Autumn Budget 2021: Health inequalities and Covid-19

“The pandemic hit after a decade that saw the longest spending squeeze in the history of the NHS. This briefing looks at long standing issues of structuring, funding and health inequalities, and how Covid exacerbated these problems.”

View and download the full briefing here

The healthcare sector has been at the forefront of the fight against Covid. The pressures on the NHS have been immense, and issues around funding and staff shortages have come to the fore. The pandemic hit after a decade with the longest spending squeeze in the history of the NHS: growth in spending was 1.6% during 2010-2019 (annual average), down from 3.7% each year since it began in 1948.

“78% of health, social care and social work employees are women.”

The health, social care and social work sectors are large employment sectors within the UK economy, employing around 4.4 million people in 2019. The workforce is predominantly female: 78% (3.45 million) employees in these sectors are women. However, these sectors are hierarchically structured by gender, and staff shortages have exacerbated long standing issues of chronic excessive workloads and burnout.

NHS hospitals, mental health services and community providers have reported a shortage of nearly 84,000 staff, including 38,000 nurses – one in ten nursing posts. It is estimated that we need to recruit 5,000 nurses from overseas every year to prevent worsening staff shortages. Shortages are likely to worsen as a result of Brexit and the end of EU freedom of movement. 71% of EU migrants who are ‘key workers’ would not be eligible for a UK work visa under the new immigration system. This includes essential non-medical NHS staff and social care workers.

“Covid mortality levels were 3.7 times higher for Black African men, and 2.6 times higher for Black African women, than they were among the White ethnic population.”

During the pandemic in England, Covid mortality levels were 3.7 times higher for Black African men, and 2.6 times higher for Black African women, than the White ethnic population. Long waiting times exacerbated by Covid have not been experienced equally: those living in deprived areas are nearly twice as likely to wait over a year for treatment compared with those in the least deprived areas.

“Nearly half of England’s maternity units closed to new mothers at some point in 2017.”

Women face a medical sector which overwhelmingly views the male body as the default in research, trials, medical training and public health campaigns. The disbanding of Public Health England will have particular impacts on women, who are more likely to rely on public health services for health visitors and sexual health support. Although they have a longer life expectancy, women are more likely than men to experience ill-health and require health services, and they make more use of GP services (partly for consultations about their reproductive health), meaning they are more affected by the decline in the availability of GPs. Giving birth is the single largest reason for hospital admissions in England; nearly half of England’s maternity units closed to new mothers at some point in 2017.

The Women’s Budget Group is calling for: a re-evaluation of feminised roles such as nursing and care work, and greater opportunities for training and career progression; tackling workforce shortages; a recognition of the increased discrimination faced by BAME and disabled staff; the prioritisation of the needs of a diverse range of groups.

View and download the full briefing here