1. Welfare Reform NHSGGC Dec 2012 Jackie Erdman Corporate Inequalities Manager

2. Context Reductions in Scotland of 2.5 billion by 2015 Now plus an extra 1.4 billion (Scotland) Increase in poverty Widening health inequality Negative impact on the local economy (1293 jobs lost in Glasgow, over 2000 across Scotland, Fraser of Allander, 2012) People on low wages make up over 50% of people considered to be living in poverty (JRF)

3. Issues Poverty is not inevitable but based on policy- poverty fell by one fifth among children in 1999-2011, by half for pensioners, little change for working adults, poverty rose for non children households. Welfare Reform Bill 2012- most radical change since Beveridge. Coalition Government didn’t listen to evidence based arguments e.g. Scottish Campaign on Welfare Reform, and very little concessions were made. Impact will hit the poorest- “Poorest 400,000 families worst off under Universal Credit” Guardian Nov 2012, other groups hardest hit are disabled people, women (particularly lone parents), social rented sector tenants, young people, private rented sector an increasing problem, low paid/ low skilled Gender impact- Fawcett Society, Engender and IFS have all showed that women have been hardest hit by the recession and welfare reform. Household payments of Universal Credit will put women and their children experiencing domestic violence at increased risk. Under 35’s- No-one under 35 will have access to single person accommodation, only bedsit or shared accommodation which may have risks for vulnerable people

4. Issues Housing- Huge impacts predicted which will mean reduced incomes, homelessness, permanent poverty in social rented sector. Social landlords need to act as anti- poverty organisations (JRF) Conditionality- increase in sanctions, proposal for sanctions of 3 years for young people, JCP information to lone parents inaccurate (possibly other groups) In work conditionality- possibly low on the list of targets but could impact on women and NHS employees Digital by default- benefits claims, job seeking all to be done on line Changes taking people unawares- benefits lapsing e.g. people with mental health problems Demonisation and stigma- increase in hate crime against disabled people, deserving and un-deserving poor, ‘scroungers’ as portrayed in the media

5. Myths & Misconceptions about Social Security Elizabeth Finn Care, a charity that supports people in need, has recently published a report that provides a guide to some of the most common myths with a response to each based on reality. Many of these common statements that often appear in tabloids about benefit claimants are inaccurate. Myth: There is an increasing number of people claiming out-of-work benefits Reality: Out-of-work benefit receipt has been in long-term decline and is half a million lower now than in the aftermath of the last recession. Myth: Benefit spending is high because of large families on out-of-work benefits Reality: Families with more than five children account for 1% of out-of-work benefit claims http://www.turn2us.org.uk/pdf/Mythbustingrevised.pdf

6. Impact on Health Increased mental health issues, suicide (gendered), also linked to poorer physical health, delayed recovery Increased poverty, fuel poverty, food poverty Increased homelessness Increase in unsuitable or dangerous working conditions Increase in child poverty Young people unable to become independent/ hardship/ homelessness

7. NHS National and Local Activity National Welfare Reform Committee, Scottish Government Salus contracted by ATOS to deliver Personal Independence Payment assessments ScotPHN Report for Directors of Public Health- leading to national group on welfare reform and its impact on health Organisational Planning Guidance mentions the recession and welfare reform Recession Indicators Report Employment and Health Strategic Group Financial Inclusion Group Strategic Group- Welfare Reform Action Plan Healthier Wealthier Children Clinical Services Review Social Policy Paper Corporate Session- Jim McCormick, DWP Job Centre Plus contact- Stuart Mitchell

8. NHS National and Local Activity Local Areas East Ren work on disability Child Poverty Sub Group Glasgow All council’s have strategies CIT (supporting national and local work) Health Reference Group Session April (HEN?) Communication- CIT E-newsletter/ Info on the website Presentations to HR Managers in Acute Research Cochrane review and the effect on lone parents of Welfare to Work Intervention GCPH research on conditionality and sanctions for lone parents Ben Baumberg work on disability- http://benbaumberg.com/http://benbaumberg.com/ Gerry McCartney- Indicators ISD- indicators Graduate working on template for NHS interventions

9. Mitigating Actions The NHS in Scotland has a key role to play as a partner and a service provider in all of these mitigating actions and has done so for many years. securing personal/household income (referrals to money advice and employability services) maintaining socioeconomic status, (rehabilitation back to work or to stay in work when off sick) keeping people close to the labour market (referrals to employability support, NHS work placements & volunteering, Modern Apprenticeships) reducing household costs (credit unions, food co-ops, growing schemes) reducing barriers to services (service design and location, reducing barriers relating to protected characteristics)

10. Future Action Maintain work on employability and financial inclusion Healthier Wealthier Children Inequalities sensitive practice Targeted campaigns e.g. DLA campaign in Glasgow Partnership work