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  • The NHS and the elderly middle class
  • Danny Dorling (bio)

On 23 June 2016, on the same day the EU referendum was held, the UK’s Office for National Statistics released its latest annual mortality figures. An unprecedented rise in mortality was reported. Some 52,400 more deaths were recorded in the year to June 2015 than in the same period a year before. In normal times we expect mortality to fall and health to improve, but death rates in England and Wales rose overall by 9 per cent during this period. Within this there was a 3 per cent increase for those aged 55-74; 5 per cent for those aged 75-70; 7 per cent for those aged 80-84; [End Page 50] 10 per cent for those aged 85-89; and 12 per cent for those aged 90+.

The decline in the health of the elderly across the UK was mainly attributed (by the authorities) to increases in dementia and Alzheimer’s, with influenza being suggested as a contributory factor. However it became clear when the size of the mortality rise was revealed that austerity had played a major role in the rapid worsening of overall UK public health. It was those with long-term care needs whose rates of mortality had increased most. (A decline in overall health has also been shown in a number of other recent statistics, such as self reported health.)

In the light of the interest shown during the referendum debate on NHS health spending, perhaps we ought to consider whether Leave won, not mainly due to the fear of others, but because many people, and especially the old, had had enough of their lives becoming rapidly worse as measured through the most important of all the measures of quality of life - health. On 14 November 2016 the BBC announced the news that dementia had become the leading cause of death in the UK, but they did not explain that part of the reason for this was the bringing forward of deaths of people with dementia, or that care has become more inadequate as a result of funding cuts.

The outcome of the EU referendum has been unfairly blamed on the working class in the North of England. In fact, because of differential turnout and the size of the denominator population, most people who voted Leave lived in the South of England. Furthermore, according to Michael Ashcroft’s final poll, of all those who voted for Leave, 59 per cent were middle class (A, B or C1), and 41 per cent were working-class (C2, D or E). The proportion of Leave voters who were of the lowest two social classes (D and E) was just 24 per cent. This is partly because the middle class is so large, and they turn out more to vote: the middle class constituted two thirds of all those who voted. As is usual, people in poor areas were most likely not to vote at all. Turnout among the young was also low, as is also usual, but there are very wide variations in the estimates of turnout by age from various polls. We have a much better idea about turnout by area as turnout figures are reported by the returning officers.

The vote for leave in the North was not especially high. It was highest in the East of England (see table below). There was remarkably confused reporting about this after the vote because of Southern prejudices about northern towns and because Sunderland reports its votes first. There are many false assumptions that still need to be corrected. For example Wales voted almost identically to the average vote for the UK as a whole. [End Page 51]

These figures are based on an exit poll of 12,370 voters published on 24 June by Lord Ashcroft, which turned out to be remarkably accurate after the event. When weighted by social class and region it predicted the final result to within 0.1 per cent of the actual result. The British people, it would appear, can accurately tell pollsters what they have done immediately after they have done it, but not before. The key geographical results...


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