Voting box with health graph

Decision-Making in Poor Health

For a non-partisan blog, it’s tricky to comment on the outcome of the election but we do have a mandate from Quids in! readers to represent the interests of people on low incomes, especially people in social housing. On their behalf, we published a manifesto calling on whoever forms the next Government to do right by them. The document, Dying for Change, takes centre stage for us as a guiding policy paper against which we will assess the performance of any new government.

In April, I blogged that “it’s just possible the election belongs to the Tories, if they can keep hold of it”, (see Remember, Remember, It’s a Privileged Agenda). They managed the discourse impeccably and the opposition failed to level the playing field and better defend the interests of people on low incomes. I acknowledged how the SNP stood apart in exposing some of the injustice meted out by the government – and look where they ended up in the final picture.

What I didn’t envisage was how this vanilla opposition would lose the faith of sensible voters. I’ve mentioned before how the age of the internet has undermined rational debate by providing evidence to support any theory and counter-theory people choose to explore. As a result, we are all left with one option, to depend on what feels right to us. Decision-making draws less on empirical data and more on personal experience. So by polling day, friends and colleagues who I know are actively or passively engaged in the fight against poverty were telling me they would ‘vote with their heart’.

On the afternoon of election day, I was asked to call the result: “The Tories will walk it. Everyone I know is voting with their conscience and it’s fragmenting the opposition.” One friend of mine spent the night lamenting her “stupid decision” in a marginal constituency that ultimately turned yellow to blue. She wishes she’d voted with her heart to oppose what she didn’t want.

Much of what Dying for Change calls for requires a shift in thinking, rather than financial investment. Good job because the Tories have pledged to cut £12 billion from the welfare budget and the electorate has told them ‘go do it’. Frankly, that means they’re coming for Quids in!readers. If they’re consistent, and if it can be done, the government will protect older people and try to minimise the impact on ‘hard working families’, so working age people not in full-time employment will hear the swoosh of the axe above their heads. How can that not lead to further impoverishment, dependency on foodbanks and, as our 2014 Survey revealed, poorer health?

The theme of this month’s Quids In Professional Network newsletter is social prescribing. In Dying for Change, we call on the health sector to link up with existing (and improved) advice for people who are in debt or struggling to make ends meet. If poverty is damaging people’s mental and physical health, then surely it follows that addressing their financial wellbeing will improve it. I suspect a simple investment in training among doctors and signposting resources from health centres will make better use of existing advice services. A measure of their impact is needed, however, because there would probably be huge returns on NHS investment in money advice projects and, as Anita Pati reports in her QIPN feature, there isn’t much evidence around as yet.

INJUSTICE, NOT AUSTERITY
Supposedly to make the books balance, austerity has been targeted at low income households, not working families or people able to withstand a little more shock. That’s not austerity, that’s injustice. We’ve just had the VE Day celebrations. Weren’t we remembering a time when austerity really did mean that we were in it together and suffered collectively?

Over and above the welfare cuts, Universal Credit is the key instrument to effect change among working age people on low incomes. I welcomed the new benefit system’s promise to make everyone better off in work but the whole thing looks increasingly like a (very expensive) dead dog. Its roll-out has been an abject failure, recently standing at just one percent of its intended scale. It systematically impoverishes claimants who wait six weeks with no income to receive four weeks’ benefit, during which time they generally run up debt and rent arrears and have been financially unable to seek work and so face sanctions. It’s based upon false assumptions about jobseekers’ ability to access IT/ internet, understand UC rules or make monthly online returns about earnings. No wonder people get sick…

Those in the know believe implementation of UC is now over-committed and there’s no going back, so it’s likely to be full steam ahead, rolling out more financial uncertainty to millions.

So I hope Citizens Advice, StepChange and the others are all on standby for an onslaught from claimants in hardship and poorer health. And I hope the same emergency service doctors who reported rises in malnutrition-caused conditions among children due to increased poverty are ready to shout louder. And I hope their colleagues in primary care are armed with all they need to direct people to the likes of turn2us and Quids in! magazine.