Long Term Conditions, Poverty, Welfare Rights and Health

Just before the summer I participated in a round table discussion on the relationship between health, wellbeing and welfare rights services. This discussion was supported by the excellent Baring Foundation and involved a range of welfare rights organisations including the Advice Services Alliance, Youth Access, the Low Commission and others.

There is a growing body of experience and evidence across a wide range of advice services of the relationship between access to advice and health and wellbeing.

I have written before about the experience of Sheffield Mental Health CAB (now part of Sheffield Citizens Advice and Law Centre) in this regard. What is clearer to me is that there is a strong relationship between increased vulnerability due to poor health and need for advice – I think the relationship is a bit like this:

The experience of MacMillan Cancer Care confirms this, in their report “Cancers Hidden Price Tag” they tell us that following a cancer diagnosis four in five people (83%) are affected and, on average are £570 a month worse off because of a cancer diagnosis with one in three people experiencing a loss in income averaging £860 a month.

Unfortunately it is still the case that many NHS commissioners are still unconvinced – they usually ask this question:

“Can you demonstrate that there is a causal link between receiving welfare rights advice and being well?”

They should actually be asking another question of course:

“What can we do to stop people with a progressive long term condition falling into poverty?”

For an eloquent and clear statement about the urgent need for reform of social welfare support see this 5 minute interview with Simon Duffy from the Centre for Welfare Reform.

What is to be done?

Despite these challenges and the continued attacks from central government on local authority funding there are some some opportunities that we need to respond to.

The Department of Health draft Care Act guidance recognises the importance of access to welfare rights and advice.

“Information and advice is fundamental to enabling people, carers and families to take control of, and make well informed choices about, their care and support and how they fund it”

The guidance notes that local authorities must ensure that information and advice services established cover more than just basic information about care and support.

The service should also address:

• prevention of care and support needs
• finances
• health
• housing
• employment
• what to do in the event of abuse and neglect

This draft guidance combined with the focus on integration through the Better Care Fund has the potential to transform the position of welfare rights and advocacy provision in the health and social care sector.

It could help ensure that welfare rights services in particular are targetted on the most vulnerable, that their contribution to wellbeing is recognised and that the NHS understands the importance of jointly commissioning services with local government.

What do you think?