UK Mortality Rates

Lord Davies of Brixton Excerpts

Thursday 12th January 2023 Grand Committee

[Lord Davies of Brixton (Lab)]

My Lords, I thank my noble and, might I add, numerate friend Lord Sikka for obtaining this debate. It is a topic of much discussion and no little misunderstanding. I look forward to the maiden speech of the noble Lord, Lord Evans. I cannot help but remember my maiden speech, which I had to give in Grand Committee; it does not have exactly the same grandeur as making your maiden speech in the Chamber, so the noble Lord has my sympathy, but it is the content that counts.

I want to talk more about mortality in general. Figures and comparisons relating to mortality always need to be considered with care. The report before us is important and topical; my noble friend Lord Sikka set out the issues clearly. I just want, in the few minutes available, to put them into a wider historical context and then say something about what we know from the latest mortality figures.

Throughout the 20th century, the United Kingdom saw significant increases in life expectancy, influenced not just by medical advances but, more significantly, by better incomes and living conditions, as well as changing habits—particularly the reduction in smoking. Yet, while mortality rates continued to improve during the first decade of this century, the improvements have stalled since 2011. For certain groups, they have gone into reverse. The work before us today, along with other reports, unequivocally points the finger for this regrettable turn at the impact of austerity since 2010—no little coincidence.

Of particular concern is the fact that inequalities in life expectancy between the richest and the poorest have widened since 2011. While people in wealthier areas of the UK continue to live longer, for those living in the most deprived areas, life expectancy is stalling or even reversing. What this tells us is that the adverse trends affecting the less advantaged groups in our society are not inevitable. It is a question of social policies.

To turn to the current situation, why are there reports in the press about very high excess deaths? It is because most of these reports compare historical data, but this underestimates deaths and demographic evolution and, as a result, overestimates excess deaths. What we need to do is to use the gold standard for this type of analysis, which is to use age-standardised mortality rates, removing the effect of the changing age structure. Clearly, as the population ages, we should expect more deaths.

However, if you dive into the figures, you find something interesting and important: there is little excess mortality explained by the demographics and Covid among the population over 65, but you find excess deaths in younger age groups, particularly those under 44. Two possible reasons for this can be dismissed; the pattern of excess deaths simply cannot be explained to any significant extent by the rollout of vaccines or the deferral of medical treatment due to the Covid epidemic that would otherwise have taken place. Absent these explanations, everything points to the increasing pressures on the NHS—particularly since last April—being the trigger.

I must refer here to the work of the Stuart McDonald, a partner at the consulting actuary firm LCP and star of this week’s BBC Radio 4 programme “More or Less”. I should mention in passing that I was once employed by LCP as a trainee many years ago. Stuart and his team have concluded in terms that:

“Our analysis suggests that a significant number of patients could be dying because of long delays accessing emergency care. We estimate this number at over 400 deaths each week between September and November, though it might be higher.”


He tweeted earlier today that:

“Data for December has just been published and paints an even worse picture. 2,200 additional deaths associated with A&E delays in December alone. That is 500 per week.”


Putting these two things together, the level of excess that we see is, to a significant extent, due to the long-term increases in waiting for medical treatment, exacerbated more recently by delays in accessing emergency care. This is the sharp end of austerity. The sooner it comes to an end, the better for the health and longevity of our whole population.