“You can’t give with one hand and take with the other” – child poverty and health inequality

By - Integrated Care Journal
 “You can’t give with one hand and take with the other” – child poverty and health inequality

The government's record on child poverty was laid bare at Conservative Party Conference as PPP launched another seismic report on UK health inequality.

When we hear the word ‘health’, very often there is an instinct to think that what we are talking about is doctors and nurses in health care, rather than the wider public services that are involved in making sure we are a healthy society.

Addressing a National Syndemic, launched by Public Policy Projects (PPP) on 4 October at Conservative Party Conference 2021, builds on the exemplary work of Professor Sir Michael Marmot, who has led the field in studying UK health inequality over multiple decades. While highlighting growing health outcome disparity across the country, the report’s central focus is on how to effective local action and partnerships can be scaled up and how governance and accountability for health inequalities can be strengthened.

Given the ample focus with which the Prime Minister gave to health inequality in his keynote address, and the central focus of his “levelling up” agenda, Tory Party Conference proved to be a more than timely place to launch this report.

Are Britain’s children going hungry?

At its launch event, PPP hosted a panel of public health experts to discuss the specific impact of child food poverty within wider health inequalities.

“Are Britain’s children going hungry? Yes. This is the reality that we face across the UK. ” said Emma Revie (pictured below), CEO of the Trussell Trust, a foodbank charity with over 1300 foodbanks under its provision.

“Are Britain’s children going hungry? Yes. This is the reality that we face across the UK. ”

Emma provided damning statistics to prove her point. In 2019/20, the Trussell Trust provided 1.9 million emergency food bank parcels to people in crisis - 720,000 of those were to children – and this before the pandemic. During 2021, the Trust has so far provided 2.5 million emergency parcels, under one million of those to children.

“That is two parcels a minute, just to children,” Emma said, “we have researched over three years, and found that it is destitution driving food bank use. ”

Figures from the Trussel Trust suggest that extreme poverty was driver of 95 per cent of those using foodbanks, with the average household income (after accommodation costs) of those coming equating to £50 a week. “The immediate drivers are problems built into the benefits system, such as delays in initial payments, caps on eligibility, having more than two children, and not enough housing support. ” 

The links between what is needed to end foodbanks and tackling the social determinants of health are stark: six out of every 10 people coming to foodbanks are disabled. Ill health and disability, adverse life events, homelessness and unemployment are all key drivers of foodbank usage.

“We must start by recognising the long-term solution does not lie with food banks. The need for food is one of several basic needs. Food cannot help you pay your bills. The food first approach is not right: providing food on a mass scale is good in theory but impossible to put into practise and lacks respect. For us it is deeply undignified thing to have to ask for food aid. We must start by ensuring our lifelines like social security provide us with what we need. ”

Emma finished by suggesting that the wider connections that foodbanks facilitate involve partners across the public sector to engineer people towards longer term solutions such as learning how to maximise income, mental health support and helping people into employment. “In conclusion, Addressing a National Syndemic demonstrates that local services are working, but the approach needs to expand and led by government by shifting mindsets about how we think about tackling problems and recognising we all have a part to play. ”

Jack Monroe (pictured below), anti-poverty campaigner and food writer certainly challenged the audience and the status quo. She began: “I first spoke in parliament about the issue of food poverty in 2013 under Ian Duncan Smith and then Frank Field as part of the APPG on food poverty that then became the Feeding Britain report – that was ignored.

“Pushing the blame back on the dispossessed and the downtrodden is far easier than a period of honest self-reflection, of culpability and amend making. ”

“If only the Feeding Britain report had been heeded eight years ago, we would not be in the situation we are in now.

“Nothing has changed since 2013 except for the fact that food bank queues have grown longer. Nothing has changed except our collective apathy and a blindness to the community food bank collection boxes at the end of every checkout in the supermarket. The need for food banks is no longer front-page shock horror as it was then. It is now just a background prop to a soap opera or a daytime television show. ” 

Speaking from her own previous experience as a single mother living in destitution, Jack provided much-needed insight into how policies around social security impact the service user in practice. “It is far easier to believe that I, as a single mother in my twenties, was merely feckless, workshy, grabby, grubby and irresponsible, rather than in the wrong place at the sharp end of the recession, hampered by benefit cuts that prevented me from being able to make anything of myself for a very long time. ” 

Jack referenced how media and government narratives for the past ten years have sought to suggest poverty is somehow the moral failing on the part of the sufferer. “Pushing the blame back on the dispossessed and the downtrodden is far easier than a period of honest self-reflection, of culpability and amend making. ” 

Turning to the inequalities in health outcomes impacted by childhood exposure to poverty, Jack highlighted that children who experience food insecurity are more likely to fall ill and have slower recovery rates from illnesses for the rest of their lives. They are more likely to end up in crime, do less well academically, and have poorer health outcomes.

“Food poverty does not exist in a vacuum. Food is a fundamental human necessity. If someone presents as being in food poverty, you can pretty much guarantee every other element of their life has gone to hell as well.

“I am often held up as the poster girl for how to manage on a tenner. It’s not how to manage on a tenner: it’s how to not get your kid taken into care on a tenner and how to stay awake long enough to get to the job centre to sign on to your benefits on a tenner. It isn’t thriving. ” 

Turning to the social security system in the UK, Jack highlighted how cuts to the system end up costing the Government more in the long run. “I don’t want to wager what I cost the NHS on a daily basis today, but I am sure it is several times over what my missed and delayed benefit payments would have been back in 2011 if they had been administered correctly. ” 

She concluded by turning to the current government. “Rishi Sunak said at the start of the pandemic that no one would be left behind. Every Conservative government since David Cameron has said that they would run a country that works for everyone. It is time they look down at the people they don’t see – if you really want to be a government that works for everyone. ” 

The Rt Hon Chris Skidmore MP (pictured below) was the final contributor the panel debate. He began by admitting past governments have been inactive on issues surrounding health inequality and food poverty. “Let’s hold our hands up as a government, we haven’t delivered on repeated promises in the past but if there is change that might occur, the pandemic should be it. ” 

Turning to the Government’s recently launched Office for Health Improvement and Disparities, which replaces Public Health England, Chris highlighted how the phrasing lacked responsibility. “The term 'disparities' suggest these problems are no one’s fault – but these disparities are political choices and are solved through political solutions. ” 

Chris explained how best practice, which is often seen in locally organised solutions, needs to be scaled up into national level. “What we need to do now with the existing infrastructure within the VCSE sector ‘is not just to reward it with a pat on the back’ but to ensure it is funded and built into the mainstream within the healthcare system. ” 

The discussion turned to the Government’s decision to withdraw permanently the temporary £20 weekly household increase in universal credit throughout the pandemic. Jack responded, asserting “Yes, I welcome the £500 million the Chancellor has put into the welfare fund, but we are removing £6 billion pounds which will affect the same people who are currently going hungry. To give with one hand and take with another – that is not levelling up. ” 

PPP and IHE's report, Addressing a National Syndemic, is available to view here.

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