Opinion: is it the fault of austerity policies and a consequent impact on health and social care provision?

For some time, there has been a big debate about what might be the best way to evaluate whether the well-being of the population is rising. Economists traditionally focus on cash-related indicators such as wages, incomes and, of course, the Gross Domestic Product (GDP). However, there is a perception, which some politicians and governments have responded to, that the narrow economic measures may be missing something. 

Enter life expectancy, a measure used by statisticians which attempts to estimate how many years an "average" baby born in any given year might expect to live given the death rates which are then operating. Life expectancy is obviously something that people care about. It does, for example, interact with important questions such as pension provision. Admittedly, people are likely to be interested in not only how far they might out-live the Biblical "three score years and ten", but also the extent to which they will remain in good health right up until the end. 

Life expectancy could even serve as a proxy for how far the economy or even government is working well. In Russia, life expectancy, especially for men, plunged in the years following the collapse of the Soviet Union. In 1994, average life expectancy reached a low of 64 years. It has recovered since 2012 and was 71.9 years in 2016 according to the Russian Federal State Statistics Service. That level was, however, achieved by France and Britain in the 1960s.

What is certain is that there are important questions to ask about behaviour around such issues as diet

Last month, the UK Office for National Statistics showed that life expectancy improvements have stalled in the UK during 2015 to 2017. Particularly concerning is what is happening at the level of the three devolved nations, including Northern Ireland, where we have seen some actual declines.

Overall UK life expectancy has remained flat over that three year period at about 79 years for men and about 82 years for women. That is below the figures for many other western economies. In the Republic of Ireland, for example, the figures in 2016 were 79.9 years for men and 83.6 years for women and annual increases were still being achieved. 

Break down the figures to the level of the four UK nations and an interesting pattern emerges. Life expectancy actually declined amongst men and women in Wales and Scotland (by about one month over 2015 to 2017) and declined by a similar amount for men in Northern Ireland. It remained flat for women in Northern Ireland and for both men and women in England. Responsibility probably does not rest with particular medical events. Flu rates were particularly bad in 2014 to 2015, but life expectancy bounced back afterwards in other western countries.

So why was there a lack of recovery in places like Northern Ireland? Is it the fault of austerity policies and a consequent impact on health and social care provision? Oxford Geography Professor Danny Dorling has argued this case, but it is hard to explain the difference between England and the other three nations in this way. The decline in public spending was been lower in the devolved administrations. In Northern Ireland, health spending per capita has been higher than in England and the way social care to elderly is administered is different. 

What is certain is that there are important questions to ask about behaviour around such issues as diet. By implication, there may be concerns about the effectiveness of health and social policy particularly in Wales and Scotland. In Northern Ireland, of course, we now don’t really have a regional government at all.


The views expressed here are those of the author and do not represent or reflect the views of RTÉ