BME Individuals are Reaping the Repercussions of Austerity
Last Friday (18 Jan), The Guardian reported that ‘hospitals are overspending by as much as £141m a year due to NHS underfunding, staff shortages and demand for care, according to Whitehall’s spending watchdog.’ The effects of NHS financial mismanagement in the wake of close to a decade of austerity and cuts are faced primarily by people in more deprived areas - which are disproportionately inhabited by people of Black and minority ethnic (BME) backgrounds, and most acutely BME women.
Areas in the UK with a general low-income character have populations with more people suffering from chronic illnesses and generally worse off health. This can be traced to low incomes which had an adverse effect on access to a balanced diet and generally healthy lifestyle. These are the same areas with less public services available, including access to GPs, and are most immediately affected by cuts. The Financial Times published two revealing graphs, produced from research conducted by Nuffield Trust, illustrating how poorer areas have disproportionately less GPs per head and how people in these areas have more difficulty seeing a GP, and - with one leading onto the other.
Despite the higher burden of ill-health in lower socio-economic groups, there is less GPs per head available in deprived areas. Meanwhile, areas of a generally higher income with a more affluent population have greater access to services they are in less need of. According to Nuffield researchers, there was an average of 1,869 patients on GP lists for each doctor in the most affluent clinical commissioning groups, compared with 2,125 in the most deprived. GPs act as the crucial “gatekeeper” to other health services, such as mental health support, so a delay in seeing a doctor can lead to delays in securing other appropriate treatment. Poorer people not being able to secure an appointment with their GP also means they are more likely to seek care at A&E leading to even more setbacks in receiving the correct care.
Figures published by Health Minister, Steve Brine, last year show that the GP workforce has fallen 50% faster in the most deprived areas than in the wealthiest areas, with a general decline in the overall workforce being noted. Residents of some of these deprived areas have noticed greater inaccessibility of health services.
A resident from Newham told me ‘two local walk-in centres have shut over the last five or six years. Now the closest one is in Dagenham which is off-putting for me to go to because of the demands studying has on my time, and inaccessible for my parents who have mobility issues.’
The UK has seen a growth of a diverse range of ethnic communities each boasting unique health profiles, many which derive from cultural traits and practices. These varieties that have intensified over the last few decades present a complex challenge to healthcare practitioners and policymakers concerning achieving equitable access. The Department of Health’s Race Equality Scheme states that ‘the NHS increasingly needs to take into account not only cultural and linguistic diversity but also needs to be able to cater for varying lifestyles and faiths’ (FT).
According to data collected by the Ministry of Housing, these deprived areas are primarily comprised of people of BME backgrounds. The research showed that among the broad ethnic groups, Black people were most likely to live in the most deprived neighbourhoods, followed by Asian people – 19.6% and 17.1% of these groups lived in the most deprived 10% of neighbourhoods. When looking at the categories more specifically, Pakistani and Bangladeshi people were most likely to live in the most deprived neighbourhoods – 30.9% of Pakistani people and 27.9% of Bangladeshi people lived in the most deprived 10% of neighbourhoods. By stark contrast, White people were least likely to live in the most deprived neighbourhoods – 8.7% lived in the most deprived 10% of neighbourhoods. This means that, alongside the difficulties faced in terms of providing culturally and religiously accommodating care, the BME population also faces the worst access to GPs, which provide the segue to accessing other vital services.
Furthermore, a report on ‘Socio-Economic Inequalities in Health Care in England’, found that as a result of greater access to services in more affluent areas, richer and more socially advantaged people tend to present to health care providers at an earlier stage of illness and to consume more preventive care.
Analysis conducted by HSJ (Health Service Journal), of pre-operative results, supported the report above and found that better off “pushy patients” from better off areas are being referred for treatment at an earlier stage of a health problem, while those from deprived regions are not sent until they are sicker. Thus, people in the most deprived areas, which are overwhelmingly BME not only struggle to see a GP but are also made to wait longer for further treatment, putting their health at much greater risk. In the era of austerity and greater stringency around referrals, the BME population, specifically those in the lowest income brackets, are being affected more adversely than their white and wealthier counterparts.
Runnymede Trust, a race equality think tank, looked at the impact of changes to taxes, benefits and public spending on services since 2010, under successive Conservative governments, on BME women. They found that the £20bn of ‘efficiency savings’ the NHS was ordered to make between 2011 and 2015 have disproportionately affected women, who are more likely to need public services, and more likely to be caring for children and other family members who need services. They also concluded that the cuts have also disproportionately affected the most impoverished families, including BME families, who are more likely to be poor. Reportedly, Black and Asian households in the lowest fifth of incomes experience the biggest average drop in living standards of 19.2% and 20.1%, equating to an annual average loss in living standards of £8,407 and £11,678, respectively.
Thus, Government cuts can be seen to have notably detrimental effects on poorer and less socially advantaged areas, with overwhelmingly BME demographic breakdowns. Health issues that arise from poverty, as well as major cuts to public services immeasurably damaging BME populations, which are already insufficiently catered for.