The weekend economist like myself, was always somehow convinced that growth, despite some ecological misgiving, was essentially good for us. If there is more, even the ones who have little will have a little more.

Not so, we are now told by an increasing number of people working the economic sector, social sciences and, very notably, by Sr. Stan and the Society of St. Vincent de Paul.

Since the early '80s, there has actually been a drop is life expectancy in all the industrial nations. And the one factor that seems most strongly associated with this drop is inequality.

Consequently, the UK was the first country to experience a down-turn in life expectancy when Mrs. Thatcher's policy of 'supply-side' economics began to make the rich richer and the poor poorer.

Apparently, it is an economy's willingness to not share out the rewards of good - or even brilliant - economic performance that makes people die. And this is where medicine - the clinical practice side, not that we should be unconcerned with people suffering - comes in. People don't just die; they are sick first, hopefully see a doctor and then, despite all our efforts, some do die and statistics show that more dying is happening now than before.

So, what about progress? Is not more and more money being spent on healthcare? Aren't the advances staggering? They are. And we seem to be making progress in some areas.

For instance, the American National Cancer Institute reported for the first time recently that both the incidence and the death rates for all types of cancer had decreased.

But, say other, we are not sure of the exact figures. Apparently, autopsy rates in the US have gone down so dramatically that it is hard to say with any degree of certainty what people die of.

But surely, with all our advance (and expensive( diagnostic tools, we have a fair idea even without autopsies?

Again, not so, according to the authors of a report on an autopsy series that found a whopping 41% of cancers we only discovered postmortem.

What's worse, 55% of these undiagnosed cancers were the actual cause of death.

I certainly do not wish to give Charlie McCreevy a further excuse to whittle away at the health budget. But it may be time we listened to people who have been saying for years that a booming economy does not automatically lead to a better life for all. If we want to reverse the trend of a decreasing life-expectancy amid growing national wealth, doctors, along with the rest of society, may need to take another look at the facts:

Does investing in modern diagnostics give the benefit we look for?

Are the newest and most expensive drugs worth the money they cost?

Do we need more autopsies to assess how effective we are?

Are the advances of medicine actually reaching those most in need?

Is medicine not even relevant - do we need a change in social policy, nutrition, education?

I don't know if anyone has ready answers. If not, now may be the time to use the resources towards finding them.