Last September there was a terrific conference in King’s College, Cambridge to celebrate the centenary of the publication of John Maynard Keynes’s famous pamphlet, The Economic Consequences of the Peace. In a mischievous spirit in the months before the event, I tried to persuade a well-known economist of my acquaintance to compose another pamphlet, The Economic Consequences of George Osborne, that we could unveil on the weekend before the Keynes conference.
Osborne, as most people know, was Chancellor of the Exchequer in the Coalition and Tory governments led by David Cameron following the 2010 general election. In that role he was the prime architect of the ‘austerity’ policy of slashing public expenditure (and therefore welfare benefits) using the preposterous rationale that somehow the public deficit brought about by rescuing the banks was due to extravagant spending by a Labour administration living beyond the country’s means. In fact, working on the principle that one should never let a good crisis go to waste, Osborne used this rationale as a cover for what he always had been seeking to do, namely to shrink the state in best Hayekian style.
Sadly, my tame expert was unable to help with the pamphlet, having been unexpectedly headhunted for a demanding role which left him little time for entertaining pursuits. So the booklet remained unwritten — until now.
But it has just surfaced under a different title and with a different set of authors. It’s Health Equity in England: The Marmot Review 10 Years On, written by a team led by Professor Sir Michael Marmot. Although the authors are much too polite and reserved to put it like this, the report shows that the consequences of George Osborne are as numerous and bleak as I had supposed. British subjects can expect to spend more of their lives in poor health, for example. Improvements to life expectancy have stalled, and declined for the poorest 10% of women. The health gap has grown between wealthy and deprived areas. And place really matters – living in a deprived area of the North East is worse for your health than living in a similarly deprived area in London, to the extent that life expectancy is nearly five years less.
In more detail, the research underpinning the report says:
- Since 2010 life expectancy in England has stalled; this has not happened since at least 1900. If health has stopped improving it is a sign that society has stopped improving. When a society is flourishing health tends to flourish.
- The health of the population is not just a matter of how well the health service is funded and functions, important as that is. Health is closely linked to the conditions in which people are born, grow, live, work and age and inequities in power, money and resources – the social determinants of health.
- The slowdown in life expectancy increase cannot for the most part be attributed to severe winters. More than 80 percent of the slowdown, between 2011 and 2019, results from influences other than winter-associated mortality.
- Life expectancy follows the social gradient – the more deprived the area the shorter the life expectancy. This gradient has become steeper; inequalities in life expectancy have increased. Among women in the most deprived 10 percent of areas, life expectancy fell between 2010-12 and 2016-18.
- There are marked regional differences in life expectancy, particularly among people living in more deprived areas. Differences both within and between regions have tended to increase. For both men and women, the largest decreases in life expectancy were seen in the most deprived 10 percent of neighbourhoods in the North East and the largest increases in the least deprived 10 percent of neighbourhoods in London.
- There has been no sign of a decrease in mortality for people under 50. In fact, mortality rates have increased for people aged 45-49. It is likely that social and economic conditions have undermined health at these ages.
- The gradient in healthy life expectancy is steeper than that of life expectancy. It means that people in more deprived areas spend more of their shorter lives in ill-health than those in less deprived areas.
- The amount of time people spend in poor health has increased across England since 2010. As we reported in 2010, inequalities in poor health harm individuals, families, communities and are expensive to the public purse. They are also unnecessary and can be reduced with the right policies.
- Large funding cuts have affected the social determinants across the whole of England, but deprived areas and areas outside London and the South East experienced larger cuts; their capacity to improve social determinants of health has been undermined.
I could go on, but you will get the point.
Since being unceremoniously sacked by Theresa May, Osborne has led an exceedingly comfortable life, topping up the income from his family Trust Fund with a lavish salary as Editor of the London Evening Standard and £650,000 for working one day a week for the investment fund Blackwater.