Transcript Slide 1

Welfare Reform and Health
Marlene McMillan
Lead Public Health Practitioner
Presented by Hazel Henderson, Consultant in
Public Health
Welfare Reform and Health
• UK Government‘s aims to make work pay, simplify the benefits
system and make savings of £18bn from the welfare budget.
• EU research shows that social spending
is linked with better health and smaller
inequalities
• There is a clear relationship between the extent of deprivation and
the scale of the financial loss. The most deprived wards are hit the
hardest.
Scottish Government Welfare Reform Committee, 5th Report, 2014
Income, Welfare and Health
• “Tax and benefit changes are regressive rather than
progressive across most of the income distribution” (IFS)
• families in bottom 40% incomes drop by over 5% by
2012/13, with drop of 7% for poorest (IFS)
• Britain's top 1000 saw collective wealth increase by
£73billion in year to 2009/10
• Poorest households, especially families, will have less
resources to pay for energy and food costs
Welfare Reform and Health
• The worst affected places in Ayrshire and Arran:
– Doon Valley & Kilmarnock South wards (£640 per adult of working age
per year)
– Irvine West & Saltcoats and Stevenston (£650)
– Ayr North (£630) & Girvan and South Carrick (£610)
Sheffield Hallam estimates based on official data 2014
• The reforms to incapacity benefits are resulting in the biggest
financial loses, particularly in more disadvantaged
communities.
• In the absence of a big shift into employment, a key effect of
the welfare reforms will be to widen the gaps in income
between communities.
Scottish Government Welfare Reform Committee, 5th Report, 2014
Income, Welfare and Health
In 2012 Scotland’s 100 richest men and women increased their
fortunes to £21 billion, up from a combined wealth of £18 billion
in 2011
What is poverty?
• Core definition in UK/Scotland is 60% median contemporary
incomes adjusted for household size.
What is poverty?
Poverty is caused by interaction of political, social, economic,
cultural and environmental factors. Risks and barriers vary
over life cycle.
It is
“anything which leads to people not having enough money. It
is not lone parenthood or unemployment... it is the fact that
they do not have enough money in those situations...
People talk about policies against poverty as if it were a
matter of altering the characteristics of the people who are
poor... (instead of ) altering the characteristics of the social,
economic or geographical environment in which they
experience that poverty
(Professor John Veit-Wilson)
Public Attitudes in 2014
Complex/contradictory attitudes:
• Less concern than in the past about inequality and hardening
approach to those on benefits, 51% wanted more equal society in
1994 – now 38%
• Poverty – individualised – ‘failure’ to grasp existing opportunities
• Strong negative stereotypes prevail/ absence of positive
stereotypes
• Government/ media: reinforce and fuel negative perceptions
• Society more likely to blame those at the bottom for their
situation
Myths and media portrayals
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Myth: We’ve seen an increasing number of people claiming out-of-work benefits
Reality: Out-of-work benefit receipt has been in long-term decline and is half a
million lower now than in the aftermath of the last recession.
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Myth: ‘welfare’ spending goes mostly to those on out of work benefits
Reality: Out-of-work benefits account for less than a quarter of welfare spending
and just over half of non-pensioner spending.
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Myth: benefit spending is high because of large families on out of work benefits
Reality: Families with more than five children account for 1% of out-of-work benefit
claims
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Myth: the welfare state is supporting households to stay out of work for
generations
Reality: Only 0.3% of households have two generations that have never worked
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•
Myth: Families are better off on benefits than in work
Reality: the vast majority of families would be better off in employment
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Myth: The welfare state enables people to ‘languish’ on benefits for years on end
Reality: Most out of work benefit claims are not long term in nature
http://www.turn2us.org.uk/pdf/Mythbustingrevised.pdf
Welfare Reform: Impact on children
Many organisations and leaders within Scotland are expressing
serious concern about children being put at risk of poverty by the
policy.
• Decline in child poverty in Scotland has stalled over the last
three years
•
Poverty amongst working age adults without children
increased over last 10 years
•
Value of out of work benefits has declined significantly in
relation to earnings
•
50% of children in poverty are in working households
•
30% of poverty pay is in the public sector
Why is this a Public
Health issue?
Impact of welfare reforms on health
•
Increased poverty, fuel poverty, food poverty
•
Increases in mental health problems, including depression, suicide and parasuicides
and possibly lower levels of wellbeing, delayed recovery
•
Longer-term increase in mortality due to heart disease – commencing 2–3 years
after increased unemployment, with effects persisting for 10-15 years
•
Increased homelessness
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Benefit payment delays for terminally ill people (policy implementation problems)1
More domestic violence (perhaps due to increased strain on families and
relationships) and possibly more homicides
•
Worse infectious disease rates, such as TB and HIV
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Fewer road traffic deaths (perhaps due to lower incomes leading to less car use)
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Increase in unsuitable or dangerous working conditions
•
Increase in child poverty
Institute of Health Equity, UCL, 2012
Poverty and food
Food banks are a service of last resort for people living in poverty. As the
authors of a report commissioned by the Department for Environment, Food
and Rural Affairs (DEFRA) on food poverty stated:
‘There is no evidence to support the claim that increased food aid
provision is driving demand. All available evidence, both in the UK and
internationally, points in the opposite direction. Put simply, there is more
need and informal food aid providers are trying to help.’
People on low incomes have traded down and down again to the cheapest
food products.
Food bank usage
Poverty and food
Mitigating Actions
NHS Ayrshire and Arran has a pivotal role to play as a partner and a service provider in
mitigating actions and has done so for many years.
• long term public health commitment to work in partnership to improve health and
tackle inequalities in health
• taking a neighbourhood approach to public health - focusing on asset based
approaches alongside co-production and informed by public health intelligence
• developing of public health intelligence function to support targeted approach to
address inequalities
• identifying, developing, supporting and leading as appropriate, the role of Public
Health in relation to integrated Health and Social Care Partnerships, Community
Planning Partnerships and locality planning
• Deliver effective and efficient services to address communicable disease and
environmental hazards, and to prevent disease through immunisation and screening
programmes.
Mitigating Actions (NHS and partners)
• securing personal/household income (links to money advice and employability services)
• maintaining socioeconomic status, (rehabilitation back to work or to stay in work when off sick)
• keeping people close to the labour market (referrals to employability support, NHS work
placements and volunteering, Modern Apprenticeships)
• reducing household costs (credit unions, food co-ops, food banks)
• reducing barriers to services (service design and location, reducing barriers relating to
protected characteristics)
• NHS Ayrshire and Arran representation and partnership working at the National, Regional and
Local Authority levels
• E-learning module being developed for staff with client groups most vulnerable to the negative
impacts
• Crossover with Work, Health and Wellbeing actions underway in Public Health