The Health Foundation published a report yesterday that should stop all Lib Dems in our tracks.
Healthy life expectancy in the UK has fallen by over two years over the past decade. The average person can now expect to live in good health only until they are just under 61. We are ranked 20th out of 21 comparable wealthy nations. Only the United States is worse. In more than nine out of ten areas of the country, people cannot expect to be healthy enough to work until the state pension age of 66 or 67. In one in ten areas, healthy life expectancy is below 55.
Read that again. Below 55.
If that statistic does not match your own experience and your observations of your surrounding community, then you are probably living in one of the lucky areas. You are the exception, not the rule.
And between the wealthiest and most deprived areas of the country, there is a gap of around twenty years of healthy life. Twenty years. In Blackpool, men can expect good health until just under 51. In Hartlepool, women until just over 51. In Kingston, where I am a councillor, healthy life expectancy is 69.4 years — just below our neighbours in Richmond at 70.2. We are not typical. We are the lucky end of a broken distribution.
This is the ground on which the populist right is growing. When people in Blackpool or Hartlepool or a hundred other places watch politicians of every stripe promise renewal, promise levelling up, promise a fair deal, and then watch their bodies give out before they reach retirement, their fury is not irrational. It is the entirely logical response to a system that has failed them comprehensively and repeatedly, and that continues to ask more of them while delivering less.
Reform and its equivalents across Europe are not the disease. They are the symptom. The Conservatives did not simply underfund the NHS. They systematically hollowed it out in the name of efficiency. Financial pressure forced trust after trust to cut everything except the most urgent, reactive care.
The logic was brutal and stupid in equal measure: stop spending money on keeping people well, then wonder why so many people become unwell. We are now living in the body of that decision. The two-year fall in healthy life expectancy is the result of choices made by people in government who knew what they were doing and did it anyway.
And Labour has not covered itself in glory either. The Health Foundation’s own report notes that successive governments, including Labour and its “much vaunted but largely abandoned health mission”, have understood the scale of the problem and failed to act. That is a damning verdict, delivered not by a political opponent but by the country’s leading health think tank, published less than a year into the new government’s term.
Which brings me to our own manifesto.
In June last year, the Liberal Democrats launched our plan to save the NHS. At its heart was a commitment to help people spend five more years of their life in good health. Those were our words. Five more years. Ed Davey said, and he was right, that “health and wealth are two sides of the same coin”. We pledged a billion pounds to restore council public health budgets. We promised GP access within seven days, mental health hubs in every community, and an invest-to-save approach that would shift the whole system toward prevention.
It was the right diagnosis. But the framing was too narrow.
We talked about fixing the NHS. We should have been talking about the social contract. Because the NHS cannot make people healthy if the conditions in which they live are making them sick. Poverty makes people sick. Insecure work makes people sick. Bad housing makes people sick. Processed food, designed by corporations to be addictive and priced lower than a bag of vegetables, makes people sick. These are not lifestyle failures. They are structural ones. And a party that believes in genuine freedom, not just the theoretical kind, has to say so plainly.
The manifesto promised five more healthy years. In the decade before we wrote those words, the country lost two. The gap between our promise and reality is not seven years in the abstract. It is seven years of people’s lives. Seven years of grandparents who cannot play with grandchildren. Seven years of workers forced out of jobs they wanted to keep. Seven years of young people, already in the grip of a mental health crisis, entering a labour market that expects everything and insures against nothing.
The Health Foundation calls this a watershed moment. It should be. But a watershed moment
demands a watershed response, and that means our party going further and faster than we did last year.
It means making the economic case forcefully: a sick population is an unproductive one, and we are paying an enormous price for the short-termism that gutted public health budgets, hollowed out social care, and left housing policy to the market. It means naming the concentrated interests that profit from an extraction economy, selling people poor food, poor housing, and poor prospects, while the rest of us pick up the bill in NHS costs and benefits spending. It means talking not just about waiting times but about the twenty-year healthy life gap between the richest and poorest communities, and treating that gap as the scandal it is.
We were right last year. But being right is not enough.
The people of Blackpool and Hartlepool are not looking for a party that has the correct policy position. They are looking for a party that is as angry as they are, and that has a credible plan to do something about it.
We should be that party. The data is there. The argument is there. The question is whether we have the nerve to make it.
* Tom Reeve is a Liberal Democrat councillor in Kingston upon Thames
Follow @libdemvoice.org on Bluesky
Like us on Facebook
Subscribe to our feed
Sign-up for our daily email digest
The mysterious mole men of New York caught on video
Doing better? The goal must be Sufficeincy
Michael Meadowcroft (1942-2026) - A Liberal to His Core
Labour deputy claims that Farage is a threat to democracy
Jason Connor
Mick Taylor
Chloe
theakes
Kira Collins
13 Comments
Ultra-processed food, the philophy that healthcare should cure rather than prevent and underfunding of the NHS plus affordable healthy food and gyms have all contributed to this.
The author makes some good points but also some poor ones. Its not just about funding . far from “The Conservatives did not simply underfund the NHS. They systematically hollowed it out in the name of efficiency.” the Tories had huge, real increase in NHS spending. From the end of the Colaition when spending was £152bn it rose to £195bn by 2024 – all in real terms. At the same time NHS productivity has dropped. We can’t fix these real problems with many people living unhealthy lives without recognising its not just about more money. https://www.kingsfund.org.uk/insight-and-analysis/data-and-charts/nhs-budget-nutshell
@Simon That is far from the crux of my argument, but I accept the Conservatives increased funding by 3% a year in real terms from 2015 to 2024. However, if you factor in the Coalition years (1% per year), the figure drops – to around 2.3% a year for 14 years. Meanwhile, financial pressures increased because of a growing, ageing population with more complex needs, alongside increased drug prices and staff wage inflation.
But my main point is that there is an unhealthy gap between the life chances of people in the wealthiest deciles and the poorest deciles.
Two doctors interviewed on Radio 4 at lunchtime ascribed some of this to mental health issues caused by financial insecurity and poor housing. The country cannot afford, either economically or politically, to excuse poor health outcomes. There’s too much at stake.
Further to my previous comment, this requires a political response, preferably one laced with a healthy dose of outrage.
My perception of our health service is that at GP level there tends to be insufficient focus on preventative measures as opposed to dishing out prescriptions.
If we are to enjoy a more healthy society, then the health service, aided by government, needs to be focusing on encouraging almost everyone to follow a much more healthy lifestyle. More money is not necessarily going to be the answer.
Currently, urging (some) people to adopt a more healthy lifestyle is simply not hitting the target. We need a dramatic change in how this advice is promoted and perceived if we are to get so many more people to take actions that can help protect themselves from medical problems.
This is a very challenging exercise – but if it were to gain traction it would not only help people but also reduce the medical costs inherent in not taking this approach.
If Government increases NHS funding by 3% a year in real terms, while waiting lists grow and health outcomes deteriorate, should Government be praised, or pilloried?
The answer really has to be “pilloried”, doesn’t it?
@Simon @David – You both make fair points about NHS spending and productivity and you’re not wrong that money alone isn’t the answer. But I’d gently suggest you are engaging with a side issue rather than the central argument.
The piece isn’t primarily about NHS funding levels. It’s about healthy life expectancy falling by two years over a decade, in one of the richest countries in the world, leaving most of the population unable to expect good health until retirement age. That is the fact that should provoke a vigorous response from our party.
And here’s what I find striking about Simon’s point: if NHS spending rose substantially in real terms over this period and HLE still fell, that doesn’t weaken the argument – it sharpens it. The system isn’t just underfunded. It is structurally broken in ways that more money alone cannot fix. Which is exactly what I am arguing.
The reason healthy life expectancy is falling is not primarily an NHS problem at all. It is a poverty problem, a housing problem, an insecure work problem, a processed food problem. The NHS is downstream of those conditions. You can pour money into reactive care and still watch healthy life expectancy fall because you are treating the symptoms while the causes go unaddressed.
That is the extraction economy argument. And the political consequence (Reform voters, the populist right, people who feel the system has taken from them and given nothing back) follows directly from it. That’s the argument I’d welcome a response to.
Might a root cause of this cruel and prarasitic abuse of so many of our citizens, and their children, be an inevitable consequence of the three main line political parties’ adherence to the basic policy of Austerity/Neoliberalism?
According to AI Overview, as presented below, its consequences include:
Stagnant wages for workers which increases poverty for the lower paid
Slower growth and greater inequality, which is now demonstrated to incude heath and length of life
Underfunding of essential services generally
Deterioration of health care where its commercialisation has resulted in reduced hospital beds, poor health outcomes and limited access to care for low income populations
Greater rent extraction
Casualisation of labour resulting in poorer pay and conditions which contribute to poor health and worse living conditions
P. S. Approximately 3.8 to 4 million of of our children, aka. future citizens and workers, experience under-feeding aka. chronic hunger/semi-starvation
https://www.google.com/search?q=disadvantages+of+neoliberalism&oq=disadvantages+of+neoliberalism&gs_lcrp=EgZjaHJvbWUyCQgAEEUYORiABDIICAEQABgWGB4yCAgCEAAYFhgeMggIAxAAGBYYHjIICAQQABgWGB4yDQgFEAAYhgMYgAQYigUyDQgGEAAYhgMYgAQYigUyDQgHEAAYhgMYgAQYigUyCggIEAAYogQYiQXSAQoyMTI3NGowajE1qAIIsAIB8QVNy7GhDBHNrA&sourceid=chrome&ie=UTF-8
Austerity made it worse but inequality was growing even before the 2008 crash. One of the root causes of that financial crash was the repackaging of poor people’s debts (ie, sub prime mortgages) into financial instruments so complex and non transparent that few people understood what they were investing in.
But inequality grew for decades before this because world governments chose to prioritise economic growth over other social goods. Some people would defend this decision but they should at least acknowledge the harm it’s done to social cohesion and democracy.
Well said Tom, and good response to the usual suspects saying ‘its not about funding’. Of course it isn’t only about funding, but a narrow view of funding is one of the reasons we are in this mess, as Tom said. Decisions to cut short term leading to long term increases in funding pressures, failure to fund preventative measures, the scandalous cuts to public health budgets for the past 15 years. It is system wide failure to invest in the services and public goods that keep us healthy, alongside a neoliberal outlook that allows the food industry to get away with practises that are killing us just as much as the tobacco industry ever did, just more insidiously.
I was talking to a woman from Luxembourg yesterday. We were talking first about their free public transport. How is it funded I asked? By the savings to society overall. So we got onto their general approach to public health. One particular policy she mentioned was support for new mothers. To encourage prenatal and post natal checks there are three 1000 Euro payments available provided all checks and clinics are attended. The savings in health costs to the system far outweigh the ‘handout’ as some would frame it, and it means those most likely to skip the clinics due to overstressed lives at the bottom of the heap are the ones most motivated by the payment. Win win.
The first Trussell food bank was set up in 2,000.
In 2008 there were 22.
In 2010, the start of Austerity-Neoliberalism, there were 35.
In 2019, after 9 years of Austerity-Neoliberalism, there were more than 1,300.
https://www.google.com/search?q=were+there+food+banks+before+the+introduction+of+Austerity-Neoliberalism%3F&oq=were+there+food+banks+before+the+introduction+of+Austerity-Neoliberalism%3F&gs_lcrp=EgZjaHJvb
https://www.theguardian.com/politics/ng-interactive/2024/jun/11/how-britain-became-a-food-bank-nation
These statistics bear wider coverage. 55 years as healthy life expectancy is terrible. Though most of the loss is probably not due to the NHS, it has some responsibililty. We urgently need a more educated population in regards for healthy living. A healthy diet is where I would focus. Also, let’s be grateful that we have reliable statistics in this area.