By Dr Mario Martínez-Jiménez
Access to timely healthcare is a fundamental right, yet for many young people in England, this right has been increasingly compromised. My latest research, recently published in Public Health as part of my PhD with the SPHR, investigates the impact of austerity measures on hospital waiting times, with a particular focus on reproductive healthcare services – including obstetrics and sexual health care.
Using data from Hospital Episode Statistics and the Next Steps study, which tracks individuals born in 1989–90, I analysed how waiting times evolved for millennials as they transitioned from adolescence to young adulthood. The findings raise serious concerns about growing inequalities in healthcare access: while overall waiting times for emergency and outpatient services increased slightly after 2010, young people in the most deprived areas faced disproportionately longer delays for essential reproductive health services.
What changed after 2010?
To understand what happened, we need to go back to 2010, when the UK government introduced austerity measures—spending cuts aimed at reducing the national deficit. These cuts hit the National Health Service (NHS) hard, making it more difficult for hospitals to keep up with demand.
I wanted to see if these policies affected hospital waiting times in emergency and outpatient care for young people. To do this, I used data from Hospital Episode Statistics and the Next Steps study, which tracks people born in 1989–90. By analysing hospital records over time, I could compare waiting times before and after austerity measures were introduced.
The findings: Delays, but not for everyone
Overall, the 2008 financial crisis did not appear to have a significant impact on hospital waiting times. However, following the austerity cuts in 2010, we observed an increase—particularly in reproductive health services.
- Emergency and outpatient waiting times: These increased slightly across the board but not dramatically.
- Reproductive health waiting times: These saw a much bigger jump, especially for young people in economically deprived areas, with an average increase in waiting time of 17.9 % per year after 2010. This equates, very approximately, to a 6 day increase in waiting time per year during the period from 2010 onwards.
- While some people were only waiting a little longer, others – particularly young people needing reproductive healthcare – faced significantly longer delays.
Why does this matter?
As well as increasing worry and anxiety and being inconvenient, delays can result in severe consequences. Prolonged waits for screenings, contraception, or pregnancy-related care may lead to missed diagnoses, increased risks during pregnancy, and poorer health outcomes for both mothers and infants.
Looking ahead: What needs to change?
The NHS continues to experience immense pressure and waiting times have only deteriorated in recent years – particularly with the additional strain of the COVID-19 pandemic. So, what actions can be taken?
- Targeted funding: Healthcare resources should be allocated to the areas that need them most, ensuring that young people in deprived regions don’t face longer waits than their wealthier peers.
- Prioritising reproductive health: Delays in this area can have lifelong consequences. More funding and staffing are needed to ensure that young people, particularly women, aren’t left waiting.
- Re-evaluating austerity policies: If budget cuts disproportionately impact essential health services, policymakers need to consider the long-term costs – both financial and social.
This research contributes to the increasing evidence that austerity policies have exacerbated health inequalities in the UK. Although some may contend that cuts were necessary, the reality is that they have had significant, tangible consequences for the health of young people. Healthcare delays should not be yet another barrier that young individuals in deprived areas must navigate.
Read the full study, a joint work with Professor Bruce Hollingsworth (LiLaC, Lancaster University) and Dr Eugenio Zucchelli (Universidad de Madrid): Austerity and waiting times: Evidence on reproductive health care delays among young millennials in deprived areas. Elsevier Public Health , 2025.
About the author
SPHR PhD alumni Mario is now an Imperial College Research Fellow in the Department of Economics & Public Policy at the Imperial College London Business School, sponsored by Professor Dame Carol Propper. Mario is an applied microeconomist with research interests in the fields of health economics, labour economics and public economics.
Mario’s current research revolves around three main areas: child development, population change, and the formation of human capital. Specifically, Mario’s projects examine (i) socioeconomic disparities in health and access to healthcare, (ii) environmental risks affecting children’s mental health, (iii) the long-term effects of early-life shocks, and (iv) investigating the reasons behind declining fertility rates.
Find out more on Mario’s Imperial profile page
