Excess Death Trends

Caroline Johnson Excerpts

Tuesday 16th January 2024 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

This is a very important debate and I will try to make my speech as short as possible. I congratulate the hon. Member for North West Leicestershire on raising this issue and on his determination to highlight the challenges that we are facing. On the one hand, we might have expected that the pandemic would shorten the lives of a number of our more frail citizens and thus have expected a fall in deaths post-pandemic, and we saw that. The ONS reported roughly 608,000 deaths in England and Wales in 2020, 586,000 in 2021, and 577,000 in 2022—that was higher than 2019 when there were about 531,000 deaths, so that does warrant further inspection. We expect a fluctuation year on year, and we also expect the total number of deaths to increase year on year as the population increases and ages. We therefore look at the five-year average, and currently we are using 2017, 2018, 2019, 2021 and 2022 because of the outliers in 2020. Even then, it is unlikely that we will be exactly at the average, and we would expect some years to be higher or lower.

The ONS monthly mortality analysis shows that, in 2022, there were 32,000 more deaths than the five-year average, and in January to July 2023, there were 21,809 more. That equates to an annualised figure of around 37,000, but the figures appear to stop in July 2023. Would the Minister advise as to why the data series has been discontinued? It would be helpful if it were not. However, those are raw numbers and we must be cautious because, as the population ages and increases, so will the number of deaths. The ONS therefore uses the age-standard mortality rate, which has fluctuated month on month but is actually down for both 2022 and 2023 when compared with the five-year average. Overall, when adjusted for age and population size, the number of deaths is not excessive, given what we would expect.

We need to look further at the trends on age and the causes of death to see a fuller picture. Others will no doubt speak of rising cardiovascular disease in men, the late presentation of cancers or the rise in liver disease, but as a consultant paediatrician, I would like to focus on children. The National Child Mortality Database collates data on children’s deaths from nought to 18. Its latest bulletin from March 2023 shows that there were sadly 3,743 deaths to the end of that month, which is an increase of 8% on the previous year. Would the Minister comment on what investigation she is doing into the cause of that increased mortality and what is being done to prevent further deaths? The purpose of the child death overview panel is to investigate those deaths, but the average investigation is taking 392 days, with less than half completed in 12 months and a significant fall in the number being completed in 12 months. What is the Minister doing to improve that process?

One particularly distressing feature of child death data is that suicide or deliberate self-harm was a primary cause of death of children between 10 and 17 years, and looking at the data, it is getting much worse with children between 10 and 14. I understand that the Government are aware of those figures and are investing in mental health for children and improving online safety. I would be grateful if the Minister elaborated further on the steps they are taking to support children and prevent further tragedies.

[Sir Gary Streeter (in the Chair)]

Order. The hon. Member is running out of time.

[Dr Johnson]

I will finish on this point. One reason why I get exasperated with the covid inquiry is that there seems to be too much focus on who said what to whom—did someone swear, did the actors like each other? I am not that interested. I want to know what lessons can be learned. Was lockdown useful? Was getting children out of school useful? Was the vaccine a suitable thing to give to children or not, particularly if they had had covid before? Those are the answers that we need.

--- Later in debate ---

[Maria Caulfield]

Not for the moment; let me respond to as many points from hon. Members as I can.

There is an increase in excess deaths. A number of factors contribute to that. We take that seriously, and monitor it constantly. Looking at the past year, for example, there was a high flu prevalence last winter, when there were still ongoing challenges relating to instances of covid-19 and a strep A outbreak, particularly among children. Those had an impact. Statistics from the Office for Health Improvement and Disparities showed that last year, there were almost 26,400 excess deaths in England, and of those excess deaths, 7,300 were due to acute respiratory infections, including flu and pneumonia.

Last winter, the number of positive tests for flu peaked at 31.8%—the highest figure in the last six years. There are schools of thought on that; one is that when people were locked down, they were not exposed to flu for a couple of years, so their immune systems struggle to cope. We have learned those lessons, and that is why, this year, we have brought forward our flu vaccination programme. We have successfully vaccinated over 17.6 million people since the campaign started in September. It is still early in the winter season, but—touch wood—we are seeing fewer admissions from flu and covid than we did last year. We are learning lessons from those excess deaths.

There are also excess deaths from cardiovascular diseases; that was pointed out during the debate. The figure is 6% higher than expected in England, with almost 13,500 excess deaths attributed to cardiovascular disease. Lockdown did have an impact on that. We know that people were not getting their cholesterol tested or their blood pressure checked, and were still smoking. Antihypertensives and statins were not being prescribed. Again, we have taken action. As my hon. Friend the Member for South West Bedfordshire (Andrew Selous) pointed out, we are supporting local authorities to resume normal NHS healthcare checks; between April and June last year, the highest number of checks were offered since the programme began in 2013. We are investing £17 million in innovative new digital health checks, to be rolled out this spring, that will deliver an additional 1 million checks in the first four years. We have a £10 million pilot to deliver up to 150,000 cardiovascular disease checks in the workplace, with free blood pressure checks being rolled out in community pharmacies to people over 40, and we are investing £645 million to include blood pressure checks in our community pharmacy facilities. That is in addition to the work the Prime Minister announced on a smoke-free generation, which will be debated further, through which we want to see smoking rates further reduce.

I turn to the elephant in the room—covid vaccines—because the hon. Member for North West Leicestershire and other hon. Members have raised concerns about their safety. It is true that Office for National Statistics data, published only in August, shows that people who have had a covid-19 vaccine have a lower mortality rate than those who have not been vaccinated. My hon. Friend the Member for Bosworth (Dr Evans) and the hon. Member for North West Leicestershire are absolutely correct that a high number of people who were vaccinated appear in the excess death population, but when 93.6% of the population have had at least one dose of a covid vaccine, there will be a high number of vaccinated people in the excess death numbers. That is prevalence, not causality. It is important that we look at the causes of excess deaths and tackle them.

[Dr Caroline Johnson]

The Minister is saying that the number of people dying who are vaccinated is higher than the number of people who are not. That is to be expected because they are more likely to be older and frailer. Does she have any data that are adjusted for age and frailty—to say whether the vaccinated population are more or less likely to die?