I wanted to find data on the consequences of Conservative cuts since 2010, in the hope that I might remember some of them to use in discussion with Conservative-leaning friends. A pdf version is available here.
The UK has experienced the worst economic recovery on record, even worse than that after the Great Depression. The UK did not lose as much GDP per capita as in the 1920s – 7% vs 10% – but ten years later, output is only 3% above pre-crash levels compared to more than 10% ten years after the Great Depression crash.
For only the second time since records started in 1987, UK households have seen their average income fall below their outgoings. The last time this happened was in 1988, with a shortfall of £0.3 billion. The shortfall in 2017 was over £24 billion.
Research from the Social Metrics Commission, 2018, Briefing on autumn budget.
2 million people live in poverty. This includes:
4 million working-age adults;
5 million children;
4 million pension-age adults;
9 million living in a household with at least one disabled person;
7 million in persistent poverty, defined as being in poverty for at least two of the previous three years.
Work is not a solution to poverty, as a majority of poor working-age families are in work:
Two-thirds of (non-pensioner) families in poverty have at least one adult in at least part-time work;
8 million working-age families are in poverty despite all adults working full-time;
1 million working-age families where someone is disabled are in poverty despite at least one adult being in at least part-time work;
700,000 working-age families with a disabled person are in poverty despite all adults working full-time.
The biggest contributors to poverty are housing costs and disability-related costs, both of which reduce disposable income.
JRF, MIS for the UK 2008-2018: Continuity and change, 2018
Gas, electricity and other domestic fuel costs have increased by around 45% since 2008
Food costs have increased, and the cheaper foods have increased proportionately more
Transport costs have increased from 10% to 20% of the budget to meet a minimum living standard, as public transport is deemed to be less adequate than in 2008 and people are travelling further for work, shops and leisure.
Bus prices have increased 65% since 2008.
Pensioners can meet almost all of their minimum income standard through benefits (including the state pension and means-tested benefits)
Working-age adults with children can meet between ½ and 2/3 of their MIS through out-of-work benefits.
Working-age adults without children can meet only 1/3 of their MIS through out-of=work benefits.
Lone parents working full-time are £70 per week short of their MIS
Single-earner couples with two children are £120 per week short of their MIS
Universal Credit is inadequate for basic subsistence
Jobseekers and adults deemed ‘unfit for work but fit for work-related activity’ receive less than half of what they would need to maintain a long-term subsistence lifestyle (44.4%). This is destitution.
Adults deemed ‘unfit for work-related activity’ – i.e. people who should in effect be on a disability pension – don’t quite receive enough for long-term subsistence (90.5%).
Unlike old age pensioners, who receive almost all of what they would need to achieve an inclusive life, ‘disability pensioners’ receive less than three-quarters of what an able-bodied person would need to be able to participate in society.
Disabled people face additional costs of around £200 per week above what they can get from extra-costs benefits, driving them even further away from an adequate standard of life.
JRF, Destitution, 2017
Reached a consensus-based definition of destitution: people who cannot afford to buy the absolute essentials to eat, stay warm and dry, and keep clean. This amounted to having only £70 per week after housing costs.
Conservative estimates, based on people who come to the attention of voluntary sector crisis services, suggest that at least 1.25 million people were destitute during 2015.
Between 1999 (Pantazis et al., 2006) and 2012 (Gordon et al., 2013; Lansley and Mack, 2015), inability to afford key items increased:
Two meals a day: 1% in 1999 vs 3% in 2012;
Celebrations on special occasions: 2% vs 4%;
Meat, fish or vegetarian equivalent daily: 2% vs 5%;
Heating to keep a house adequately warm: 3% vs 9%;
Enough bedrooms for children: 3% to 9% of children
Daily fresh fruit/veg: 5% to 7%
Damp free home: 7% vs 10%;
Being able to replace or repair broken electrical goods: 12% to 26%
One in four people can’t repair or replace broken electrical equipment, making healthy eating even more difficult. One in twenty can’t afford daily protein; one in 28 can’t manage daily fresh fruit or vegetables, and one in 33 can’t manage more than two meals a day.
ESA is associated with around 200 additional suicides per year and 90 000 additional cases of mental illness.
More than 2 in 5 people on ESA have made a suicide attempt at some point.
The Work-Related Activity Group drives people further away from work:
9 in 10 people in in the Work-Related Activity Group are anxious about being there
8 in 10 in ESA WRAG don’t feel ready to take part in work-related activity.
More than 8 in 10 felt anxious about the activities they were required to do or about being sanctioned. Fewer than 1 in 10 didn’t feel anxious.
Participants who have completed two years on the Work Programme are further away from work at the end, not closer
More than half of disabled people have no savings, compared to one in ten of the general population.
Disabled adults have lost £2500/year in support since 2010. Disabled adults who were already in poverty have lost £4600/year, with the most severely disabled losing £6350.
Research in Southwark (Safe as houses 2, 2018, The Smith Institute) found that:
20 weeks into Universal Credit, social housing tenants are in arrears by 14%. In comparison, housing benefit recipients are in credit by 5%.
Housing benefit and Universal Credit recipients are just as likely to be in arrears. However, Universal Credit tenants have higher arrears; nearly four in ten have arrears of over 75%, whereas fewer than one in ten HB recipients are in arrears by over 75%.
Universal Credit arrears tend not to get fully paid off. Arrears start high, declining to week 20 but building up again after week 40. In Southwark, which as 15,000 working-age tenants with an average rent of £110 per week, the cost of Universal Credit arrears could reach £6 million per year.
Research by Shelter, Briefing 2018
14,420 households were accepted as homeless between Oct and Dec 2016, up 50% from the same period in 2009.
The number of households in TA rose to 76,000 in Dec 2016, an increase of 60%
60,000 households contained children or pregnant mothers.
120,000 children are living in temporary accommodation, 73% higher than in 2010.
Temporary accommodation cost £845 million in 2015/16
In May 2018, one quarter of the 79,000 households in temporary accommodation were being paid for through exorbitant ‘by the night’ lettings. This form of letting has grown by 500% since 2009.
Homelessness has increased due to increased rent and decreasing housing benefit
TA is typically very poor, with constrained cooking facilities, overcrowding, disrepair, infestations, damp, mould, and a lack of security
Over 80% of local authorities have found it difficult to meet their statutory duties to homelessness applicants.
29% of households receive housing benefit, but:
housing benefit covers less than 30% of properties;
28% of private rentals are inadequate;
The absolute number of inadequate private rental properties is increasing.
Only 20% of landlords are willing to let to benefit recipients;
The proportion of affordable properties and willing landlords has fallen because of benefit cuts.
By 2020, housing benefit for a two-bed property won’t cover the rent for a property at the 25th percentile (bottom quarter of houses) in 83% of areas.
It is believed that over two million people live in houses that actively damage their health.
78% of the increase in homelessness since 2011 is because of households losing their private sector tenancy.
Funding from central to local government has fallen 40% since 2010/11.
Central government funding now makes up 50% of local government revenue, down from 75% in 2010/11.
Council spending has fallen by 18%, or 22% per person, between 2009/10 and 2015/16 (in real terms)
Council spending power in 2019/20 will be 1.4-4.0%, or 4.2-6.7% per person, lower in 2019/20 than in 2015/16 (lower figures are based on projected real-terms growth in business rates).
The most deprived councils have experienced the most cuts. From 2015/16 to 2017/18, the most deprived councils have lost 2.8% in funding whilst the least deprived councils have gained by 0.3% (real terms; assuming growth in business rates).
Research by the Institute for Fiscal Studies, Changes in councils’ adult social care and overall service spending in England, 2009/10 to 2017/18:
Total service spending by councils has fallen by 24% per person since 2009/10.
Because social care has been relatively protected (at 9% fall per person), all other services have seen higher spending cuts of 32%.
The cuts have fallen more heavily on more deprived councils, at an average of 32% per person in the 30 most deprived councils versus 17% per person in the 30 least deprived councils.
The number of people receiving social care fell by 25% from 1.7million in 2010 to 1.3million in 2015.
Net spending on social care in 2015/16 was only a little smaller than in 2010/11, but would have been substantially higher had it kept pace with demographic change.
The steepest cuts have occurred in home-based and day care.
Residential and nursing home providers are closing down or handing back contracts in almost 1/3 of local authority areas.
Half of local authorities used some of their council reserves to go towards social care in 2017/18. At current rates, 10% will have run out of reserves by 2020/21.
In 2018/19, local councils plan to reduce social care spending by a further 5%. Social care funding has already fallen from £21.5bn in 2010 to £14.5bn in 2018.
Research by the Independent Living Strategy Group (Charging for social care: a tax on the need for support? 2018) found that:
72% of social care users had to pay more towards their care in 2018 than in 2016.
Around half of social care users experience difficulty in funding their care. This includes using money for essential household costs to pay for social care; drawing on savings; and borrowing informally from friends and family.
13% frequently and 20% occasionally reduce spending on housing costs in order to fund social care. 17% frequently and 27% occasionally reduce spending on food; 13% and 27% reduce spending on heating; 19% and 33% reduce spending on travel; 15% and 18% reduce spending on work training; and 38% and 33% reduce spending on travel.
2 million people aged over 65 have unmet social care needs.
Research by Care and Support Alliance, 2018. Voices from the social care crisis
1 in 5 go without meals, more than 1 in 3 have been unable to leave their house, and more than 1 in 4 have gone without basics like washing, dressing and using the toilet.
1 in 3 say their health is deteriorating because of a lack of social care. 1 in 6 have missed medical appointments, 1 in 4 have needed hospital care and 1 in 8 have been delayed leaving hospital because of inadequate social care.
1 in 5 are unable to work because they don’t get enough social care. Both disabled people and carers have had to give up work.
48% of adults in need of social care get nothing.
32% of adults in need of social care don’t get enough.
400 000 fewer adults got social care in 2013/14 than in 2009/10, even though the absolute number of people needing care increased.
Research by ADASS, 2018 Budget Survey:
Social care funding has decreased by £7 billion since 2010/11.
A temporary reprieve was provided through the Better Care Fund and by allowing councils to increase council tax by up to 2.99% a year. However,
the Better Care Fund in 2019/20 is worth only £337 million, a third of its 2017/18 value; and
councils are not allowed to raise council tax by more than 6% over three years.
Consequently, 42% of councils are unable to raise (real) council tax at all in 2019/20 (compared to only 4% who didn’t increase council tax in 2018/19),
21% can only increase council tax by 1%, and
15% don’t know if they will raise council tax or by how much.
A 1% increase in council tax would raise £148 million nationally.
Councils are funding shortfalls in social care predominantly by using up reserves (50%), cutting other council services (41%) and accessing the Improved Better Care Fund (27%).
Research by the Institute for Fiscal Studies, Changes in councils’ adult social care and overall service spending in England, 2009/10 to 2017/18:
Spending on adult social care has fallen by 9% per person since 2009/10.
The 30 councils with the highest deprivation have made the highest cuts to adult social care, at 17% per person versus 3% in the 30 least deprived areas.
IFS 2018 Securing the future: funding health and social care to the 2030s:
Social care spending needs to rise by 3.9% per year for the next fifteen years, just to maintain the current system – which is restrictive, low-quality and unfairly means-tested
10% reduction in funding for public health (preventative measures) since 2015/16
Data available at Nuffield Trust, The NHS workforce in numbers: Facts on staffing and staff shortages in England. 30/10/2017, updated 26/04/2018.
50,000 vacancies across all clinical staff in 2014, and a shortfall of 5.9% between the number needed and budgeted for, and the number actually in post
45% reduction in district nurses since 2010. There are fewer than 6000 qualified district nurses in post – not even 10 per constituency.
At least 36,000 FTE nursing vacancies in December 2017
More than 20,000 vacancies for mental health staff in the English NHS, nearly 10% of the funded posts.
Registered mental health nursing posts have fallen by 12% between 2009 and 2016. Of the remaining 67,800 posts, 11% are vacant.
Despite increases in ambulance staff, there continues to be a national shortage. Paramedics were added to the shortage occupation list for migration in April 2015.
In July 2017, 20% of paediatric trainee and 25% of more senior trainee posts were vacant
In 2016, only 50.4% of junior doctors moved into specialist training after their first two years of foundation training, down from 71.6% in 2011. Most take a career break or work abroad, rather than seeking non-training service posts in the NHS.
“The Royal College of Physicians reported in March 2017 that 84 per cent of their members were experiencing staffing shortages across the team, with rota gaps occurring on a regular or frequent basis. Where gaps in rotas mean there are not sufficient senior medical staff to assure the quality and safety of training, junior doctors may be withdrawn from hospitals, reducing the staffing complement even further.”
GPs are leaving faster than they can be replaced, with a net loss of 1,252 FTEs in March 2017 compared to March 2016.
IFS 2018 Securing the future: funding health and social care to the 2030s:
Healthcare spending needs to increase by an average of 3.3% per year for the next 15 years to maintain the current level of service
This needs to be 5% in the short-term and 4% in the medium term.
Per capita healthcare spending has increased by 0.6% per year between 2009/10 and 2016/17 – in an ageing population. Age-adjusted per capita spending has increased by just 0.1% per year.
The UK has the fewest practising doctors per 1000 people of the EU15 countries.
The number of GPs per 1000 people has been falling since 2010
Spending on primary healthcare has fallen in real terms since 2010
NHS Confederation, NHS statistics, facts and figures. In March 2017 the NHS employed (FTE):
106,430 doctors; 10,934 more than in March 2010
285,893 nurses and health visitors; 3,910 more than in 2010
19,772 ambulance staff; 2197 more than in 2010
In 2012/13, frontline NHS organisations were in surplus overall.
Clinical Commissioning Groups in 2018/19:
35% of CCGs are fairly or very concerned about their ability to meet their financial target at the end of 2018/19, despite additional money from the government;
47% of CCGs expect to delay or cancel planned spending in order to try to stay within their budgets;
CCGs were also planning for longer waiting lists for surgery;
stopping routine funding for treatments with limited clinical effectiveness; and
increasing the use of eligibility criteria – such as smoking status and body mass index – to determine access to care
NHS provider trusts forecast a deficit of £558 million in 2018/19
Some individual trusts expect deficits well over £100 million
44% of trust finance directors are fairly or very concerned about meeting their financial target
Many NHS trusts are dependent upon financial loans from the Department for Health and Social Care
NHS England is hoping to achieve financial balance through
further restrictions on spending
Short-termism, eg through restraints on capital spending, which will lead to higher long-term costs
Selling off assets
Masking individual financial trouble by transferring financial risk between different NHS providers/commissioners
Allowing the “general feeling of dysfunction pervading the NHS’ financial system” to continue
Increases in waiting times for elective healthcare
Nuffield Trust, A&E waiting times, August 2018
In 2012/13, A&E targets were routinely met
An operational target of admitting, transferring or discharging 98% of patients within four hours was introduced in 2004. This target was met in 2005, with performance varying between 96% and 98% for type 1 (major) A&E attendances, whilst the target was consistently met by type 2&3 (minor) attendances.
The operational target was reduced to 95% in 2010. The percentage of patients spending less than four hours in A&E has been falling since 2010. In the first three months of 2018, 76.8% of type 1 A&E attendances (major) were admitted, transferred or discharged within four hours. This is the worst performance since the four-hour target was introduced in 2004.
The 95% target has not been met since summer 2014 (bar a trough of 95.01% in July 2015) and the previous 98% target has not been met since summer 2010.
In November 2018, the record number of emergency admissions in a month was broken with a 6.3% increase in admissions compared to November 2017
The median waiting time for treatment has increased from around 50 minutes in summer 2011 to 60 minutes in summer 2018
The percentage of patients waiting over four hours between the decision to admit and being admitted has increased less than 1% in summer 2010 to over 7.5% in summer 2018. Winter peaks have increased from 3.1% in December 2010 to over 15% in Decembers 2017 and 2018.
Nuffield Trust, 10 crucial trends, December 2017
Of ten measures of NHS performances, seven have got worse (largely since 2014); two have plateaued (MRSA and C.difficile) after initial improvements; and one (diagnostic waiting times), whilst improving, is still above target.
The target for cancer patients is that no more than 15% of cancer patients wait more than 62 days from referral to starting treatment.
Prior to 2014, this target was met (bar a peak in January 2011). Since 2014, this target has been met only once.
By summer 2017, 19% of patients were waiting more than 62 days to start treatment.
The target for elective waiting times is that no more than 8% of patients should wait more than 18 weeks from referral to admission to hospital for elective treatment.
Performance improved in the first half of 2012, from around 9% down to around 6%
From July 2014, performance deteriorated, breaching the 8% target again by the start of 2016.
Performance in summer 2017 was nearly 10%, similar to summer 2009
The target for diagnostic waiting times is that no more than 1% of patients wait more than 6 weeks for any of 15 key diagnostic tests.
Performance in meeting this target has been erratic, with deteriorations between November 2010 (1.07%) and May 2011 (2.73%) and between October 2013 (0.47%) and May 2014 (2.35%).
Performance was improving up until Jul 2017 (end of available data) but, at 1.52%, still above the target 1%.
In 2004, the government introduced a target to reduce MRSA infections by 2008 to half of what they were in 2003/04. This was exceeded, as MRSA fell to 2,935 from 7,770.
MRSA infections continued to fall up to the end of 2011
MRSA infections levelled off after 2011
In 2007, the government set a target to reduce C.difficile infections by 30% by March 2011 compared to 2007/08
difficile dropped from over 1250 per month in winter 2009/10 to just under 400 per month in winter 2013/14.
Since then C.difficile cases have remained relatively level
In 2007, the government set a target to reduce Gram-negative bloodstream infections by half by 2020. E.coli make up 65% of these infections.
coli cases remained relatively level between summer 2011 and summer 2013, at around 2,700 per month.
coli cases have increased since then, reaching around 3,400 in summer 2017.
The 2017/18 NHS mandate gave a target of reducing the number of hospital bed delays from 5.6% to 3.5% by September 2017
Delayed transfers of care were relatively flat between 2009 and mid-2015, at around 115,000 per month.
The number of bed delays started to increase from mid-2014
Bed delays reached 200,000 per month in winter 2016/17
Sutton Trust, Stop Start, 2018
At least 500 sure start centres have closed since 2010, according to official figures
But a lack of clarity over how centres are identified and changes reported mean the true figure could be 1000.
Counting registered centres only, more than 30% – over 1000 – have closed between 2009 and October 2017.
Remaining centres have reduced the hours they are open (four in ten local authorities report that most centres are not open full time)
Centres have reduced the range of services that they offer, with 65% providing fewer than ten services.
Centres have integrated into children’s centres, increasing their age range from pre-school up to 19.
Lack of funding, a change in policy from 2013 (reducing open access services and increasing targeted services), the suspension of Ofsted inspections and the lack of any new national guidance have downgraded the importance given to Sure Start and children’s centres.
“Recent developments indicate a shift in funding and policy focus away from quality early education for child development towards childcare affordability for working families. Investments in affordability are welcome, but neither the tax-free childcare scheme nor the 30 hour entitlement for working families are well-designed to promote social mobility, meaning longer hours in state-funded early education for children who are already relatively advantaged, which may be expected to widen gaps in child development at school starting age. Particularly worrying, these investments are coming at the expense of the quality of provision.”
1/3 of staff in group-based care lack either English or Maths GCSE or both
Although there are targeted places for two-year olds, nearly 1/3 do not take up their place, and most places are not in the highest quality settings.
Cuts to benefits have a significant impact on families and children
“Changes to benefits and tax credits are projected to lead to sharp increases in child poverty in the next five years, undoing much of the progress of the early 2000s. It is difficult to see how even well-designed policies to support parenting and ensure access to high quality early education can have their optimal impact against such a backdrop.”
In 2010 there were 3,043 static libraries in England, and 4,579 library services in the UK (Full-fact, 2012). The BBC gives 4,290 council-run libraries in 2010.
Between April 2011 and April 2012, 57 library buildings and 53 mobile libraries were closed. 46 libraries were taken over by volunteers, social enterprises or parish councils
Funding was cut by £50m in 2014/15 and £25m in 2015/16, from £1bn in 2013/14
From April 2015-2016, 67 libraries shut (The bookseller, 2017)
343 libraries had closed by March 2016, to 3,765 (The BBC). A further 174 were transferred to community groups, and 50 to other external organisations. 59 new libraries started, 20 in buildings and 8 mobile libraries.
105 libraries shut in April 2016-2017 (The bookseller), close to the expected 111 (BBC)
By Dec 2016, 478 libraries had closed in Great Britain (Bookseller, 2016)
In April 2017, there were 3,745 libraries (buildings and mobile) in Great Britain
Paid staff in March 2016 were 24,000, down from 32,000
Unpaid volunteers doubled, from 15,700 to 31,400
Day-to-day pending on six neighbourhood services declined 29% from 2009/10 to 2016/17
38% trading standards
29% road maintenance (13% after including increases in capital spending)
25% food safety
25% health and safety
20% waste collection
LAs have increased charges, with 8.1% of spending on the six services coming from charges in 2016/17 compared to 6.5% in 2009/10
6% trading standards
3% waste collection
Garden waste is charged for in 199 councils in 2017/18, vs 88 in 2010/11
Charges for non-statutory advice on food safety
Demand on services is increasing
England and Wales population has increased 6.6%
Increased traffic volume
Number of food businesses
How much people throw away
Staff levels are decreasing
34% decreasing in library staff; 171% increase in volunteer numbers and 300% increase in volunteer hours
Professionally qualified food standards and food hygiene staff in England fell 60% and 17%; the former fell from 4.4 to 2.9 staff per 1000 food businesses. Food standards staff completed 328 interventions in 2017/18, more than double the number in 2009/10
The number of FTE trading standards officers fell 56% between 2009 and 2016, from 3,500 to 1,500
The number of inspectors with health and safety powers fell 48%, from 1000 to 540 FTE
Level of service is falling
Number of councils providing weekly rubbish collection has fallen from 152 to 87. Dry recycling collections have also declined
Food hygiene interventions continue to be completed on time in just under 90% of cases. Food standards interventions, which are less critical, has fallen from 62% to 37%
The ‘broad share’ of planned health and safety inspections have fallen by 94%, whilst visits following requests or complaints have declined only 33%
Spending on road maintenance has remained broadly flat; however, it is largely short-term ‘surface dressing’ treatments. Large sums are likely to be needed for extensive repair in the future
Councils are running out of money. Unplanned use of reserves increased from £114m in 2010/11 to £658m in 2016/17.
Per-pupil spending rose between 2009/10 and 2015/16. Good data for academies is only available from 2011/12. Between 2011/12 and 2017/18, school funding rose overall by 4%.
This was boosted by an extra £1.3bn over two years in July 2017. Funding has decreased since 2015/16, and decreased per pupil by 4% since 2014/15 due to a ‘small baby boom’ in the mid-2000s.
Sixth-form spending has fallen by 24% or £80 per pupil. This will impact secondary schools that include sixth-forms.
61% of local authority primary and 68% of LA secondary schools overspent in 2016/17, compared to 33% and 30% in 2010/11. The average secondary school deficit rose from £293,000 to £375,000. Overspending by secondary academies increased from 40% in 2012/13 to 60% in 2014/15
Spending for services such as transport and educational psychologists has fallen by 55% in real per-pupil terms, to £534 in 2016/17, potentially pushing these costs onto schools
The number of referrals from schools to children’s social care has risen 34% from 2013/14 to 2016/17
The number of primary teachers has broadly risen in line with pupil numbers, up to 2017/18 where teacher numbers have fallen. The pupil:teacher