Welfare reform is a very relevant issue locally given the large number of people claiming out-of-work and/or housing related benefits in Hackney especially, the relatively high cost of housing in London, and the high cost of child care (particularly for lone parents).  The reforms are significantly affecting households with children. The reforms also place an additional financial pressure on households already on low incomes, which can in turn create increased pressure on health services, including through: 8 9 10 11

  • increased demand for GP consultations focusing on patient’s social and economic concerns
  • increased demand for psychiatric services
  • more antidepressant and antipsychotic use and increasing self-medication with drugs and alcohol
  • increases in A&E admissions due to alcohol and drug-related harm.

Welfare reform measures include housing costs and affect the housing options available to local people.  The benefit cap effectively makes all private sector self-contained accommodation in Hackney unaffordable to single people in receipt of benefits. There is already some evidence of upwards pressure on homelessness and the use of temporary accommodation across Hackney, both of which are linked to poorer health outcomes (see the ‘Housing and homelessness’ section of this JSNA chapter).  Previous analysis by Hackney Council suggests that 15% of Hackney residents affected by the benefit cap have specific needs and/or are from vulnerable groups, i.e. with mental health problems or learning disabilities, victims of domestic violence or families living in temporary accommodation.

Changes to benefits for people with disabilities or long-term health problems include a more challenging (re)assessment process.  In the case of Incapacity Benefit reform, there have been local and national reports of delays in processing assessments and appeals, which have placed financial and psychological stress on claimants. 12  Changes being made under PiP (as a result of reassessment and the requirement for periodic reviews of entitlement for all claimants) are also expected to reduce the number of claimants – both of PiP and other ‘passported’ benefits (including automatic entitlement to Shopmobility,13energy efficiency grants, Disabled Facilities Grants and exemption from the overall benefit cap). 14  These reforms have the potential to place increased stress and financial hardship on those already affected by long-term health conditions.

Changes to the AtW scheme are likely to significantly affect Deaf users of British Sign Language (BSL), as around four-fifths of the highest-value AtW awards pay for BSL services.

References

  1. Faculty of Public Health, “The impact of the UK recession and welfare reform on mental health,” [Online]. Available: http://www.fph.org.uk/the_impact_of_the_uk_recession_and_welfare_reform_on_mental_health. [Accessed September 2016]
  2. D. Blane and G. Watt, “GPs a the deep end: GP experience of the impact of austerity on patients and general practices in very deprived areas,” Deep End Steering Group, Glasgow, 2012
  3. K. Burton, M. Higgins and L. Mann, “UK Welfare Reform: final guidance for NHS Boards in Scotland on mitigating actions,” Scottish Public Health Network, 2013
  4. D. G. Gudmundsdottir, “The Impact of Economic Crisis on Happiness,” 2013. [Online]. Available: http://link.springer.com/article/10.1007/s11205-011-9973-8
  5. Commons Work and Pensions Select Committee, “Legacy benefits,” [Online]. Available: http://www.publications.parliament.uk/pa/cm201516/cmselect/cmworpen/372/37207.htm. [Accessed September 2016]
  6. Shopmobility is a service that helps all people who consider themselves to have mobility problems (whether through disability, illness or injury) to continue to get around city and town centres independently, with freedom, confidence and dignity.
  7. London Councils, “Disability benefit reform,” 2015
  8. Faculty of Public Health, “The impact of the UK recession and welfare reform on mental health,” [Online]. Available: http://www.fph.org.uk/the_impact_of_the_uk_recession_and_welfare_reform_on_mental_health. [Accessed September 2016]
  9. D. Blane and G. Watt, “GPs a the deep end: GP experience of the impact of austerity on patients and general practices in very deprived areas,” Deep End Steering Group, Glasgow, 2012
  10. K. Burton, M. Higgins and L. Mann, “UK Welfare Reform: final guidance for NHS Boards in Scotland on mitigating actions,” Scottish Public Health Network, 2013
  11. D. G. Gudmundsdottir, “The Impact of Economic Crisis on Happiness,” 2013. [Online]. Available: http://link.springer.com/article/10.1007/s11205-011-9973-8
  12. Commons Work and Pensions Select Committee, “Legacy benefits,” [Online]. Available: http://www.publications.parliament.uk/pa/cm201516/cmselect/cmworpen/372/37207.htm. [Accessed September 2016]
  13. Shopmobility is a service that helps all people who consider themselves to have mobility problems (whether through disability, illness or injury) to continue to get around city and town centres independently, with freedom, confidence and dignity.
  14. London Councils, “Disability benefit reform,” 2015