Health

The cruel cuts that curb life expectancy | Letters


I read your report (Austerity linked to stalling life expectancy, 25 February) with interest but no surprise. Life in substandard, insecure accommodation, with insufficient money for basics, permanent indebtedness, going hungry to feed your children etc is bound to damage your health. There have been a succession of eminent reports saying the same thing over the last 40 years. In the late 70s a Labour government commissioned the Black report to examine why, even with a free NHS, poorer people’s lives were shorter than those of the wealthy.

The report was ready as Margaret Thatcher came to power and only published on a bank holiday in 1980 with minimum publicity and a firm rejection of its findings and proposals by the government. Then there was the Acheson report, published in 1998. This did influence the new Labour government and for a brief time innovations such as the Sure Start programme, reasonable benefit levels (no cap, no bedroom tax, less inhumane fit-for-work tests), and less harsh tenancy rules helped support families, people with disabilities, older people and so on. Sadly, what headway was made has been thrown to the winds by successive Tory governments.

Sir Michael Marmot adds to the weight of argument about the life-shortening effects of “straitened circumstances and poor life chances” unsurprisingly linked to austerity. But now we have “levelling up”. Matt Hancock promises “world-leading plans to improve children’s health”. Has anyone seen details of these policies? I don’t care if they’re world-leading or not; I’d just be grateful if they got the job done – at last.
Susan Hofsteede
Bangor, Gwynedd

Sir Michael Marmot reminds us that healthy lives depend on a number of factors, including “early child development, education …adequate income and a healthy and sustainable community”. As chair of governors of an inner-city primary school and children’s centre in a disadvantaged area, I commend staff’s work against the effects of austerity, adding a food bank, a clothing bank, subsidised fruit and vegetables and a major holiday feeding programme to their catalogue of support for families.

Our pupil population hasn’t changed, but we are deeply conscious of the pernicious effects of changes to benefits and specifically the rollout of universal credit and the lowered threshold for entitlement to free school meals (FSM), from about £16,000 a year to under £8,000, affecting mostly the working poor. Our FSM figures have fallen from 75% to 55% in two years. For our reception intake of 54 children in September, the figure is 16%. The impact on pupil premium funding, based as it is on historical FSM figures, will be deep and lasting, and pupils will be doubly disadvantaged.

Marmot reports the deepest funding cuts falling on the most deprived local authorities such as Liverpool. The school feels the effects of those cuts particularly in support for special educational needs and support from social services. Liverpool has, miraculously, managed to preserve its children’s centres, but we fear for the future. We need more research evidence of this quality to argue for our children, families and communities.
John Murphy
Liverpool

You quote Ian Hudspeth, chair of the LGA’s community wellbeing board, as saying “councils want to work with government on closing this gap [in life expectancy] by focusing on the social causes of ill-health, such as early years development”.

Mr Hudspeth should know all about these social causes and arguably contributed to them. As leader of Oxfordshire county council, he oversaw the closure in 2016 of virtually all of the county’s 44 Sure Start children’s centres. They offered free stay-and-play facilities for pre-school children, skilled support for disadvantaged families in difficulty, a non-judgmental venue for meeting and sharing experiences with other families, and parenting guidance free of the stigma for many families associated with statutory social intervention. Children’s centres undoubtedly helped to “narrow the gap” for the most disadvantaged children across the country, yet Conservative-led Oxfordshire was among the first shire councils in England to close its children’s centres as a cost-cutting measure, in defiance of government statutory guidance at the time and vigorous local opposition.

I wish a reformed Mr Hudspeth better luck in working with the Johnson government to tackle these social causes than he had with the May one, but I’m not holding my breath.
Robin Gill
Oxford

Michael Marmot authoritatively documents the human costs of the lost decade since the financial crisis, especially for poorer women and children. Most countries of Latin America and sub-Saharan Africa suffered worse for most of a 20-year period, from 1980 to 2000.

In the name of austerity policies to tackle debt, incomes often fell, education and health worsened, GNP per capita sharply slowed in Latin America and fell seriously in SSA. As a Unicef report showed, a reverse shock-absorber effect was operating. The poorest countries generally suffered most and, within them, the poorest families and, within them, the women and children – a truly negative multiplier. The British government could and should have learned from this experience. Let’s hope they now will – but it will take the adoption of clearer human objectives, new policies, regular monitoring and a shift of focus from GNP growth to human development.
Sir Richard Jolly
Institute of Development Studies

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