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The Guardian - UK
The Guardian - UK
Comment
Owen Jones

Britain’s excess death rate is at a disastrous high – and the causes go far beyond Covid

Ambulance workers in London, January 2023
Ambulance workers in London, January 2023. Photograph: Anadolu Agency/Getty Images

When most people hear that phrase “humanitarian crisis”, they think “abroad”, “somewhere far away”, and certainly not in Britain. But how else to describe the tens of thousands of bodies avoidably piling up in the nation’s mortuaries? One funeral home worker says that they’ve run out of spaces for the deceased and “are having to keep some encoffined in office rooms”; another hospital porter reports that the mortuary has been near capacity for two weeks. This national issue should be splashed on every front page and leading every bulletin. It isn’t: why?

Last year in the UK there were nearly 40,000 excess deaths – that is, deaths above a five-year average. That’s nearly as many as were killed by the Luftwaffe in the blitz. In the last two weeks of 2022, deaths were a fifth higher than the average from 2016 to 2019 (the last pre-pandemic year), and that’s taking into account factors such as a bigger, ageing population.

According to the Office for National Statistics, there have been about 170,000 excess deaths in England and Wales since the pandemic began. Most of these can be directly attributed to Covid-19 itself: after all, the virus’s name is scrawled on the death certificates of more than 212,000 UK citizens. Some of those who died may have been vulnerable or infirm, but in other circumstances years away from death. As the pandemic waned, we could have expected excess deaths to shift to below average levels over time. This has not happened.

By the beginning of last year, the number of deaths was similar to 2019. As the actuary Stuart McDonald points out, we had been through the worst of a pandemic in which many frail members of society died, and normally mortality falls year on year, so to only equal the death toll of 2019 was already indicative of a worrying trend.

Even this data uncovered something disturbing – higher death rates among relatively young adults, and as spring came, more dying than in 2019. And here’s the thing: while the dreadful Covid death toll continues to mount, many of these excess deaths are driven by other factors.

Britain is scarred by features that have made it particularly vulnerable, both while the virus raged before mass immunisation, and in the aftermath. Some are the direct consequences of Tory policy, some are more profound: about the way our society is organised. That means today’s excess deaths go way beyond Covid.

One, the crisis in our NHS. There were about 2,200 additional deaths in England associated with A&E delays in December alone. Average ambulance response times in England are now the worst on record, and more than half of patients are waiting for more than four hours at A&E for the first time since records began in 2011.

Now consider former health secretary Jeremy Hunt’s confession that he was partly to blame for an NHS staffing crisis that left Britain more vulnerable to the pandemic and its after-effects. Consider the impact on retention and recruitment of the Tories’ scrapping of the nurses’ bursary, and the fact that nurses have lost, on average, £5,000 a year in real terms pay since 2010: there are about 50,000 vacancies in England.

There is no question that Covid has resulted in high levels of staff absenteeism, and burnt-out health workers who, normally, would have had some respite outside the winter months. A larger, better-resourced workforce would surely have absorbed the impact better.

Consider, too, that one of the crises currently afflicting the NHS is that medically fit patients who nonetheless need support cannot be discharged. A major driver of this is a lack of capacity in social care – which, since 2010, has suffered hundreds of millions of pounds’ worth of cuts, despite there being ever greater demand for it from an ageing population.

There is also a more structural factor at play. Our society is defined by inequality, and poverty breeds poor health: conditions such as obesity, high blood pressure, respiratory disease, even cancer. So what happens if you throw a pandemic at an under-resourced healthcare system, in a profoundly unequal society ravaged by poor health?

What if you add a cost-of-living crisis which – just as an example – leads vulnerable people to fear turning on their heating in cold snaps such as the one we endured in early December? What if you also have a government that has spent years obliterating the public health budget, which is intended to promote healthy lives and prevent illnesses that impose pressures on the NHS?

This is the British tragedy: a country left exposed to disaster because of the fatal conjoining of a broken economic system and an ideologically crazed government. This is a humanitarian crisis, and it should be framed as such. But as those bodies pile up in our mortuaries and funeral homes, remember this – it was all avoidable.

  • Owen Jones is a Guardian columnist

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