Sir Michael Marmot, a former government adviser, highlights ‘miserly’ levels of spending on health and social care
A century-long rise in life expectancy has stalled since 2010 when austerity brought about deep cuts in NHS and social care spending, according to research by a former government adviser on the links between poverty and ill-health.
Life expectancy at birth had been going up so fast that women were gaining an extra year of life every five years and men an additional 12 months every three-and-a-half years.
But those trends have almost halved since ministers made a “political decision” in 2010 to reduce the amount of money it put into the public sector, said Sir Michael Marmot. The upward trend in longer life that began in Britain just after the first world war has slowed so dramatically that women now only gain an extra year after a decade while for men the same gain now takes six years to arrive.
The rate of increase was “pretty close to having ground to a halt”, Marmot said.
“I am deeply concerned with the levelling off; I expected it to just keep getting better. Since 2009-2015 it’s pretty flat, whereas we are used to it getting better and better all the time,” added Marmot, who published a major review of health inequalities for Gordon Brown’s Labour government in early 2010.
In 1919 men lived for an average of 52.5 years and women for 56.1 years. That rose to 64.1 years and 68.7 years respectively by 1946. Life expectancy then rose in an almost unbroken gradual upward curve to 77.1 years for men and 81.4 years for women in 2005 and again to 78.7 and 82.6 in 2010, the year David Cameron’s Conservative-Liberal Democrat coalition took office.
Since then life expectancy has continued to creep upwards, but at a slower rate, according to Marmot’s latest analysis. In 2015 average life expectancy in Britain was 79.6 years for men and 83.1 years for women, according to the latest Office for National Statistics data.
Marmot, who is the director of the Institute of Health Equity at University College London, denied the rise had stalled because there was a natural limit to how much life expectancy can increase. “It is not inevitable that it should have levelled off,” he said.
There is no reason why the UK could not emulate Hong Kong, where life expectancy for men is 81.1 years for men and 87.3 for women – the highest in the world – Marmot added. Hong Kong has overtaken Japan in terms of how long citizens can expect to live.
Marmot, who has also advised the World Health Organisation, did not claim that the introduction of austerity had led directly to life expectancy stagnating. But he highlighted that “miserly” levels of spending on health and social care in recent years – at a time of rising health need linked to the ageing population – had affected the amount and quality of care older people receive.
Marmot cited the growing numbers of deaths among the over-75s and over-85s and continuing high death rates from heart disease as other key potential factors in the stalling rise in life expectancy.
“Life expectancy has been increasing year on year for a generation, to the extent that we had begun to take it for granted as inevitable. But this authoritative analysis suggests this long period of improvement may now be coming to an end, with big implications for us all,” said a spokesman for the charity Age UK.
Cases of dementia and Alzheimer’s have been rising so rapidly that they are now the leading cause of death for both sexes, among women 80 and over and men 85+.
The increase in dementia and needs of the ageing population will place the NHS and social care services “under considerable strain” in the near future, Marmot added.
Dr Matthew Norton, director of policy at Alzheimer’s Research UK, said: “This report shines a spotlight on a hard truth: that unless we can find ways to prevent and treat dementia, deaths from the condition will continue to rise as our population ages. The reality today is that with no treatments to stop or slow the underlying diseases, the condition is placing an ever-growing strain on our health services.”
The Department of Health played down Marmot’s findings. A spokesman pointed out that the NHS had just last week been judged to be the best, safest and most affordable healthcare system out of 11 rich countries analysed in a major review published by the Commonwealth Fund, a respected US thinktank.
“Life expectancy continues to increase, with cancer survival rates at a record high whilst smoking rates are at an all-time low. We continue to invest to ensure our ageing population is well cared-for, with £6bn extra going into the NHS [in England]over the last two years and an additional £2bn for the social care system,” he added.