UK

The election debates need to interrogate politicians about the human cost of their policies

Prem Sikka 

21 June, 2024 
Columnist Left Foot Forward  Opinion

Party manifestos are disconnected from the lives of the people.

An interesting feature of the debates leading to the UK general election is the almost total absence of any discussion of human consequences of the policies proposed by parties. People have been made invisible as parties focus on taxes, public debt and cuts in public services.

Party manifestos are disconnected from the lives of the people. The average real wage is lower than in 2008 and the result is misery. Due to low incomes, some 12m Britons live in poverty, including 4.3m children. People are increasingly relying upon charity. In 2023/24 there were nearly 3,000 foodbanks compared to almost none in 2007. In 2023/24 Trussell Trust, the largest chain with nearly 1,700 food banks, provided nearly 3.1m food parcels compared to just 25,809 in 2008/09. Life expectancy in Britain has flatlined in the last ten years. Yet no major party is promising to alleviate poverty by redistributing income and wealth, adoption of progressive taxation, increasing workers’ share of gross domestic product and maintaining real value of social security benefits.

To appease corporate interests, major parties promise deregulation but ignore the resulting social cost. For example, some 1.8m workers were suffering from work-related ill health, with approximately half of the cases down to stress, depression or anxiety. Deregulation of the finance industry is mooted again without any mention of the social cost. After the 2007-08 crash the state had to find £1,162bn of cash and guarantees (£133bn cash + £1,029bn of guarantees) to bail out banks, and millions suffered from the resulting austerity.

Both Conservative and Labour want to maintain the two-child benefit cap which deprives 550,000 households of at least £3,455 each year. The removal of the cap would cost £2.1bn in 2024/25, rising to 790,000 households and £3.4bn by 2029-30. Children as young as 11 are being sectioned for mental health problems. In 2023/24, 36,000 children were referred to mental health services for urgent attention. Yet child welfare is just a financial number to major parties as they remain silent on the human cost of this policy. Would more children and their families be forced to live in poverty? Would the resulting anxiety and insecurity stunt children’s and the nation’s future?

Political automatons recite the mantras of self-imposed fiscal rules to justify further cuts in public spending though none ever obstructed corporate bailouts and subsidies. Fiscal rules are seemingly there to curb aspirations of the less well-off. Spending cuts always result in loss of hard-won rights and lower real wages which reduce people’s access to good food, housing, healthcare and welfare. If people are undernourished and ill, how can that help to reinvigorate the economy? How will low wages and cuts in spending impact the supply of skilled labour? Political elites seem unwilling or unable to connect the dots and explain the human impact of their policy choices even though the last 14 years have shown that austerity, low wages and failure to invest in public services have delivered deadly consequences. Here are a few examples.

Underinvestment in the National Health Services (NHS) means that people can’t get a timely access to family doctors, dentists, ambulances and hospitals. This also makes the healthcare system less resilient. Such fears were confirmed in 2016 by an investigation codenamed Exercise Cygnus. It concluded that the NHS would not be able to cope with a flu pandemic. The government, focused on reducing public spending, responded by reducing the stock of personal protection equipment and the number of hospital beds. Some areas in England lost 40% of the hospital beds. Today England has an average of around 2.3 beds per 1,000 of population. Some have considerably less. For example, Homerton University Hospital NHS Foundation Trust has 0.9 beds per 1,000 people. Bedfordshire Hospitals NHS Foundation Trust has just 1.7 hospital beds per 1,000 people. The average for Japan is 12.6; 7.8 for Germany; 6.9 for Austria; 5.7 for France; 5.5 for Belgium; 5.2 for Latvia and average of 4.3 beds for OECD countries. The lack of investment had tragic consequences. Some 232,000 people died in the Covid pandemic, considerably more per capita than most European countries.

At the end of April 2024, there were some 7.57m unfulfilled NHS England hospital appointments, compared to 2.5m in 2010 and 4.5m in February 2020 just ahead of the pandemic. Some 2.7m working-age adults are chronically ill and unable to work. If the current obsession with low wages, austerity and reducing public services continues that number is expected to rise to 3.7m by 2040.

Between 2018 and 2022, some 1.5 million people in England died whilst waiting for a hospital appointment in England. That is a staggering 300,000 a year. The victims are mainly people suffering from delays and cancellations to hospital appointments and the less well-off. Some 14,000 people a year die whilst waiting in poorly resourced accident and emergency departments in hospitals.

Britons die sooner from cancer and heart disease than people in many other rich countries, partly because of the NHS’s lack of beds, staff and scanners. The number of people dying before the age of 75 in England from heart and circulatory diseases is at the highest level since 2008. 39,000 died prematurely of cardiovascular conditions including heart attacks, coronary heart disease and stroke. Delayed health checks for people with diabetes have caused 7,000 excess deaths a year.

A study published in a peer reviewed scholarly journal reported that between 2012 and 2019, government imposed austerity caused 335,000 excess deaths in England and Scotland i.e. nearly 48,000 a year. One-third of these deaths were among people under 65. Another study reported that each year some 93,000 people, 68,000 pensioners and 25,000 people of working age, die from poverty. Evidence shows that 28,655 older people died in 2022/23 before ever receiving the social care for which they were waiting. This is an average of 79 deaths a day, 550 a week, and 2,388 a month. 1,300 people died while homeless in UK during 2022.

In 2023, some 800,000 patients were admitted to hospital with malnutrition and nutritional deficiencies, a threefold increase on 10 years ago. Children born to undernourished parents are likely to have low birthweight and suffer from ailments throughout their life. Infant mortality rate in the UK is nearly 4 deaths per 1,000 live births, compared to 1.7 in Japan, 1.8 in Finland, Slovenia and Sweden. Children from poorest families are almost 13 times more likely to experience poor health and educational outcomes by the age of 17. They are less likely to go for higher education and have lower social mobility. In later life they are more likely to suffer from heart attacks, cancer, diabetes and other debilitating health issues which lead to greater pressures on welfare and healthcare services.

A study by the Institute of Health Equity reported that between 2011 and 2019 England experienced nearly 1.2m excess deaths due to a combination of Covid, poverty and austerity. A poor English girl could on average expect to live 7.7 years less than a rich girl; and a boy 9.5 years less. Public services are a key part of the tragedy. The Economist reported that “during the 2010s, spending per person decreased by 16% in the richest councils, but by 31% in the poorest. Benefits were also cut … places with the largest relative declines in adult social-care spending and housing services were the ones that suffered the greatest headwinds to life expectancy”. Yet major parties reel-off fiscal rules and more austerity without a word about human consequences.

This election, in common with the last few, has lots of radio and televised debates. Politicians well coached by PR experts come and read their rehearsed lines, and interviewers add their tuppence worth. However, there is little discussion of the human cost of policies. People are treated as invisible casualty of politics. It is the same in parliament too. Government bills are routinely accompanied by an ‘impact assessment’ but none ever refers to the human consequences of regressive taxation, austerity, cuts in public services or tax handouts to the rich. We need to change political debates so that the stark consequences of political choices are discussed and human life is prioritised over the interests of markets and corporations.

Prem Sikka is an Emeritus Professor of Accounting at the University of Essex and the University of Sheffield, a Labour member of the House of Lords, and Contributing Editor at Left Foot Forward.