UK > History > 2010 > Poverty (I)

Poor in UK

dying 10 years earlier than rich,

despite years of government action

Department of Health and NHS
criticised for making too little progress
on tackling key barometer of inequality

Denis Campbell, health correspondent
The Guardian, Friday 2 July 2010
This article appeared
on p1 of the Main section section of the Guardian
on Friday 2 July 2010.
It was published on guardian.co.uk at 00.05 BST
on Friday 2 July 2010.
It was last modified at 00.05 BST
on Friday 2 July 2010.

The life expectancy gap between rich and poor people in England is widening, despite years of government and NHS action, a hard-hitting National Audit Office report reveals today.

Extensive efforts have failed to reduce the wide differential, which can still be 10 years or more depending on socio-economic background, says the public spending watchdog. While life expectancy has risen generally, it is increasing at a slower rate for England's poorest citizens.

In Blackpool, for example, men live for an average of 73.6 years, which is 10.7 fewer than men in Kensington and Chelsea in central London, who reach 84.3 years. Similarly, women in the Lancashire town typically die at 78.8 years – 10.1 years earlier than those in the London borough, who reach an average 89.9.

The gap in life expectancy between government-designated areas of high deprivation and the national average has continued to widen, so Labour's aim of reducing it by 10% will not be met, the NAO concludes. The failure to meet the target has cost an estimated 3,300 lives.

The report criticises the Department of Health and the NHS for making too little progress to tackle this key barometer of inequality. Although the DoH set a target in 2000 to reduce health inequalities and published a strategy in 2003, real NHS action did not begin until 2006, it says.

"The Department of Health has made a concerted effort to tackle a very difficult and long-standing problem," said Amyas Morse, head of the NAO.

"However, it was slow to take action and health inequalities were not a top priority for the NHS until 2006."

The service was also slow to apply three key policies, including giving more poor people drugs to reduce their blood pressure or cholesterol level. "These have yet to be adopted on the scale required to close the inequalities gap," the NAO said.

The report also highlights a continuing lack of GPs in poor areas with high health need, despite shortages having been identified as a problem in 2000. It is also unclear whether an extra £230 a head spent in some areas to improve health outcomes has had any real impact.

Professor Alan Maryon-Davis, president of the UK Faculty of Public Health, said the disparities showed the inequality of English society. "If we see ourselves as a civilised society, these gaps are an indication of unfairness, which shouldn't be there, and is an unfairness which costs lives, damages people's health and will eventually be a huge burden on the NHS if they aren't tackled," he said.

But the NAO report did contain good news about improvements in the health of England's poorest citizens, he added. "The health of the people in the poorest areas is going in the right direction – that's good news. We shouldn't regard that as a failure. But the bulk of the population are improving their health at a faster rate." He urged ministers to resist any temptation to cut spending on health inequalities in the tough financial climate.

Anne Milton, the public health minister, emphasised the government's belief in health equality. "Everyone should have the same opportunities to lead a healthy life no matter where they live. We want the public's health to be at the very heart of all we do, not just in the NHS but across government," she said.

"This report shows that efforts have been made to address health inequalities but that more needs to be done to tackle the deep-rooted social problems that cause ill-health. I want to see the NHS, doctors and local government acting at the right time to improve the health of those who need it most."

The NHS Confederation, which represents most health service organisations, admitted that more progress was needed. Jo Webber, its deputy policy director, said: "The NHS and its partners, especially in local government, have a responsibility to help stop people falling into and continuing in ill-health rather than picking up the pieces when it may be too late. Encouraging improved health requires a focus on all aspects of society, including economic inequality, and quality of life in early years."

Tammy Boyce, of the King's Fund health thinktank, said the NHS could only achieve so much. "Tackling health inequalities is not a task for the NHS alone. It requires a co-ordinated, long-term commitment across government to address the wider causes of ill health such as poverty and poor housing," she said.

"The first test of whether the coalition government is likely to succeed where the previous government failed will come in this autumn's spending review. It is vital that cross-cutting issues like health inequalities are not overlooked in the scramble to deliver spending cuts on a department-by-department basis."

Michelle Mitchell, charity director at Age UK, said the big gap in life expectancy had to be tackled in the light of the government's intention to increase the age at which people can draw the state pension. "With a 13-year disparity in life expectancy between different areas of the country, it's shocking that primary care trusts are still failing to use simple and effective treatments to help tackle the problem.

"This report follows the government's announcement last week to raise the state pension age further and faster, which will hit those with a shorter life expectancy in the poorest areas of Britain hardest," she said. "In this context, tackling health inequalities is more urgent than ever and the government must set ambitious targets to close the yawning life expectancy divide."

Poor in UK dying 10 years earlier than rich, despite years of government action,
G, 2.7.2010,
http://www.guardian.co.uk/society/2010/jul/02/
poor-in-uk-dying-10-years-earlier-than-rich

Forced to choose eating or heating,

family burns furniture to keep warm

Demand for free parcels at food banks soars as big freeze leaves many unable to pay for both food and warmth

Sunday 17 January 2010
19.06 GMT
Guardian.co.uk
Paul Lewis
This article was published on guardian.co.uk at 19.06 GMT on Sunday 17 January 2010.
A version appeared on p6 of the UK news section of the Guardian on Monday 18 January 2010.
It was last modified at 19.07 GMT on Sunday 17 January 2010.

Holly Billen sat perched on the edge of her sofa, holding the bump of her unborn child and nervously biting her lip. "It's nothing to be proud of to say you don't have the money to feed yourself," she said. "But I'm not ashamed to say it."

Aged 26 and eight months pregnant, she has had to endure most prolonged ­cold snap in her lifetime. The soaring ­heating costs mean the choice between going cold or going hungry has become a daily dilemma.

Food is sacrificed for warmth in her terraced cottage in Wilton, Wiltshire, not least because her eight-year-old son, Brandon, has contracted a succession of colds. "I've felt really bad some nights," she said. "He's in bed, and really cold. But there's no money for the extra heat. So its extra blankets and socks and vests under pyjamas."

Recently, she turned to a less conventional remedy for the sub-zero temperatures. Completely out of money for gas, she took apart a shelf unit to use as fuel in her fireplace. "I figured I needed it more for heat than storage," she said. "My boyfriend came into the garden because he heard me out there with a saw."

It may sound like a story set in the Victorian era, but Billen, a dancer, is not alone. She is among thousands of people who have begun relying on food handouts to free up money to spend on heating during what the Met Office is describing as the longest spell of freezing conditions since December 1981. While some areas had milder weather today, forecasters said fresh snow could arrive by Tuesday.

Empty shelves

Four miles from Billen's home, the depot for the largest food bank in the country is feeling the strain. In the cold weather, demand has doubled at the depot, on the outskirts of Salisbury, and the shelves that normally hold fruit juice, sugar and canned meat are nearly empty.

The Trussell Trust, a Christian charity that runs the depot and a network of 56 others across the country, said the cold has led to an unprecedented demand for its parcels, which contain enough donated items to keep a family fed for six days. To qualify for a box of food under the scheme, an individual or family needs to be provided with a voucher by a care professional such as a teacher, social worker or doctor. In December – when the freezing weather in large parts of the UK began to bite – demand more than tripled in some places. Some of the busiest banks have been in Scotland, site of some of the worst weather and lowest temperatures. A food bank in Ebbw Vale, south Wales, provided food to 118 families in December – up from 74 the previous month. During the same period, demand for tinned food and drink from the Suffolk bank jumped from 29 to 197 families.

The charity says initial feedback suggests there has been similar, if not higher, demand for handouts in January, an increase it puts down to the rising costs of heating homes.

There have been a raft of measures introduced in recent years to help people cope with financial cost of cold weather, and over 12.3molder people will benefit from winter fuel payments this year, totalling about £2.7bn. Already the Department of Work and Pensions (DWP) has paid out an additional £260m this winter to families under the cold weather payment scheme, which grants £25 a week to some vulnerable households when – as has happened across the UK – the temperature falls to zero for seven consecutive days.

"As temperatures plummet, I don't want vulnerable people to feel left in the cold," DWP minister Helen Goodman said recently. "The payments are automatic so everyone entitled will get them and should not worry about turning up their heating." But not every vulnerable family is entitled, and even those who receive the payments complain they do not absorb the spike in bills.

Research by Age Concern has shown that, despite government relief, one in five older people skip meals to save money for heating. Tonight the charity urged ministers to do more to ease pressure forcing elderly people into the "cruel choice" between food or warmth.

On Wednesday last week, Northamptonshire county council announced a serious case review into the deaths of Jean and Derek Randall, a couple believed to be in their 70s whose bodies were found in their frozen home. Their cause of death is unclear but neighbours told a local radio station the couple were relying on a single electric heater and the electric hob rings on their cooker for warmth.

"It's completely inappropriate in 21st-century Britain that pensioners should experience such an ordeal and die such tragic deaths," said the couple's Labour MP, Sally Keeble.

Chris Mould, director of the Trussell Trust, said people in poverty were more likely to use expensive electric heaters and pre-payment gas meters. Aside from higher bills, the Arctic climate has brought with it other expected costs, he said. "We're seeing a lot of people who are in a crisis triggered by the cold weather. Broken boilers. Broken cars. Things temporarily break down and cost money, and these incidents can tip people into crisis. It's sort of sadly obvious."

The government's cold winter subsidies do not apply to Billen who, instead of receiving income support, gets £140 in working tax credits plus child benefit. Still, she said her frustration is directed at her energy supplier, Southern Electric.

When she struggled to pay a £500 bill last year, the company encouraged her to sign up to a pre-payment meter that, she was told, would take a slice each time she paid her bill in order to recoup the money she owed. A failure when the machine was installed meant the debt was never paid, however, and Billen now finds that, when she puts £10 in, Southern Electric automatically takes £7 to pay the debt. That leaves £3, which pays for a few hours' heat. "I spent hours on the phone to the call centre," she said. "I said to them, I'm expecting a baby. I'm not working. I can't afford this. They basically said: 'Too bad'."

She was given a food bank voucher after explaining her predicament to her midwife. "I loved the fact I could eat a meal without feeling guilty about not spending the money on heating," she said.

Pre-payment meters

A spokesperson for Scottish and Southern Energy, which owns Southern Electric, encouraged anyone in Billen's position to contact them, and said it would provide an "individual, tailor-made package" to help people keep warm.

Hours after the Guardian told the company it would feature Billen's story, she received a call from the company. "They're coming as soon as they can to take the meter out," she said. "They're lowering the repayment of existing debt to a third of what it was. And I'm going to pay monthly. Really I'll end up paying a hell of a lot less."

But not every family struggling to pay their energy bills can benefit from what Billen thought was a brazen, though welcome, public relations stunt. Many feel ignored; they say the nightly television news bulletins about travel chaos, problems with gritters and school closures belie the more severe plight that cold weather has brought to people in poverty.

Mark Ward, who manages the Salisbury food bank, said he had seen "much younger" clients using it recently. . He recently delivered food to a young couple with a baby in the nearby village of Dinton. All three were eating, sleeping and living the single dowstairs room they could afford to heat.
 

Another beneficiary of the food bank, Donna Buxton, 38, a partially blind mother from Great Bedwyn, had a similar story. "I've been putting £30 a week in my meter and the heating wasn't keeping the place warm, so I brought the mattress into the living room," she said. "Me and my 11-year-old daughter, Libby, slept in there with two quilts and the cat."

A short walk from the Salisbury depot in Bermerton Heath, one of the poorest areas in the market town, there are similar stories behind most front doors.

Lucy and Mark Mitchell, food bank recipients in their 20s, said they had taken to sleeping in the same bed as their two young boys to keep warm.

Inside a cold flat on the edge of the estate, Mick Cutler, 56, an out-of-work van driver, explained how his wife, Julie, and 10-year-old stepson were making do with hot water bottles rather than radiators. They too have turned to the bank for food.

"Really you're begging, aren't you?" he said. "But it's bloody hard to be honest with you. I'm not too bad – I don't feel the cold as much as Julie and Matthew," he said. "He does go to bed with his clothes on sometimes. When he has a bath, he wants to have the heating on, but I have to say 'no'. I feel guilty. How can you tell a 10-year-old you can't keep him warm?"

    Forced to choose eating or heating, family burns furniture to keep warm, G, 17.1.2010, http://www.guardian.co.uk/uk/2010/jan/17/eating-heating-furniture-cold-weather