5. Proposed welfare reforms

Matter for discussion submitted by RCN London Board

That this meeting of RCN Congress discusses the potential impact of health and wellbeing resulting from the Government’s proposed welfare reforms

Progress report

Submitted by: Northern Board
Council lead and committee assigned: None
Committee decision: New work
Members involved: None

Final summary update at May 2012

This was a matter for discussion and so no work was mandated to be taken forward.

However, the RCN is continuing to see the effects of the welfare reforms and is monitoring this through casework systems, while also contributing to any consultations and calls for evidence, where possible.

Debate report

Members said they understood the need to reform the welfare system, but felt the current reforms would only further disadvantage people at the bottom end of society.

In a matter for discussion submitted by the London board, proposer Christopher McDonnell said reforms should not cause the health and wellbeing of people to worsen if their benefits are removed.

Mike Smith, from the Outer South West London branch, said any deterioration in the health of people who have had their benefits cut would increase pressure on acute care services. Agenda Committee member Lisa Crooks said while many people become stuck in a ‘benefits trap’, it is important vulnerable patients still receive what they are entitled to.

Former Chair of Congress Jason Warriner, representing the Public Health Forum, talked about how cuts to public sector and voluntary organisations – such as councils and the Citizens Advice Bureau – are also having an impact. He said: “People on benefits are being denied the opportunity to apply for them in the first place because of cuts to services which support them.”

Andy McGovern, from the London board, said: “Welfare reform may well be necessary. It has to be for the right reasons and not ideologically driven, as they are at the moment.”

Background

In June 2010 Chancellor George Osborne announced that £11 billion (subsequently raised to £15 billion) would be cut from the annual welfare budget, which currently amounts to £192 billion.

Cuts to housing benefit, incapacity benefit and welfare could have an impact on the health and wellbeing of some of the most vulnerable members of society. Whilst some individuals do use the benefits system to their advantage, there are many who genuinely depend on it to maintain a minimum standard of life and ensure a minimum standard of health.

Health inequalities and the gap between rich and poor appears to be growing and the changes in housing benefits could lead to families being forced to move from more affluent areas, creating ‘ghettos’ in affordable areas – which in turn could impact on the health economy. Conversely it could be argued that any reduction in the welfare bill could be better invested on health and in particular the public health agenda.

There are complex associations between housing and health inequalities. The stability and security of housing arrangements, the quality of housing, and accessibility to services and amenities all affect physical and mental health wellbeing. Certain regions may see greater impact from the proposed cuts – for example, the proposed housing benefit reform may have a greater impact in London and the south east where housing costs are more expensive.

According to the mental health charity Mind, around half of the people claiming out-of-work benefits for illness or disability have mental health problems, and there are concerns that the work capability assessment, unsophisticated return-to-work programmes and changes to disability benefits may not be a fair deal for this group and may worsen mental health and wellbeing. The proposal to establish the personal independence payment and cut the current rates of disability living benefit by 20 per cent may also remove essential support for those in need.

There have been widespread concerns expressed that the welfare reforms will affect certain groups disproportionately – such as those not working due to disability or mental health concerns. Some commentators also argue that women and children will also be unfairly hit by the proposed freeze in child benefit and child trust funds, and the axing of the health in pregnancy grant.

In Scotland, while policy on benefits is reserved to Westminster, health and social care policy is almost entirely devolved. Tensions have already arisen between Holyrood and Westminster in relation to the implications of UK welfare decisions on Scottish health policy – for example, over Westminster’s decision to withhold attendance allowance and some elements of the disability living allowance from those receiving free personal care in a Scottish care home). The RCN will continue to monitor how UK welfare decisions may influence the implementation of devolved policy in Scotland to improve health and wellbeing. There are similar issues in Wales.

References and further reading

Department of Work and Pensions (2010) 21st century welfare, London: Stationery Office (Cm7913). Available at:
http://www.dwp.gov.uk/consultations/2010/21st-century-welfare/
(accessed 10/2/11) (Web).

Department of Work and Pensions (2010) Universal credit: welfare that works, London: Stationery Office (Cm 7957). Available at:
http://www.dwp.gov.uk/docs/universal-credit-full-document.pdf
(accessed 10/2/11) (Web).

Marmot Review (2010) Fair society, healthy lives: strategic review of health inequalities in England post-2010, [London]: Marmot Review (Chairman: M Marmot). Available at: www.marmotreview.org/ (accessed 10/2/11) (Web).