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Health And Social Care Cuts Linked To Excess Deaths
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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:
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If these findings are reflective of reality, and cuts in public spending are the cause, are the excess deaths worth the benefits of austerity?
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://
If these findings are reflective of reality, and cuts in public spending are the cause, are the excess deaths worth the benefits of austerity?
Answers
I managed to get through the first two papers -- which, incidentally
18:33 Fri 17th Nov 2017
“Despite what NJ says, austerity has actually been a thing for the last few years,…”
Really?
Austerity: “…a political-economic term referring to policies that aim to reduce government budget deficits through spending cuts, tax increases, or a combination of both”
Government spending:
2011/12: £720bn
2012/13: £740bn (+2.8%)
2013/14: £746bn (+0.8%)
2014/15: £761bn (+2.0%)
2015/16: £762bn (+0.1%)
2016/17: £780bn (+2.4%)
A total increase in spending of 8.3% over five years. Inflation (measured by the CPI) over the same period was 7.8%.
I accept that there has been an increase in the tax take over that period (so meeting one half of the definition of austerity) but that is not what this question is about. Government spending continues to rise both in absolute terms and compared to the rate of inflation. It will continue to do so because the country is hooked on it and any attempt to rein it in is met with howls of derision and accusations of “austerity”. There cannot be austerity when spending continues to rise unabated. People are being bamboozled into believing that this is the most evil and vicious administration the world has ever seen (as they are whenever there is a Conservative government) and that people are dying in the gutter from hunger, disease and pestilence because of their actions. There are many reasons why the country cannot spend as much as it might on healthcare, but government cuts are not among them.
Really?
Austerity: “…a political-economic term referring to policies that aim to reduce government budget deficits through spending cuts, tax increases, or a combination of both”
Government spending:
2011/12: £720bn
2012/13: £740bn (+2.8%)
2013/14: £746bn (+0.8%)
2014/15: £761bn (+2.0%)
2015/16: £762bn (+0.1%)
2016/17: £780bn (+2.4%)
A total increase in spending of 8.3% over five years. Inflation (measured by the CPI) over the same period was 7.8%.
I accept that there has been an increase in the tax take over that period (so meeting one half of the definition of austerity) but that is not what this question is about. Government spending continues to rise both in absolute terms and compared to the rate of inflation. It will continue to do so because the country is hooked on it and any attempt to rein it in is met with howls of derision and accusations of “austerity”. There cannot be austerity when spending continues to rise unabated. People are being bamboozled into believing that this is the most evil and vicious administration the world has ever seen (as they are whenever there is a Conservative government) and that people are dying in the gutter from hunger, disease and pestilence because of their actions. There are many reasons why the country cannot spend as much as it might on healthcare, but government cuts are not among them.
I'm not disputing that the NHS lacks efficiency Sqad, or that it needs more of it. I'm just a bit skeptical about the implicit suggestion that everything in that organisation will be fine if we only make it efficient enough (in fact I think people have slightly magical attitude towards the word "efficiency"). I think there are more profound structural problems in the NHS - e.g. PFI debt, staff shortages - that have a more serious impact on how well it functions.
//Lots of ifs and buts there Kromo. I’m not saying your postulation isn’t interesting but all you’ll get are people’s opinions!rather than any conclusion.//
I suppose, yes. But that's fundamentally what the News section is about. I had to make some kind of question out of the topic and soliciting opinion rather than analysis is more fruitful.
Incidentally I don't usually award BA's because I think they are pointless and just reinforce the OP's opinion, but I made an exception here because Jim's answer was excellent and insightful.
I suppose, yes. But that's fundamentally what the News section is about. I had to make some kind of question out of the topic and soliciting opinion rather than analysis is more fruitful.
Incidentally I don't usually award BA's because I think they are pointless and just reinforce the OP's opinion, but I made an exception here because Jim's answer was excellent and insightful.
One other thing is that if efficiency is indeed a problem in the NHS, then it's certainly not a *new* problem. I mean, people have been complaining about it for almost as long as the NHS has been a thing, no?
You can't use an endemic long-term problem with NHS services to explain a short-term spike in death rates. That's not to say that the NHS can't be made more efficient, but if there is a genuine causal factor in the 2015 death rate then it's a shorter-term effect.
I'll debate the existence or not of "austerity" with NJ elsewhere. But, to be fair, he might enjoy debating the principle with George Osborne, who couldn't shut up about it for as long as he was Chancellor, or certainly did nothing to dispel the myth NJ imagines.
You can't use an endemic long-term problem with NHS services to explain a short-term spike in death rates. That's not to say that the NHS can't be made more efficient, but if there is a genuine causal factor in the 2015 death rate then it's a shorter-term effect.
I'll debate the existence or not of "austerity" with NJ elsewhere. But, to be fair, he might enjoy debating the principle with George Osborne, who couldn't shut up about it for as long as he was Chancellor, or certainly did nothing to dispel the myth NJ imagines.
‘I'm just a bit skeptical about the implicit suggestion that everything in that organisation will be fine if we only make it efficient enough’
Me too.
‘Figures have suggested that more than twelve million GP appointments are missed each year in the UK, costing in excess of £162 million per year. A further 6.9 million outpatient hospital appointments are missed each year in the UK, costing an average of £108 per appointment’
A free system gives people a sense of entitlement unfortunately. And the ‘ive Paid my subs, I’m gonna use it’ attitude doesn’t help.
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Factor in people using A&E unnecessarily, and you immediately have a BIG problem.
Me too.
‘Figures have suggested that more than twelve million GP appointments are missed each year in the UK, costing in excess of £162 million per year. A further 6.9 million outpatient hospital appointments are missed each year in the UK, costing an average of £108 per appointment’
A free system gives people a sense of entitlement unfortunately. And the ‘ive Paid my subs, I’m gonna use it’ attitude doesn’t help.
https:/
Factor in people using A&E unnecessarily, and you immediately have a BIG problem.
“…more than twelve million GP appointments are missed each year in the UK, costing in excess of £162 million per year.”
Probably because the patients either got better or died before their appointment date.
“A further 6.9 million outpatient hospital appointments are missed each year in the UK, costing an average of £108 per appointment’”
Yes. I imagine included in that are three that were made on behalf of Mrs NJ and me in the last eighteen months. She received notification of two (one at a hospital more than a hundred miles away) and I of one. Neither of us was expecting an appointment mainly because there was nothing wrong with us. This had happened to Mrs NJ a year or so previously. She was busy so I did the decent thing and rang the hospital to point out the error. After a lengthy wait listening to “Vivaldi” I was told I could not cancel Mrs NJ’s because, as I was not the patient, they would not discuss the matter with me. So I left the appointment to stand and we didn’t bother after that and just binned the paperwork.
“Factor in people using A&E unnecessarily,…”
Many people that visit A&E do so because they have nowhere else to go. There are no minor injury units around. In 2014 Mrs NJ suffered an accident and needed stitches. She made an appointment with her GP’s practice nurse to have them removed a couple of days before we were due to go on holiday. The practice nurse went sick (two days prior to Mrs NJ’s appointment but nobody bothered to inform her). Upon arrival Mrs NJ explained that she could not delay the removal of her stitches as she would be away for two weeks. She was advised to go to A&E to have them removed. She stood her ground and eventually had them removed at the doctor’s surgery (one of the GP’s having to do it). But she could, of course, have become one of the “unnecessary” visitors to A&E.
Probably because the patients either got better or died before their appointment date.
“A further 6.9 million outpatient hospital appointments are missed each year in the UK, costing an average of £108 per appointment’”
Yes. I imagine included in that are three that were made on behalf of Mrs NJ and me in the last eighteen months. She received notification of two (one at a hospital more than a hundred miles away) and I of one. Neither of us was expecting an appointment mainly because there was nothing wrong with us. This had happened to Mrs NJ a year or so previously. She was busy so I did the decent thing and rang the hospital to point out the error. After a lengthy wait listening to “Vivaldi” I was told I could not cancel Mrs NJ’s because, as I was not the patient, they would not discuss the matter with me. So I left the appointment to stand and we didn’t bother after that and just binned the paperwork.
“Factor in people using A&E unnecessarily,…”
Many people that visit A&E do so because they have nowhere else to go. There are no minor injury units around. In 2014 Mrs NJ suffered an accident and needed stitches. She made an appointment with her GP’s practice nurse to have them removed a couple of days before we were due to go on holiday. The practice nurse went sick (two days prior to Mrs NJ’s appointment but nobody bothered to inform her). Upon arrival Mrs NJ explained that she could not delay the removal of her stitches as she would be away for two weeks. She was advised to go to A&E to have them removed. She stood her ground and eventually had them removed at the doctor’s surgery (one of the GP’s having to do it). But she could, of course, have become one of the “unnecessary” visitors to A&E.
‘Probably because the patients either got better or died before their appointment date’
That’s a BIG assumption NJ. I have inside information that this is definitely not the case. I would hope that the system isn’t that inefficient that it wouldn’t cancel appointments in both cases although I’m not that naive to expect that some aren’t ‘caught’.
That’s a BIG assumption NJ. I have inside information that this is definitely not the case. I would hope that the system isn’t that inefficient that it wouldn’t cancel appointments in both cases although I’m not that naive to expect that some aren’t ‘caught’.
£165 million in missed appointments is indeed a substantial sum of money. It is chicken feed however in a total budget of £116 billion. It's also pretty insignificant when you compare it to the £3,700 the NHS spends every minute on private healthcare as a result of badly-arranged PFI schemes.
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The reason there is so little money in the NHS has far more to do with wealth extraction than it does inefficiency.
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The reason there is so little money in the NHS has far more to do with wealth extraction than it does inefficiency.
“I would hope that the system isn’t that inefficient that it wouldn’t cancel appointments in both cases”
“The System” won’t cancel appointments in either case. It is up to the patient to do so. If the patient gets better he’s probably been waiting so long to see a doctor that he’s forgotten about his appointment and in any case he’s probably got more pressing tasks to deal with than spend an hour trying to get through to his doctor’s surgery. If the patient dies it would be incumbent on his friends or relatives to cancel any appointments he may have. There are three snags with this: 1. They may not know of his arrangements; 2. They probably have other things on their mind; 3. If they did contact the surgery I doubt the appointment would be discussed with anybody other than the patient who is er… dead.
“The System” won’t cancel appointments in either case. It is up to the patient to do so. If the patient gets better he’s probably been waiting so long to see a doctor that he’s forgotten about his appointment and in any case he’s probably got more pressing tasks to deal with than spend an hour trying to get through to his doctor’s surgery. If the patient dies it would be incumbent on his friends or relatives to cancel any appointments he may have. There are three snags with this: 1. They may not know of his arrangements; 2. They probably have other things on their mind; 3. If they did contact the surgery I doubt the appointment would be discussed with anybody other than the patient who is er… dead.
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