Is austerity linked to 120,000 unnecessary deaths?

“There was a report this week, we are getting 120,000 unnecessary deaths every year in this country as a direct result of the austerity.”

Val McDermid, 16 November 2017

A report by academics at University College London published this week found a link between restrictions on health and social care spending and an estimated 45,000 more deaths between 2010 and 2014 than there would have been had previous trends continued.

This is not an estimate of how many could have been avoided, the authors stressed. Nor is it an estimate of the amount of deaths every year. 

While lower growth in health and social care spending since 2010 may be behind the increase in deaths, these findings should be treated with caution as the research doesn’t prove this is the case. Reduced spending is one of a number of possible explanations for the results.

Where does the 120,000 come from?

When the study began the authors only had official figures for the number of deaths up to 2014, so they projected what might happen to the number of deaths between 2015 and 2020.

Taking the 45,000 figure and adding it to the number of additional deaths they predicted between 2015 and 2017, they estimated that there were an “additional” 120,000 deaths between 2010 and 2017. Again, that’s compared to what would have been the case had previous trends continued.  

What might be behind the ‘additional’ deaths?

To see if there is a link between health and social care spending and these additional deaths, the authors also looked at some other possible causes. These included changes in the economy (like unemployment and inflation) and changes in average weekly pensions. They also looked at the combined effect of spending and its impact on changes in health and social care staff and infrastructure.

Accounting for these things, the authors concluded that restrictions on spending and the number of nurses were linked with the 120,000 additional deaths.

Older people accounted for more of these additional deaths, with deaths at care homes and at home contributing most to the estimated additional deaths. Deaths in hospital were lower than expected. The authors put this down to greater pressures on social care spending, but also a drive to move more patients reaching the end of possible health treatments out of hospital.

While other academics have said the conclusions are “plausible” they have also stressed other possible explanations.

For example, Dr Richard Fordham, Senior Lecturer in Health Economics, University of East Anglia, has said: “...This is indeed a plausible hypothesis. But other explanations are available. Patient cohorts may have changed (for example more end-stage, longer-term illnesses); patients may have succumbed to  different or new diseases (eg. MRSA, cirrhosis etc.); or had greater multiple morbidities (asthma plus diabetes plus cancer etc. ) than similar cohorts of the same age before them?”

Professor Martin Roland Emeritus Professor of Health Services Research, University of Cambridge said: “This study suggests that a change happened to cause deaths to stop declining around 2014. This is likely to be a correct finding. However, the link to health and social care spending is speculative as observational studies of this type can never prove cause and effect."

You can read their full comments here, published by the Science Media Centre, a press office for scientific commentary on the news.