Cost of living crisis increasing health inequalities - Justine Duncan

Health inequalities have been with us for generations and now, exacerbated and accelerated by pandemic and international conflict, continue to be the most intractable and multi-faceted public policy challenge we face.

The rising cost of living and energy price rises are driving people into poverty like never before and the costs of recovery, delays in treatment, increasing demands on unpaid carers and continuing worry about social care support are not creating common purpose but common concern. And this is a crisis that we’ve seen coming for decades.

The impact will be seen across society; third sector organisations reporting increases in vital running costs, charities warning of potential closure, paid carers wilting under increased fuel charges and vital social care support under threat.

Health inequalities affect everyone, but it is people who are disabled, living with long term conditions and unpaid carers who will be at the sharp end of economic and health impacts; more costs, more delays, increased societal constraints, greater reliance on public services, and a more tentative approach to normalising their lives in a “Living with Covid” world.

The rising cost of living and energy price rises are hitting family budgets hard.

Scottish Government projects that, with the increases, one in three households will meet the definition of fuel poverty and with income or state entitlements not increasing as fast as prices are going up, these are alarming figures.

Neither can many disabled people, people living with long term conditions, and unpaid carers who are experiencing significant fuel poverty, mitigate their deteriorating quality of life with no way to safely reduce energy usage.

It’s clear, in addition, that choices over whether to heat homes or run essential medical equipment will exacerbate existing health inequalities.

In the newly launched ALLIANCE podcast Equally Valued – Fuelling Scotland’s health divide, the cost of spiralling energy prices in partnership with healthandcare.scot, we hear through the lens of those affected most.

Leuchie House, the National Respite Centre, a care home providing short breaks for guests with long term conditions, reported that they have had to lay out capital to install a biomass boiler to cushion them from an out-of-control heating bill and, on the staffing side, two valued members of staff have had to resign because of the cost of travelling to work.

Unpaid carer, Carolyn Hunter’s daughter Freya has severe and complex health needs and is cared for by a multidisciplinary team at home. The sophisticated equipment that manages her health is expensive to run. While she can afford her next energy bill, her costs will rise to £850 a month and she now has to consider if her daughter will be better cared for in residential care.

All over Scotland, families in similar circumstances are under the same pressure and are buckling.

ALLIANCE Community Links Workers based in Deep End GP Practices in the most deprived areas of Scotland are already seeing increased community impacts with increased phone calls from people worrying about bills, from local housing associations reporting revenue pressure on tenants and from local churches responding to local emergencies.

However, emergency action isn’t sustainable and strategic policy needs to be developed.

It’s easy to show excellent practice and through the FARE Scotland initiative, Link Workers in Glasgow are distributing food vouchers to families in crisis. They are reporting that it’s easy to find these families across the city but it’s less easy to find answers to difficult questions.

Who else can people turn to? Who do you contact if you can’t pay your bills? People and families are being advised to cut their bills, but the responsibility needs to be on policy makers and services to provide these answers and not on people and families themselves.

We have been talking about prevention as a service imperative for a long time, how it is needed to keep people out of acute services and how we support people to live their lives better at home within supported communities.

Time now to call unequivocally upon the Scottish Government and the UK Government to address cost of living before we end up in a crisis we can’t invest our way out of.

What is the least that is required? No less than a detailed, costed and targeted intervention, an investment programme to assist disabled people, people living with long term conditions and unpaid carers to pay increased fuel bills. Now.

Justine Duncan, Interim Director of Policy and Communications, Health and Social Care Alliance Scotland (the ALLIANCE)