Never has there been a greater need for the voluntary sector in Scotland’s struggle to eradicate health inequalities
Health inequities are getting larger and sadly seem likely to grow greater still in the coming years, particularly as we see greater pressures on our public services and challenging demographic changes.
In my own organisation at Carers Scotland, we know that unpaid carers are more likely than non-carers to experience health inequalities. They are more likely to be at risk of diabetes, heart disease, musculoskeletal conditions, and even premature death. 28% of unpaid carers live in poverty compared to 18% of non-carers. These are some of the most vulnerable people in our society, and we are hearing of more and more cuts to services that support carers every week, and the negative impact that is having on their mental and physical health.
Like many we fear that further cuts will fall on services that are supporting those most vulnerable, and the mood music coming out of the UK and Scottish Governments is doing little to abate those fears.
Sadly, the programme for Government announced this week did little to reassure me for the future, with the Government rowing back on many commitments that support vulnerable communities. There is a strong feeling that more cuts are likely to come post budget as well. The First Minister said eradicating child poverty would be his government’s “moral compass” and promised “a system of whole family support”, which is very welcome, but then in the same speech he scaled back their ambition on free school meals for all primary school children. Vision must be followed by action, and sadly this was not it.
Tied to that, we know that planned reductions in health and social care, particularly mental health services, will not only create problems in the short term but will exacerbate problems in the long term, and widen existing health inequalities across the population. There is a positive correlation between poor health and poverty, so again, how can Government expect to deliver on its ambitions by reducing opportunities to tackle health inequalities. The two don’t add up.
With the Government under increasing pressure to make savings to accommodate financial pressures, it must resist any urges to cut those services and organisations working to bring equity in health and wellbeing. It is a false economy.
Austerity and disinvestment in services that support health and wellbeing always disproportionately impact on the most vulnerable in society driving even greater inequality. It will also ultimately cost the state more in the long run, as it has to deal with greater levels of ill health and demand on expensive healthcare services, particularly those in acute settings.
The voluntary sector plays a critical role in delivering many services and support to those most vulnerable and helping to address health inequalities. With Government funding pressures high, cutting support to the third sector should not be seen as an easy option for Government and other statutory funders, as they move forward in this period of financial uncertainty. Instead, Government should double down on its investment in the sector offering fair multi-year funding deals to charities which would empower the sector to do much more than it currently does working in restrictive short-term funding cycles, which limp on from one year to the next.
Such investment would not only improve the outcomes of many of our most vulnerable communities but would likely make efficiencies within the wider health and social care system, as crisis after crisis would be avoided, diversion away from acute services into the community would be more likely, and more people would be supported into employment, education, volunteering and other community roles that are much needed and valued.
The need for organisations that champion improvements in our approaches toward tackling health inequities and public health has never been more important. For twenty years VHS has been at the forefront of bringing together Scotland’s voluntary sector in an effort to ensure that health inequities are considered at the highest levels of Government and that the work of the voluntary sector is amplified to demonstrate its value and contribution. It is a national voice for organisations in Scotland like mine. We need all these voices to be speaking loud and clear now, so that governments can change course before its too late, and perpetual health inequalities are ingrained in future generations of our people, and a critical sector, the voluntary sector, is decimated beyond recovery.
Richard Meade is Director of Devolved Nations, Carers Scotland & Carers NI, and is a VHS Board Member.
