: “The dramatic increase in inflation, alongside increases to the National Living Wage and higher energy costs, has added at least £2.4 billion in extra costs onto the budgets councils set in March this year.
“With local government then facing a funding gap of £3.4 billion in 2023/24 and £4.5 billion in 2024/25 it is clear that the Government needs to come up with a long-term plan to manage this crisis.”
Sian Norris discussed the implications of a new wave of austerity on health with Adrian Goldberg on the ‘Byline Times Podcast’