UK Policy Briefings
Spring Budget 2022: Health inequalities and gender
Date Posted: Tuesday 8th March 2022
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 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. The 2021 Autumn Budget and Spending Review committed an annual increase of 3.8% between 2019/20 and 2023/24.
In September 2021, a new Health and Care Levy was announced, to tackle the NHS backlog pressures and provide additional funding for social care. The conflation of short-term healthcare pressures and long-term social care funding is unhelpful, and it is unclear whether it will be successful given long-standing staff shortages. The Autumn Budget in 2021 announced an increase of NHS core funding to £162.6 billion, a real-terms growth of 3.8%. This is very welcome, but is still below the 4% that the Kings Fund estimated is needed to improve services.
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.
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 they make more use of GP services, meaning they are more affected by the decline in the availability of GPs.
BAME communities generally experience poorer health than the overall population, and health inequalities exist between different minority ethnic groups.
Intersecting inequalities affect people’s health. Less well-off socioeconomic groups have a higher incidence of poor mental health; 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; BAME communities generally experience poorer health than the overall population, and health inequalities exist between different minority ethnic groups. Women from Black ethnic backgrounds are five times more likely, and women from Asian ethnic backgrounds are two times more likely than White women to die during pregnancy or within 42 days after pregnancy. 28.8% of disabled adults in England report having bad or very bad health, compared with 0.9% for non-disabled populations.
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.