Echoes of Thatcher years as expert warns of Tory austerity's impact on Scots

Gerry McCartney, professor of wellbeing economy at Glasgow University, also warned that plans in Michael Gove’s levelling up strategy to narrow inequalities in healthy life expectancy are unlikely to succeed.

That has been echoed by a health charity, which has calculated under the current rate of progress the ambition for healthy life expectancy to rise by five years by 2035 would not be achieved in Scotland until 2080.

The UK Government’s plans for levelling up, outlined in a white paper last week, came as figures revealed the number of years that Scots can expect to live in good health has fallen for the last four years for women and the last three for men.

Gerry McCartney

Shocking figures from the National Records of Scotland show those living in the most deprived areas have on average 24 fewer years in good health than those living in the least deprived areas.

Those in the poorest areas also die younger, and spend more than a third of their lives in poor health.

McCartney said overall life expectancy in Scotland had been improving for decades and decades until around 2012 – when the rate of increase stalled.

“Life expectancy essentially has been unchanged since 2012, up until 2020 and the pandemic, which has led to a decrease in life expectancy compared to the pre-pandemic time period,” he said.

“But for people living in more deprived areas in Scotland, life expectancy is actually getting worse since 2012.

“So the 40% poorest or most deprived areas in Scotland have seen a decline in their life expectancy since 2012, whilst it has improved a little bit in the least deprived areas, although even there at a much lower rate than previously.”

McCartney said various reasons had been put forward for the causes of the decline in progress – such as a severe flu season in 2015, the role of drug-related deaths or deaths from heart disease.

But he said evidence shows “fairly clearly” that the change in economic policy after 2010 – when the Tories came to power at Westminster – is explaining the trends.

This includes issues such as cuts to benefits, low wage growth, an increase in zero hour contracts and in-work poverty.

“As we have lookwed at all these different causes, it is becoming increasingly clear that it is the underlying economic policies that are the root of this – so what you might term austerity,” McCartney said.

“The manifestation of that in the UK has been cuts to the real term value of social security benefits and increased conditionality,

“Another huge manifestation of the austerity programme was a reduction in the funding for local government, so that has meant in practical terms jobs going within local government, but also services being reduced to the statutory minimum in many places.

“We have also seen macroeconomic consequences – what has happened to people’s wages and incomes over time.”

McCartney said it was similar to the pattern which happened following the 1980s.

He said: “You see lagged effects from decades ago of urban planning, policy decisions and the 1980s economic changes and how that translated into people’s alcohol deaths a decade or two decades later. So it is not unprecedented.”

But he added: “These inequalities haven’t always been this wide – inequalities in health and mortality reduced between the 1920s and the 1970s in Scotland and across the UK.

“This was because we had policies at the time which built up the welfare state, they created the NHS, council housing, narrowed income inequalities, increased the power of organised labour, and brought many utilities and things into public ownership.”

McCartney argued the UK Government’s levelling up strategy is unlikely to achieve its aims for a number of reasons, including that much of the funding involved is old money that used to be in place through EU structural funds.

Gove’s plan also announced Glasgow as one of the UK’s “innovation accelerator” centres, focusing on research and development, similar to the model of Silicon Valley in the US.

McCartney added: “This kind of investment in innovation and regeneration doesn’t address the fundamental causes of health inequalities. For that kind of innovation-led regeneration, we have reviewed the evidence on that previously and there is no evidence that provides work or income for the poorest groups.

“That said, if the policy was to redistribute capital investment from the south-east of England to elsewhere, there might be some hope for it. But I have not seen any evidence yet that this policy would achieve that aim at present.”

David Finch, assistant director in the Healthy Lives team at the charity Health Foundation, said improvements in healthy life expectancy had been lost again in Scotland in recent years.

David Finch

“If you take the rate of improvement between 2009-11 and 2017-19 for male health life expectancy in Scotland, it would take until 2080 for an extra five years of healthy life expectancy to build on top,” he said.

“For women it’s actually a worse picture in Scotland – and England as well – where healthy life expectancy has been falling in the period before.

“So there is a much bigger challenge for female life expectancy too to reverse the negative trend and then add five years on top as well.”

He said if the ambitious goals in the white paper on factors such as employment, housing, access to local services and equality could be met then it would improve future health.

He added: “Where the gap exists is between the ambition and the actual content of the paper – there was very little extra there that would directly improve some of the risk factors associated with health, but also some of those wider determinants of health.

“There is a commitment for a white paper looking specifically at health improvement and disparities. Our concern is whether it takes, as historically happens, a fairly narrow focus on things like obesity, smoking, drug and alcohol abuse.

“These are important factors for health, but it really needs to take a cross-government approach and set out some more clarity.”