After 13 years of British Conservatism it’s time to vote again. Admittedly they are for local councils where turnout is notoriously low and falling lower as the power and cash has been stripped from them, leaving councils struggling to make a difference and the elections far from the front of most people minds.
Nevertheless, this is democracy as it stands and offers feedback to a period of government which has been defined by austerity, Brexit and the pandemic. Since David Cameron took the helm from Labour, on the back of the 2010 banking crisis ,there has been a decisive shift in how we manage our society with particular emphasis on shrinking the role of the state. For many, it seems we have had Conservatives in power for ever.
The UK conservatives have done well electorally, Trump is rumbling in the background, Italy now has a far right leader, Hungary and Poland are led by extremists. Lula, at least scraped in after a bruising election campaign and sour grapes in Brazil. So what is the effects this shift to the right on health? For me the health of the population is a better measure of success than crude measures of economic output.
There is compelling evidence that conservatives, those protectors of wealth, are damaging huge number’s of people health. Hence the provocative title – killer conservatives. Is it justified?
AUSTERITY
Like a tree that is weakened by successive summer droughts, our social structures have been chronically weakened by a decade of cuts in provision of public services since Conservative came to power. It is probably an underestimate that 350,000 excess deaths were caused by austerity in between 2012-19 when the Tories started making their “difficult decisions”. While more men die prematurely than women, in poorer areas the research suggests austerity hits women harder.
There is no doubt that Austerity kills, fuelling the fires of poverty and unhealthy lifestyles. Then came the needless self harm which is Brexit.
Brexit
The Conservatives called a needless referendum in an attempt to end drift of voters to the far right UKIP, taking a huge risk with the country’s future to ensure ongoing power for their party. They dedicated much of their time in power to the build up to the referendum and the complex negotiations following the result which will take a generation to conclude. By the time it does most people would be against it as young replace the old. Already, 63% of people think leaving the EU was a bad idea. In terms of health, it certainly was.
For one thing, Brexit is now playing out in our poor economic performance. It has also led to a significant political shift in that those who opposed Brexit have been marginalised, leading to the emergence of a more right leaning government. Some MP’s with extreme ideas, who would have previously languished on the back benches are now ministers, in power and making some historically terrible decisions.
Brexit has been a failure so far though Brextremist and eternally smug Rees Smog suggests, rather conveniently, that we wont be able to tell for 50 years! So far so bad.
This plays out in real life in simple terms like the £200 added to the annual food bill by Brexit. Every little hurts! That mythical sovereignty – the bedrock of the case for Brexit – is nowhere to be seen. The best that can be said are dubious trade deals which harm our own farmers and the planet. Public sector staff have been lost, influence and research possibilities dimmed, and co-operation with Europe more complex. In other words a failure which will cost £100billion in lost output. This matters for government income, public services and health.
The exodus of NHS staff following Brexit led to unethical drives to recruit from elsewhere in the world where healthcare staff are desperately needed, but even that still leaves the UK with 100,000 empty NHS posts. This report from the Nuffield Trust highlights the damage done. Some key points:
- The number of nurses joining the UK register from the rest of the world has risen from 800 in 2012/13 to 18,000 in 2021/22. However, this is not sufficient to make up for ongoing shortages.
- Certain specialities have been hard hit, anaesthetics and cardo-thorassic surgery in particular as they relied on EU staff more heavily pre-Brexit. Dentists and social care staff have also been lost.
- Staff are leaving nations who need them most, in the summer of 2012, recruitment from “red-list” countries has increase from 100 a month to 1000 a month. This is ethically wrong and will lead to poorer health outcomes in places where they are already struggling.
- Shortages of medicines, problems of supply, increased cost due to a weak pound all add together to make the provision of healthcare tougher.
Martin McKee, professor of European public health concludes: “..there is no escape from the fact that Brexit will continue to damage health and the NHS for the foreseeable future.”
The effects of Brexit are compounded by staff retiring early from due to overwork and stress, and many recently qualified staff finding work in other sectors or countries. Chronic underfunding has hit the wall and the results clear to see if historical strikes by NHS staff.
Public services
Even in terms of getting to hospital, there are big problems. From 2016-19, estimates suggest that over 5,500 people have lost their lives while waiting in an ambulance or on an A+E trolley. That was before the pandemic. Things have steadily got worse since.
Recent research now shows that one in 82 people who are waiting in an ambulance more that 6 hours will die. This translates to 500 needless deaths a week.
People dying in ambulances before they get into hospital a tragedy in itself, but also very difficult for ambulance staff and paramedics to cope with, again meaning more staff become ill or leave.
Then there is waiting lists. Here the evidence seems stark that political choice matters. Conservatism and a public sector healthcare do not get on well together!
GPs too are having problems with referrals. Many are finding referrals bouncing back by triage systems causing delay and frustration.
The two week wait target for to see a specialist for suspected cancer is frequently not met. Plans to solve the latter by simply extending the target to a month have not, thankfully, gone through.
Strikes are now in full flow from public sector workers who have had enough, not only with diminishing pay, but also with the exodus of skills and experience from the public sector which leaves the workplace ever more stressed.
Failing of the public services we depend on are evident everywhere, from the care sector, primary care, hospitals, the criminal justice system, housing, education – everywhere. Even pot holes in roads.
All the way to the Food Bank
Food banks are a vivid marker of desperation. The Trussell Trust saw record numbers of people seeking help between April and September last year, with 320,000 people forced to turn to the charity’s food banks. That is a 40 per cent increase in comparison to the previous year and comes on the back of increases pre pandemic.
That set the stage for how we managed a global pandemic from early 2020, with health services already stretched by the new normal of political austerity. What difference has political leaning made?
COVID 19
Evidence shows that mortality is higher in Republican states in the US. COVID19 death are higher in Republican areas and represents an acceleration of the same trends before the pandemic. Some of this is driven by the misinformation rampant in the US media sector with Fox and its former kingpin leading the way – it makes a difference. This research reveals that those viewing these shows “downplaying the threat of COVID-19 experienced a greater number of cases of deaths.”
Things were already getting worse in the USA before the pandemic.
This effect was present before the vaccination campaign and exacerbated by the lower uptake in republican areas leading to increased numbers of republicans dying from Covid.
That his difference increased significantly after vaccination became available is a terrible inditement of misinformation from far right media outlets like FOX.
The research concludes: “a a linkage of 2017 voter registration in Ohio and Florida to mortality data from 2018 to 2021. “We estimate substantially higher excess death rates for registered Republicans when compared to registered Democrats, with almost all of the difference concentrated in the period after vaccines were widely available in our study states”
This was worsened by advocates of useless treatment such as hydroxychloroquine, Ivermectin, and others, driven by belief in some truly terrible studies, which while widely viewed are in reality, gibberish.
In summary, the highly polarised USA offers distinct evidence that Conservatism kills. This has been personified by the scandal of a State Surgeon-General Florida, in charge of public health, doctoring reports to make vaccines look dangerous – about the worse example of malpractice one can imagine, and appointed by DeSantis, astonishingly, a potential US president..
The wider picture
We live in serious times, yet we have extremist politicians running the roost in much of Europe and the possibility of either De Santis or Trump running the US state in two years and trying to out-bid each other with far right policies. Here in the UK, Conservatives have used every opportunity to push the same small state, free market ideology that harms not only our own collective health, but with environmental destruction most evidence with climate change, the prospects of every generation to come.
Voting in the elections this week will not change the world, but offers a rare chance to send a message to those politicians in power; not only in that performance is simply not good enough, it has been deadly, costing lives, creating misery and failing to deal with the problems which are self evident all over the globe.
Beyond this discussion lies the huge changes we need to slow down climate change and the problems it is already creating, before we even arrive at summer.
We need big, better government, more public spending, state control of utilities, profits utilised for the common good and better regulation – a far cry from what we have got with Conservatism which favours the rights of the individual over our collective health right now and the survival of our species as the next few years roll by.
Yes we have had appalling government. But the Tories are not wholly to blame Labour for so much of the time failed to provide a credible alternative. They also failed to support May when she was fighting the ERG all 22 of them that were steering-if that is the right word- the country to the rocks.
Thanks Owen, Indeed, but next year will have only had a singly GE winner in the Labour side in 50 years, the focus must surely be on the Tories.
Tory ministers have access to the data; they have access to the best public health expertise. They can commission reports by civil servants who will do the donkey work summarising the evidence from people such as Prof. Marmot. It is not a lack of understanding that is an issue…it is the lack of political will. Their agenda is focused on current financial and wealth-creating structures that benefit asset owners and short-term ROI decision-making. They knowingly commit social murder, but they hide behind the proximal causes of death (e.g. smoking, poor lifestyle choices) to avoid dealing with the distal causes (housing, low pay, austerity…..). The legal system cannot hold them to account because proximal causality is what counts. For example, deaths caused by air pollution cannot come about because it is a distal cause – instead, the focus is on the proximal cause, such as asthma which is nobody’s fault (not even the Romans). What do we do? Within the context of an ideological war right now – think about the ‘National Conservatism*’ movement about to hold a conference in London, let alone the ‘woke’ distraction – I don’t hold out much hope. British ‘capitalist democracy’ is slowly voting towards fascism, and Labour under Starmer is failing to counter it. Only some form of social and environmental catastrophe on a scale we have not seen since 1945 will galvanise enough desperate people to take to the streets. I’m afraid direct action must be taken to shift the killer conservatives from power. That will invoke a repressive backlash (it has already begun).
*aka fascism.
Gloomy prospects indeed Benny. I cannot help but feel an environmental catastrophe will not be something from which we can recover. I am so impressed by so many people, families, groups, but it seems the bigger the group, the less sense they come out with, as humanity as a species is behaving with no more collective with than a bread mould on a slice of bread. When the bread is all consumed what then?