How bad is this recession?

This is shaping up to be the longest recession the UK has ever experienced.

The first estimate of UK real GDP for the third quarter of 2011 is due to be published on 1 November. Analysis of monthly data and measures of business and consumer confidence suggests it will show growth of around 0.4 per cent compared to the second quarter. Most of this growth will be due to special factors that held back output in the second quarter: the extra bank holiday for the royal wedding and the disruption to supply lines caused by the Japanese tsunami.

With the economy not having grown at all over the previous three quarters, this means the economy will have grown by the same 0.4 per cent over the last year. Technically, this is not a recession - but it is about as close as it is possible to get to a recession without actually being in one.

In fact, it could be argued that the UK has still not emerged from the recession that began in 2008. Even after 0.4 per cent growth in the third quarter, real GDP will be 4 per cent lower than its peak level, reached in the first quarter of 2008. In none of the five previous serious recessions experienced by the UK economy in the last 100 years has real GDP been so far below its peak at a comparable period (data for the 1920s and 1930s are taken from NIESR).

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On this basis, this is shaping up to be the longest recession the UK has ever experienced. If we take the Office for Budget Responsibility's (OBR's) latest forecasts for 2011Q4 onwards, real GDP will not exceed its previous peak until the second quarter of 2013 - fully five years after the recession began. This will make it a year longer than the previous longest recession - the one that began in 1979.

But the OBR's forecasts were made in March. The outlook for growth in the UK has deteriorated since then. Independent forecasters have been revising down their growth forecasts for 2011 and 2012 and the OBR is likely to do so too when it publishes its new forecasts on 29th November (alongside the Chancellor's Autumn Statement). If these new forecasts prove correct, this recession could last as long as six years.

Of course, as the last year has shown, there is a wide margin of error in growth forecasts, even for the relatively short-term. One reason for this year's disappointing growth has been higher food and energy prices, which have squeezed households' spending power, reduced demand and so led to cutbacks in output. If food and energy prices should fall sharply in 2012 - and they are more volatile, and thus harder to forecast, even than real GDP - then these effects could go into reverse. By this time next year, the economy might be growing at a healthy rate.

However, there are also reasons to fear growth will remain very weak for the next few quarters. Most areas of the global economy - even China - are less dynamic than they were a year ago. In particular, the effect of the euro zone sovereign debt crisis on the UK economy has only been felt in the last few months and it is likely to affect UK exports until well into 2012. The Chancellor talks of Britain being a safe haven in a storm, but even he must realise that the storm brewing in the euro zone has the potential to wreak havoc with the UK economy.

Despite the uncertainties, what is apparent is that the 'expansionary fiscal contraction' hoped for by the Chancellor and his supporters - in which cuts in the budget deficit would unleash a wave of entrepreneurial activity and strong private sector growth - has failed to materialise, and is unlikely to do so. As the Keynesians rightly warned, businesses are worried first and foremost about demand for their goods and services. Unsurprisingly, they have taken the view that a hike in the rate of VAT and substantial cuts in public sector spendingand employment, at a time when interest rates are already at rick-bottom levels, will reduce demand. So they have been extremely cautious about increasing investment spending and hiring extra workers.

After the GDP figures, all eyes will turn to the Autumn Statement. It is already too late to avoid this recession being the longest in the UK's history, and the external environment means 2012 may be just as tough a year as 2011. But it is not too late to take steps to promote stronger growth in the UK over the medium-term.

Those hoping for a change of course on the pace of deficit reduction are likely to be hoping in vain. The Chancellor and the Prime Minister have too much political capital invested in Plan A. Is it too much to hope, though, that the Chancellor, spurred by the underperformance of the economy over the last year, will announce a proper plan for growth? Not one that starts from a set of measures agreed by the coalition partners and attempts to build a plan around them. But one that starts by identifying what is needed for the economy to grow - increasing supplies of capital, labour and land and better ways of utilising them - and asks how these might be achieved. Perhaps it is; we will have to wait and see.

Tony Dolphin is Chief Economist at ippr

Tony Dolphin is chief economist at IPPR

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All doctors kill people – and the threat of prosecution is bad for everyone

We must recognise the reality of medical practice: just because a doctor makes a mistake, that doesn’t mean they’ve all broken the law. 

On 15 November the Court of Appeal quashed the 2013 conviction for gross negligence manslaughter (GNM) of a senior consultant surgeon in London, David Sellu. Sellu, who had completed his prison term by the time the appeal was heard, will never get back the 15 months of his life that he spent in jail. Nor will the personal and family trauma, or the damage to his reputation and livelihood, ever properly heal. After decades of exemplary practice – in the course of the investigation numerous colleagues testified to his unflappable expertise – Sellu has said that he has lost the heart ever to operate again.

All doctors kill people. Say we make 40 important decisions about patients in a working day: that’s roughly 10,000 per annum. No one is perfect, and medical dilemmas are frequently complex, but even if we are proved right 99 per cent of the time, that still leaves 100 choices every year where, with the benefit of hindsight, we were wrong.

Suppose 99 per cent of those have no negative consequences. That’s still one disaster every 12 months. And even if most of those don’t result in a fatal outcome, over the course of a career a few patients are – very regrettably – going to die as a result of our practice. Almost invariably, these fatalities occur under the care of highly skilled and experienced professionals, working in good faith to the very best of their abilities.

If one of these cases should come before a crown court, the jury needs meticulous direction from the trial judge on the legal threshold for a criminal act: in essence, if a doctor was clearly aware of, and recklessly indifferent to, the risk of death. Sellu’s conviction was quashed because the appeal court found that the judge in his trial had singularly failed to give the jury these directions. The judiciary make mistakes, too.

Prosecutions of health-care professionals for alleged GNM are increasing markedly. The Royal College of Surgeons of England identified ten cases in 2015 alone. This must reflect social trends – the so-called “blame culture”, in which we have come to believe that when a tragedy occurs, someone must be held responsible. In every one of these cases, of course, an individual’s life has been lost and a family left distraught; but there is a deepening sense in which society at large, and the police and Crown Prosecution Service (CPS), in particular, appear to be disconnected from the realities of medical practice.

Malpractice investigation and prosecution are horrendous ordeals for any individual. The cumulative impact on the wider health-care environment is equally serious. In a recent survey of doctors, 85 per cent of respondents admitted that they were less likely to be candid about mistakes, given the increasing involvement of the criminal law.

This is worrying, because the best way to avoid errors in future is by open discussion with the aim of learning from what has gone wrong. And all too often, severely adverse events point less to deficiencies on the part of individuals, and more to problems with systems. At Sellu’s hospital, emergency anaesthetic cover had to be arranged ad hoc, and this contributed to delays in potentially life-saving surgery. The tragic death of his patient highlighted this; management reacted by putting a formal rota system in place.

Doctors have long accepted the burden of civil litigation, and so insure themselves to cover claims for compensation. We are regulated by the General Medical Council, which has powers to protect patients from substandard practice, including striking off poorly performing doctors. The criminal law should remain an exceptional recourse.

We urgently need a thorough review of the legal grounds for a charge of GNM, with unambiguous directions to the police, CPS and judges, before the spectre of imprisonment becomes entrenched for those whose only concern is to provide good care for their patients. As Ken Woodburn, a consultant vascular surgeon in Cornwall who was accused and acquitted of GNM in 2001, has said: “You’re only ever one error away from a manslaughter prosecution.”

This article first appeared in the 01 December 2016 issue of the New Statesman, Age of outrage