With the situation worsening in the UK, journalist Kaye McIntosh asks whether change is really possible, and explores how we might get there.
The studies and statistics highlighting poverty in the UK reveal a worsening problem. More than one person in five was living in poverty in 2021-22, according to a landmark report (Joseph Rowntree Foundation (JRF, 2024a). To put that into context, it’s been six prime ministers and 20 years since we experienced a sustained fall in poverty.
Meanwhile, the most severe form of poverty – deprivation – is growing. In 2021-22, six million people, 40% of the poor, were in very deep poverty, with an income 59% below the poverty line (JRF, 2024a). Levels of deprivation rose by 54% from 2017-2019 (JRF, 2023a).
Katie Schmuecker, the Joseph Rowntree Foundation’s principal policy officer, says: ‘These are families who can’t afford to cover the absolute basics of being clean, dry, warm and fed. In 2020, one million children experienced destitution. In a country as wealthy as ours that should not be happening.’
IT’S HARD TO HAVE A
HEALTHY LIFESTYLE WHEN
YOU ARE DESPERATELY
POOR. ‘IF YOU CAN’T AFFORD
WIFI HOW DO YOU USE
THE NHS APP TO BOOK AN
APPOINTMENT? IF YOU’RE ON
A ZERO-HOURS CONTRACT,
YOU CAN’T REALLY AFFORD
TO TAKE TIME OFF WORK’
Meanwhile, according to government statistics released in March, the number of people in the UK living in ‘absolute poverty’ – the government’s preferred measure of poverty – jumped to 12 million in 2022-2023, a rise of 600,000 (Department for Work and Pensions, 2024). It was the number of children and working-age adults in poverty that each rose by about 300,000. The rate of absolute poverty stands at 18% – up by 0.78%.
What’s more, a recent survey of health visitors revealed that poverty is now their biggest concern: most respondents (93%) reported an increase in the number of families affected by poverty in the last 12 months (Institute of Health Visiting, 2023). And nine in 10 (89%) reported an increase in the use of food banks.
Poverty can literally determine how long a person lives (see Poverty kills). Put simply, poverty devastates lives. ‘We really need to turn the tide on two decades of political failure’, Katie says.
CAUSE AND IMPACT
| 1 million children are in destitution: their families can’t afford the basics – enough food, to heat their homes, to live in decent housing |
Various groups are hardest hit and face particularly high poverty levels. These include disabled people, children, people from ethnic minorities (around half of people in households headed by a person with a Pakistani or Bangladeshi heritage are in poverty), larger families and lone parents (JRF, 2024a).
| £29BN Cost to the public purse from effects of poverty on healthcare |
Some disabled people face a double whammy of being less likely to be employed while facing higher electricity costs for heating or powering equipment. Many larger families are caught by the benefits cap.
Just how did we reach this point? Crucially, benefits in the UK have dwindled over the last decade, with ‘the real-terms value of payments reaching a 40-year low at the same time inflation hit a 40-year high, pushing people deeper into financial hardship’ (JRF, 2024a). The global financial crisis of 2008 had long-term effects, depressing income growth, for example (incomes haven’t grown as they did in previous decades and are therefore not keeping pace with inflation).
| £91/WEEK: current level of universal credit for a single person, yet £120/week is needed for the basics |
The energy price crisis caused the sharpest increase absolute poverty seen in the UK for 30 years. Government statistics released in March showed that the percentage of individuals in ‘food secure households’ fell among all age groups. The drop was bigger for those in low-income households. All estimates are at their lowest levels since the introduction of the food insecurity measure at the end of 2020 (Department for Work and Pensions, 2024).
AN UNHEALTHY CYCLE
Poverty also strains the public purse. It was estimated in 2016 that the extra public spending due to greater health care need and use amounted to £29 billion – about £34 billion today (JRF, 2016). About £1 in every £5 spent across public services was devoted to dealing with the results of poverty.
In March, a King’s Fund report said: ‘People living in poverty are getting sicker and accessing services later – A&E attendances are nearly twice as high in the most deprived groups, and emergency admissions 68% higher’ (King’s Fund, 2024).
‘IT’S REALLY IMPORTANT
TO BUILD CROSS-PARTY
SUPPORT FOR THE CHANGES
THAT ARE SO NECESSARY
IN OUR SOCIAL SECURITY
SYSTEM. WE NEED THEM
TO BE MADE FOR THE
LONG TERM’
It’s hard to have a healthy lifestyle when you are desperately poor – 8% of households with an annual income below £10,000 have no cooker and 16% lack a freezer, the report reveals.
According to Saoirse Mallorie, a King’s Fund senior analyst, accessing the NHS is also problematic: ‘If you’re struggling to pay your phone bill, how do you ring up at 8am every morning? If you can’t afford wifi how do you use the NHS app to book an appointment? If you’re on a zero-hours contract, you can’t really afford to take time off work to attend an appointment.’
Saoirse adds: ‘There’s still a stigma around poverty. People believe they will be taken less seriously because of their circumstances. That can lead to a lack of trust in any public sector service, including the health system.’
Heather Buckingham, social change adviser at food bank operator the Trussell Trust, says: ‘We frequently hear people are unable to attend hospital appointments because they couldn’t afford the bus fare to get there. If people can’t afford to heat their homes sufficiently, that can exacerbate existing health conditions.’
CHANGE IS POSSIBLE
| CP SUPPORT |
| Community practitioners are playing a key supportive role, notes Heather, from the Trussell Trust: ‘We know that many CPs are referring people to foodbanks in our network and we’re really grateful.’ Being aware of local services, including from charities and voluntary organisations, such as Citizens Advice, is vital: ‘Signposting people to these as early as possible can help in potentially preventing people from needing to access emergency food.’ Annie Hair, a senior nurse in children’s services with NHS Greater Glasgow and Clyde and the CPHVA executive’s representative for Scotland, is concerned: ‘CPs are working extremely hard to deliver a high-quality service, but in a really difficult environment that is getting in their way.’ |
There is hope, however, as Katie explains: ‘The huge reduction in the numbers of pensioners who are experiencing poverty has been driven by policy decisions made by previous governments: to introduce pension credit, to introduce the [state pension] triple lock, to increase security for pensioners in various ways. We also saw big falls in child poverty in the late 1990s and early 2000s.’
More than 100 organisations, including the British Medical Association and Age UK, back the JRF’s campaign for an ‘essentials guarantee’. This would set levels of universal credit that would cover basic needs for food and heating, for example. The basic rate of universal credit for a single person rose to £91 a week in April – still £29 a week short of the guarantee.
| POVERTY KILLS |
| Life expectancy for people living in the most deprived areas of England is on a downward trajectory, according to the Joseph Rowntree Foundation’s 2024(a) poverty report. During 2018-20, women were expected to live for nine fewer months and men four fewer months than had been the case from 2011-13. In Scotland, male life expectancy in the most deprived areas fell by 18 months and female by 17 months from 2013-15 and 2019-21 (JRF, 2024a). In Wales, male life expectancy in the most deprived areas has fallen by four months and by 10 months for females since 2011-13 (JRF, 2024a). In Northern Ireland, male life expectancy has decreased by four months and female life expectancy by six (JRF, 2024a). |
| SCOTLAND – A LITTLE EXTRA |
| Poverty is just as widespread in Scotland as the rest of the UK. But the Scottish Government has introduced some measures to help. While the Scottish Child Payment for low-income families is worth £25 a week for each child, other UK countries have not followed suit. Annie Hair, from the CPHVA executive, says the payment offers ‘some mitigation’ for poorer families. Local authorities can also make additional small payments under Section 22 of the Children (Scotland) Act 1995. ‘It’s a last resort,’ Annie says. ‘We’re supposed to encourage people to look into food banks and other support but there’s an opportunity for us to pay rather than go to social services.’ While families can feel stigmatised and fear that their children will be taken away if they are referred to the local authority, many councils are ‘trying to look at things through a poverty lens rather than a neglect issue’, Annie stresses. |
Heather says: ‘Universal credit isn’t calculated on any assessment of the cost of things like food or energy or basic household items. The Trussell Trust says the guarantee should be set by an independent body and regularly reviewed with a remit that allows the body to respond if there is a crisis between review dates.’
The charity has been speaking to politicians about the campaign, she adds, but acknowledges that ‘there’s a long way to go in terms of progress in this area. We need to see significantly more change.’
Heather adds: ‘It’s really important to build cross-party support for these changes that are so necessary in our social security system. We need them to be made for the long term.’
GOVERNMENT ACTION?
A Department of Work and Pensions spokesperson told Community Practitioner: ‘There are 1.1 million fewer people in poverty than in 2010, and we are continuing to support households with a £108 billion cost of living support package which has prevented 1.3 million people from falling into poverty.
‘We know work is the best route out of poverty which is why we are giving jobseekers the tools they need to get on and get ahead through our £2.5 billion Back to Work Plan, while our network of jobcentres is providing apprenticeships, bootcamps and skills programmes to help even more people into work.’
For Saoirse from the King’s Fund, much more action is required. ‘Tackling the root causes of poverty, as opposed to just the symptoms, will require a cross-government approach. The healthcare system, housing, transport – virtually every department has a role to play.’
Katie says: ‘We need to hear from each of the parties, what is their ambitious plan in order to make a difference in the lives of the worst off in our country.’ Key to this is ‘making sure that we have a system of employment support that genuinely motivates and supports people to find work that is a good fit for them’.
It’s not just the government that needs to act. The NHS must reach out to poorer people, Saoirse says. ‘The answer is going to vary from area to area, but it could include making sure transport and out-of-hours appointments are available. Talking to the local communities and saying, what are your barriers. It might be a big language or cultural issue or transport in rural areas. Find out what they need and build trust.’
‘IF WE DON’T PRIORITISE
POVERTY, IN 10 YEARS THE
NUMBER OF PEOPLE LIVING
WITH MULTIPLE LONG-TERM
CONDITIONS IS GOING
TO HAVE SKYROCKETED,
WHICH LEADS TO GREATER
COSTS FOR THE NHS AND
THE WIDER ECONOMY’
THE PREDICTION
If nothing is done, experts are clear that poverty will only worsen. Saoirse says: ‘We have a growing and an ageing population that is getting less healthy. This will increase pressure on the NHS.’
| 6 The number of different PMs in power since there was last a sustained fall in poverty |
She continues: ‘If we don’t prioritise poverty, in 10 years the number of people living with multiple long-term conditions is going to have skyrocketed, which leads to greater costs for the NHS and the wider economy.’
Katie adds: ‘What it needs is the political commitment to actually make the changes and have a plan.’
Unfortunately, work to tackle poverty isn’t always a high-profile issue for politicians – even though it’s essential, says Saoirse. ‘This won’t be quick, it won’t be glamorous, but it needs doing.’
| RESOURCES |
| > The key report: Joseph Rowntree Foundation UK Poverty 2024 |
| > The essentials guarantee |
| > Trussell Trust, anti-poverty charity and community of food banks |
| > A positive example of organisations other than government taking action – Community Health and Wellbeing Workers – From Brazil to the UK (National Association of Primary Care, 2024) |
WHAT ARE YOUR EXPERIENCES?
Are you seeing more poverty in families? Are you noticing a greater impact of poverty and in what ways? Do you feel well enough equipped to support such families? Get in touch with your views. Email editor Aviva Attias
aviva@communitypractitioner.co.uk
REFERENCES
Department for Work and Pensions. (2024) Households Below Average Income: an analysis of the UK income distribution: FYE 1995 to FYE 2023. See: bit.ly/3TOGpUq (accessed 11 April 2024).
Institute of Health Visiting. (2023) State of Health Visiting, UK survey report. See: bit.ly/3JfWeP9 (accessed 11 April 2024).
JRF. (2024a) UK Poverty 2024. See: https://www.jrf.org.uk/pdf/15211 (accessed 11 April 2024).
JRF. (2024b). Guarantee our Essentials: reforming Universal Credit to ensure we can all afford the essentials in hard times. See: bit.ly/3PXaJem (accessed 11 April 2024).
JRF. (2023a) Charities and organisations unite behind a powerful call on party leaders to guarantee essentials for low-income households amid rising hardship. See: bit.ly/3xzfLaL (accessed 11 April 2024).
JRF. (2023b) Destitution in the UK 2023 Summary): See: jrf.org.uk/deep-poverty-and-destitution/destitution-in-the-uk-2023 (accessed 11 April 2024).
JRF. (2016) Counting the cost of UK poverty. See: jrf.org.uk/counting-the-cost-of-uk-poverty (accessed 11 April 2024).
King’s Fund. (2024) Illustrating the relationship between poverty and NHS services. See: kingsfund.org.uk/insight-and-analysis/long-reads/relationship-poverty-nhs-services (accessed 11 April 2024).
Image | Freepik
