UK Policy Briefings
Spring Budget 2023: Health inequalities and gender
Date Posted: Thursday 2nd March 2023
After a decade of austerity that saw real-terms funding growth at a record low and in the wake of a global pandemic, the NHS is facing significant pressures that are exacerbating existing health inequalities.
The Autumn Statement in 2022 provided top up budgets for the NHS in England, which will maintain a 3.1% growth in real terms until 2024/25, as planned in the 2021 Spending Review. However, we argue that this will not be enough to deal with the massive backlog in the sector as NHS waiting lists for consultant-led care have reached a record of 7.2 million people in December 2022.
‘Those living in deprived areas are nearly twice as likely to wait over a year for treatment compared to those in the least deprived areas.’
The NHS is facing a massive recruitment and retention crisis, with NHS hospitals, mental health services and community providers reporting a shortage of nearly 133,000 staff, including 47,500 nurses, which represents a five-year high. The pandemic has increased the pressures on existing staff, exacerbating long-standing issues of chronic excessive workloads and burnout. As women comprise three-quarters of the healthcare workforce, they have been at the frontline of the crisis. On top of this, Brexit has contributed to increasing staff shortages, supply issues around medicines and reduced access to health and medical research funding.
Gender is an important driver of health inequality. Often it intersects with other inequalities based on class, ethnicity, disability, gender identity and/or sexual orientation and other characteristics to present a widely uneven landscape of access, treatment and health outcomes.
‘Black women are four times more likely to die in pregnancy and childbirth than white women and Asian women are twice as likely to die in childbirth or pregnancy.’
GP numbers and the number of GP practices have fallen consistently since 2015, which is disproportionately impacting women whose consultation rate is 32% higher than for men. Pregnant women in particular face challenges in accessing adequate health care. As a result of capacity and staffing issues, nearly half of England’s maternity units closed to new mothers at some point in 2017 as evidenced by the Royal College of Midwives. Disabled women have also reported not having their needs met by maternity services.
The Women’s Budget Group calls on the government to prioritise the needs of a diverse range of groups, including those of older, black, Asian and minority ethnic, migrant, disabled, and LGBT people and those living in deprived areas. To achieve gender equality in the healthcare workforce, there must be a re-valuation of feminised roles such as nursing and care work, and greater opportunities for training and career progression. Workforce shortages should be tackled, to alleviate the chronic excessive workload and burnout of the existing staff. The government must also recognize the increased discrimination faced by black, Asian and minority ethnic,and disabled staff.