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May and Cameron have a terrible record on health, and it could be cutting lives short

Life expectancy in the UK has stalled. In many places, and for more vulnerable groups, it is now falling.

Between them, David Cameron and Theresa May have managed to secure the worst health record of any post-war prime ministers. Life expectancy in the UK has stalled. In many places, and for more vulnerable groups, it is now falling. No other country in Europe has had such a bad record in health between the years 2010 and 2018. It is not just the elderly who are suffering, although the large majority of untoward deaths are in this group, it has also been people of working age, especially those who have had their disability benefits slashed, and infant mortality rates in the UK have risen for children born into poorer families.

The recent UK health record is not only awful in terms of rising mortality for some groups, ranging from poorer babies to elderly women, but also in declining mental health. Some of greatest declines in mental health have been for people who are so ill that they required government employment and support allowance to survive with any decency. By 2016 over 40 per cent of this group between the ages of 16 and 64 and living in England were known to have made suicide attempts in recent years. 

Epidemiological studies have shown that new more stringent government tests result in an additional six suicides a year for every 10,000 people re-assessed in an area, an unknown (but of course much higher) increased number of suicide attempts, and many times more suicidal thoughts.

British politicians who have held power since 2010 are trying to impose the US model by stealth. This results in poor health in the US, with little “regulation over powerful food and drug companies blinded by greed and arrogance”, according to Columbia University's Jeffrey Sachs.

More and more British health services are now “delivered” by “private providers”. More and more state facilities are now run by private companies.

Those who suffer the most are the weakest and least powerful. The number of prisoners who have died in custody each year has increased by over 60 per cent since the Conservatives first came to power as part of a coalition in 2010. At the same time deaths among patients with mental illness have increased by more than 200 per cent between 2011 and 2016 and may soon be greater each year than the number in prisons.

The NHS Winter Crisis

Reports of “third world conditions” in NHS hospitals dominated the media this winter. Pictures of ambulances queuing outsides A&Es and patients lying on floors in corridors confirmed the fears many leading medics and academics had warned of: the NHS was not sufficiently funded to be able to respond to a surge in demand. Office for National Statistics (ONS) provisional weekly death data shows 6,346 more people died in the first 4 weeks of 2018 than the average for the last 5 years. This includes the worst year-on-year rise for 50 years in 2014/15. Obviously, this does not allow for changes in population age, but it is certainly a warning sign.

Following the 2014/15 winter, when excess deaths soared, concerns were raised that under-funding of health and social care could be linked to the patterns being seen. Last year, Professor Sir Michael Marmot raised the alarm, after government statistics showed stalling life expectancy. There is a growing body of evidence linking austerity, particularly cuts to health and social care, and worsening health outcomes, and rising deaths. Yet, when experts raise concerns, the government, so far, does not react.

The government’s responses

The crisis this winter was, to some, predictable. The political choice of austerity has been linked to rise in food banks, homelessness, suicide rates, infant mortality, and, increasingly, to a greater number of deaths. The significance of the number of deaths was previously disputed, but with the official ONS figures now available, comparison of the 2016-based projection to the 2014 reveals 120,000 lives “cut short”, thus projecting many more in the future.

The numbers are not disputable. But what underlies these deaths is. Whilst a growing number of experts turn to the cuts in health and social care as the cause, some still believe influenza to be the culprit, or an unknown infectious agent. Data error is no longer a viable alternative.

Experts do not dispute that what has happened is significant. Yet, despite multiple warnings from heads of Royal Colleges, academics, junior doctors, charity sector workers, and other health professionals, The Department of Health does not appear to be listening. The department's responses to concerns raised have included accusations of bias, information that is unrelated (“Life expectancy continues to increase, with cancer survival rates at a record high whilst smoking rates are at an all-time low”), and failing to satisfactorily answer a Freedom of Information request asking for their press responses to these issues.

Health outcomes in England and Wales are deteriorating. More people are dying, and certain groups can now expect to live shorter lives. The Department of Health must, firstly, acknowledge this. The time for ignorance is over. Secondly, the Department of Health must urgently explore why this is happening. If it doesn't act, then we have strongly suggested there should be an urgent independent inquiry by the select committee of the House of Commons. Protecting the health of the population is a key part of the social contract Government holds with its electorate. Failing to do this, is a failure of Government.

Lucinda Hiam is an NHS GP and Danny Dorling is the Halford Mackinder Professor of Geography at the University of Oxford.

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I'm not going to be General Secretary, but the real fight to change Labour is only just beginning

If Labour gets serious about a new politics, imagine the possibilities.

For a second time, I was longlisted for the role of General Secretary of the Labour Party this week. For a second time, just as in 2011, I was eliminated in the first round. The final shortlist now consists of two veteran trade unionist women leaders, Jennie Formby of the Unite union and Christine Blower - formerly of the National Union of Teachers and the Socialist Party. I met them both yesterday at the interviews; I congratulate them, and look forward to hearing more about their ideas for Labour party renewal.

Last week in both the New Statesman and LabourList, I explained why I thought we needed a General Secretary “for the many”. I set out a manifesto of ideas to turn Labour into a twenty-first century campaigning movement, building on my experience with the Bernie Sanders campaign, Momentum, Crowdpac, 38 Degrees and other networked movements and platforms.

I called for a million-member recruitment drive, and the adoption of the new “big organising” techniques which combine digital and face-to-face campaigns, and have been pioneered by the Sanders movement, Momentum, Macron and the National Nurses Union in America. I set out the case for opening up the party machine in a radical but even-handed way, and shared ideas for building a deeper party democracy.

I noted innovations like the Taiwanese government’s use of online deliberation systems for surfacing differences, building consensus and finding practical policy solutions. Finally, I emphasised the importance of keeping Labour as a broad church, fostering more constructive internal discussions, and turning to face outward to the country. I gladly offer these renewing ideas to the next General Secretary of the party, and would be more than happy to team up with them.

Today I am launching, a new digital democracy platform for the Labour movement. It is inspired by experience from Taiwan, from Barcelona and beyond. The platform invites anyone to respond to others’ views and to add their own; then it starts to paint a visual picture of the different groupings within the movement and the relationships between them.

We have begun by asking a couple of simple questions: “What do we feel about the Labour party and movement? What’s good, and what’s more difficult?” Try it for yourself: the process is swift, fun and fascinating. Within a few days, we should have identified which viewpoints command the greatest support in the movement. We will report back regularly on this to the media.

The Labour movement is over 570,000 members, thousands of elected representatives, a dozen affiliated unions and millions of Labour voters. We may disagree on some things; but hopefully, we agree on far more. Labour Democracy is a new, independent and trustworthy platform for all of us to explore our differences more constructively, build common ground, and share ideas for the future. I believe Labour should be the political wing of the British people, as close to the 99 per cent as possible – and it will ultimately only be what we make of it together.

Yesterday I spoke over Skype with Audrey Tang, the hacker and Sunflower Movement leader who is now Digital Minister of Taiwan. Audrey is a transparent politician, so she has since posted a video of our conversation on YouTube. I recommend watching it if you are at all interested in the future of politics. It concludes with her reflections on my favourite Daoist principle, that true leadership leaves the people knowing that they have made change themselves.  

This General Secretary recruitment process has been troubled by significant irregularities, which I hope the party learns from. The story is considerably more complex and difficult than is generally understood. I have spent considerable time in the last week trying to shine greater light on the process in the media and social media, and encouraging the national executive committee, unions and politicians to run a more open and transparent process. I even started a petition to the NEC Officers group, calling for live-streamed debates among the candidates for this crucial and controversial party management role. I very much hope that there is no legal challenge.

Most importantly, the last week has exposed a significant fault line in Labour between the new left and the old left. When Jon Lansman of Momentum entered the contest against the “coronation candidate” Jennie Formby, many people read this as a fight between two factions of the old left. But Jon’s intent was always to open up a more genuine contest, and to encourage other candidates – particularly women – to come forward. Having played the role only he could play, he eventually withdrew with dignity. His public statements through this process have been reflective of the best of the new politics. And despite our very different political journeys, he kindly agreed to be one of my referees.

There has been plenty of the old transactional machine politics going on behind closed doors in the last couple of weeks. But out in the open, the new left movements and platforms have shown their strength and relevance. Momentum emailed all its members encouraging them to apply for the role. On Facebook Live, YouTube and podcasts like All The Best, the Novara Media network has been thoughtfully anatomising the contest and what it means for the future of the left. Even the controversial Skwawkbox blog finally agreed to cover my candidacy, and we had a constructive row about the leaked memo I wrote for Corbyn’s office back in December about how to win the next election using data, organising and every new tool in the box.

I am worried about the old left, because I feel it is stuck in a bunker, trapped in a paradigm of hierarchical power and control. The new left by contrast understands the power of networks to transform conversations and win hearts and minds.

The old left yanks at levers, and brokers influence through a politics of fear and incentives. But this tired game is of decreasing relevance in this day and age. The new left has the energy, the reach, the culture and the ideas to build a new common sense in this country, and to win decisive victory for Labour and progressives in the next general election – if the old left will partner with it. 

I am keen to help. So are many others. I hope we can start to have a more constructive and equal conversation in Labour soon. Otherwise an exodus may begin before long; and no-one wants that.

Paul Hilder is an expert on new politics and social change. He is a co-founder of Crowdpac, 38 Degrees and openDemocracy. He has played leadership roles at, Avaaz and Oxfam, and was a candidate for general secretary of Labour in 2011.