Will the rising cost of living be paid for by our health? – with Dame Clare Moriarty and Bim Afolami MP Episode 19 of the Health Foundation podcast

22 April 2022

Illustration showing a large wave washing over people standing on piles of coins.

Will the rising cost of living be paid for by our health? 

This year households across the UK are facing the biggest squeeze in living standards since the 1950s. Most of us will feel the impact, but poor households are being hit the hardest. We know that poverty and the stress of debt harms our health in the short and long term.  

One role of the state is to provide a welfare safety net. After last month's Spring Statement, what should the government do now to support those experiencing the worst effects of rising costs? What impact on households and health are we already seeing? And what more can be done to help?   

Our Chief Executive Dr Jennifer Dixon is joined by:

  • Dame Clare Moriarty is chief executive of Citizens Advice. She’s a former senior civil servant and served as permanent secretary at the Department for Environment, Food and Rural Affairs and the Department for Exiting the European Union. She was also chair of our COVID-19 Impact Inquiry

  • Bim Afolami MP has been the Conservative MP for Hitchin and Harpenden since 2017. He's on the advisory board of the Money and Mental Health Policy Institute and is chair of the All-Party Parliamentary Group for Financial Markets and Service. He's also patron of two mental health charities in his constituency. 

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Jennifer Dixon: This year we're facing the biggest squeeze in living standards since the 1950s. Inflation is at its highest for 30 years, and most of us are now paying more tax. All this comes after the financial crash of 2008, the weak recovery, a decade of austerity, Brexit adding to economic woes, and the pandemic with all its costs. And now the impact of conflict in Ukraine. Most of us will feel the squeeze, but poorer households are being hit hardest and having to make harsh choices between say, heating or eating. We know that poverty and the stress of debt injures our health in the short and long term. Will we end up paying for costs of living with our health? And don't forget the impact on equality, the inequality that policy makers say they want to reduce by leveling up. One role of the state is to provide security, a welfare safety net. So after last month's Spring Statement, what should the government do now to catch those experiencing the worst effects of rising costs? What impact on households and health are we already seeing and what else can be done to help? Well with me to discuss for this, I'm really pleased to welcome Dame Clare Moriarty, who since April '21 has been the chief executive of Citizens Advice. She's a former senior civil servant serving as permanent secretary at Defra, DExEU and has had stints elsewhere, notably the Department of Health. And Bim Afolami who has been the conservative MP for Hitchin and Harpenden since 2017. He's also on the advisory board of The Money and Mental Health Policy Institute, a charity founded by Martin Lewis. And he's chair of an all-party parliamentary group on financial markets and service. He's also patron of two mental health charities in his constituency. Welcome both. Can you both give an idea of the background picture of the cost of living?

Clare Moriarty: Thank you. So what we are seeing is a really worrying rise in the cost of living across really all fronts, a big acceleration in cost pressures. What we saw with the big increase in energy prices, which was kind of contained for many people, by the energy price cap, until the new energy price cap came in last week and a huge jump up in people's energy prices. And that in turn goes along with and feeds into a broader set of cost pressures. So we've seen food prices going up. We anticipated, back in the autumn, that potentially one in 10 people would find it difficult to make ends meet. That's only got more difficult in the intervening period. We recently estimated that 5 million people would find themselves unable to meet the increase in energy bills in April. And that could be a much higher figure in October when we're expecting to see energy prices go up again. And meanwhile, inflation is running at, 6, 7% and people are saying it could go even higher. So this is a generational crisis in terms of cost of living. It affects everybody. But what we are seeing is it has a particularly sharp impact on people who are on the lowest incomes, partly because they have so few options in terms of absorbing those increases.

Jennifer Dixon: Yeah. And I was reading that the typical energy household bill went up by 54% in April and that's after a hike again, the previous October.

Clare Moriarty: There will be a lot more to come in October. So, it's gone up 50% from an average of about 1,300 to 2,000. I mean, there's still some uncertainty about how much it will go up by in October, but best estimates at the moment for it will be another £600. So by October it will be double what it was last October.

Jennifer Dixon: Just go on to a little bit more about what kind of impact you are both seeing locally then. Bim with your constituents perhaps, or in some of your charities and Clare, obviously in your role at Citizen's Advice, what are you seeing? What are people telling you that they're facing?

Bim Afolami: All constituencies and areas are different. My constituency is comparatively wealthier than the most, and so I preface what I'm about to say with that, because I know it's not the same everywhere. I think people are definitely, definitely feeling the pinch and people you may not expect to have felt that pinch, often people on middle income are finding things very difficult at the moment. I think that the mental health issues that I'm seeing in my constituency are still a hangover from the COVID period. I'm seeing a lot of that, and I'd be very interested in Clare's experience at Citizen's Advice because, there are many people for whom COVID was a sort of bad dream and they've sort of woken up and they're really back to normal. But a lot of people whose mental health problems were exacerbated or created by that whole situation and are really still in that sort of dark hole.

Clare Moriarty: So one of the things that really worries us at Citizen Advice is that we are already seeing a huge surge and the need for crisis support. And that was happening in the first three months of this year, before the energy price and other increases that cut-in on the 1st of April and before we get anywhere near at the further increases that are going to come in October. So in January, February and March successively, we broke our previous record for the number of people needing crisis support. And by that we mean people who either need a food bank voucher or who need support from some form of charitable donation. So we were in the sort of 25,000 people in each of those months, which is higher than we've ever seen it before. And many of the tools we're used to using assume that people have got some ability to manage their way out of debt by budgeting in a sensible way. We sort of reaching the point where the problems aren't to do with how people manage their money, they are to do with a fundamental imbalance between the amount of money that's coming in and what people need to pay out. So we've seen a 20% increase in demand for debt advice over the last year on year. We're expecting that will go up and debt is increasingly its utility bills rather than credit card bills. A lot of it is government debt. So council tax. I think council tax arrears have now been overtaken by fuel debt. But those are the sorts of problems that people are coming with. And we are seeing that could only get worse. And then alongside the statistical side of things we hear the stories of people who are having to turn off the heating because they can't afford to keep it on people. People who've retreated to one room of their house. People who are diabetic, who need to have insulin who need to keep the insulin in the fridge, but they can't afford to keep the fridge on. And that is before, as I say, these big increases have begun to work through.

Jennifer Dixon: Are there any patterns in the populations of groups of people who are asking for support in terms of where they live in the country, what kind of families, are they people with children, for example, are they on benefits or are they in low paid work?

Clare Moriarty: By definition, it's going to be on people who are on low incomes. Of course people on low incomes, 40% of people on Universal Credit, as I say are in work. So some of these wealthy people who are in work and in many cases also in receipt of Universal Credit but some of them will also be people who are looking for work or unable to work. And certainly we are hearing about families and single people.

Jennifer Dixon: What's your assessment of the Spring Statement and how families have been protected on the rise of cost living?

Clare Moriarty: We were certainly disappointed by the lack of targeted support within the Spring Statement. So across the announcement that the government made at the beginning of February when the new price cap was announced and the Spring Statement, I think there's £22bn that have been injected in terms of support for cost of living, but only £500m of that, which is about 2% has been specifically targeted at people on the lowest incomes. The other measures have either been that are applicable to everyone or to everyone in work. The council tax rebate was for bands A to D but that accounts for 80% of all households. So most of the measures that have been put in place a lot of money behind it have been pretty much universal measures. And what we are seeing is that there is a real need to target support on people on the lowest incomes. And so far, that's only been in the form of an increase in the Household Support Fund, which is a discretionary fund. So overall we feel that there is a really big crisis happening, and the response to it at the moment doesn't feel sufficiently focused on the people who are feeling the sharpest impact on that.

Jennifer Dixon: So Bim, on the Spring Statement, the Chancellor, as all the commentary has said, gets a huge windfall, additional tax receipts from inflation. I mean, inflation brings in extra tax doesn't it? And some of that was given away, but not very much. A modest amount was given away. IAF said, £5bn out of potentially £35bn, not enough to protect the poorer households. And some commentary said the rest was kept for the election war chest. That was Chris Charles from the Financial Times.

Bim Afolami: There's a lot here to analyse. So let me first explain what I think the inflation context is because I think this has actually been under discussed by the commentators. And that's because the sort of inflationary pressures that are global, you find them in the United States, you find them in the Euro-zone, et cetera. That we have not really seen since the 1980s. And there are no policy makers or very few policy makers who are currently in post, who were in any way involved in public policy the last time that this happened. So I think that is the overarching context. And I think that the Chancellor is very, very mindful of the impacts that that will have, in two specific ways. The first is obviously on ordinary people. Whether it be energy bills, which obviously is driving quite a lot of the underlying inflation globally, but also just in the rising prices of food, the rising prices of everything in the shops that everybody can already feel and notice. But the second in impact, and this goes to the heart of the point around, how much a wiggle room the Chancellor has with higher inflation, you get more tax receipts in, in a sort of nominal way, but the amount you have to repay on your debt as a government that you issue rises as well. You've got to measure those two things, and it's very, very difficult to work out exactly how things are going to pan out over the next six, 12, 18 months. That is why the Chancellor was cautious in terms of spending this sort of so-called sort of spare capacity or windfall or whatever term you want to use, because actually you don't really know what's going to happen. Specifically, to answer Clare's point around people on the lowest incomes. Look, I think this is really important to consider because what the Chancellor's tried to do as far as I can see is he's tried to focus the support on making work pay as much as he can. Whether that be in the budget last year, reducing the taper-rate, which is a technical term for meaning that as people earn more money when they're on Universal Credit, they keep more of that money than they previously did. I think that's a good thing, whether it be the minimum wage rise that we're also seeing right now, which means that people on the lowest incomes are getting more money, on minimum wage, which again, helps them take more home. Whether it also be on the rise and thresholds of National Insurance which, again, helps those on the lowest income. So I think that the approach of the Chancellor has been to make sure that people in the lowest paid work, trying to make that pay as best as possible. I think that is his approach at the moment, at the same time as being cautious around the public finances, because of course, none of us know how things are going to go over the next few months.

Jennifer Dixon: But there are also people on benefits where they are particularly squeezed aren't they? Because the working age benefits and indeed pensions, aren't increased in line with inflation as it is now. But in line with inflation last September, which was 3.1%. So, they really will have a real terms cut and as some others have said, that core level of support is as low as it was in the mid-80s now. Now that matters, doesn't it? Because those individuals, we know that debt and poverty massively increase your risks of ill health and reduce your possibility of working because you're ill. So, I'm just wondering, given the fact we do have a labour shortage, Bim, what's the logic there about really cutting off those on benefits as opposed to those and low paid work?

Bim Afolami: Well, it's not so much cutting off those in better benefits. I mean, there's always a debate you can have about what the right level of benefit support is. And that's an art rather than a science in terms of trying to get that right. I think the point that has already been made so far in our discussion around resilience is a very, very important one because I think that what we need to be doing as a party is a government people in politics need to be thinking about how do we increase the resilience of people, to shocks. One of the difficulties with COVID is that because of the government's necessary support, which amounted to over 400 billion pounds, is that people. I think there's an expectation that the government can solve more things than it actually can. Now I know that's always a very popular thing for politicians to say, I'm sure when it comes to elections, politicians always are saying, "I can do everything for you." But actually, when you're faced with these huge global macro-pressures of inflation and the questions are public finances the government can only do so much. And what we need to do is to enable people to withstand these sorts of shocks much more effectively. At every level of the income distribution, by the way. And it's not just the very lowest paid. I think this is really, really important of those on benefits. One of the reasons why the support had to go to over 70, 80% of households is because that a lot of people on what we might think of as middle incomes are also being incredibly tightly squeezed. And so how do we increase resilience? We need more savings; we need to have worked towards lower taxes on working people. We need to improve home ownership rates and reduce the cost of housing so that people just have a bit more discretionary incomes so they can save a bit more. I think the policies in that regard are actually very, very important to dealing with this overall problem because shocks will happen in life, in economies and societies. Governments can't do everything.

Jennifer Dixon: I'll bring in Clare in a second, but I noticed the Resolution Foundation you've done a lot of the analysis you mentioned, just on them. They say that absolute poverty is set to rise, especially in households with two or more kids. And they reckon that 1.3 million people will be now added to the numbers in absolute poverty as a result of the Spring Statement. So I'm just interested in a sense, we know what that does to health, we know what that does to children, and that stocks up problems for the future. So it's true that the Spring Statement was mildly progressive, according to Paul Johnson from the IFS but nevertheless, there was still quite a lot of people who lost out and these are the poorest in society who we will depend upon for labour in future. It almost seems as if they're paying the price effectively of these economic shocks more than the rest of the population.

Clare Moriarty: There's a few things in here. And I mean, this whole debate both about support to people on not just on the lowest incomes, because the cost of living crisis Bim says is something that affects everyone, and also the focus on as Bim was saying, making work pay, we've had the government talk a lot about wanting people to be in high-paid, high-skilled jobs. And I don't think anyone would disagree with that, but you can't wave a magic wand and suddenly find that everybody is in high-paid, high-skilled jobs. There's there are all sorts of questions about where the jobs are relative to where people are. There are questions about whether people have got the right skills and actually there are all sorts of issues about having the confidence to acquire the skills and to get the work which interact with issues about people's health. So I think, I would say need to be more sophisticated about what actually helps achieve what I think is a shared goal. We also need to remember that there are over 2 million people on Universal Credit who are not able to work as well as people who are looking for work, as well as 40% or so of people on Universal Credit are in work. And so there are lots of people for whom saying, "We want to make work pay," just does not translate into any ability to change their lives. With £22bn to spend across the whole of the economy, what is the right balance between spending that on things which benefit as many people as possible versus having targeted support for people who are in really dire situations. And for only 2% of that 22bn to have been targeted specifically on people who are in really extreme circumstances, that just feels like the balance is in the wrong place. Yes, let's remember that this is a crisis that affects everyone, but it doesn't affect everyone in the same way. Many of us are in a position where we might have to tighten belts a bit, but it's within the bounds of things that we can respond to. But we are increasingly seeing people who just have nowhere to go and we're driving people into extreme poverty or not applying the resources that are available to support people who are finding themselves in these extreme situations. It just feels like it's not a great long-term solution. When as you say, there is a hugely strong connection between poverty and ill-health. We know that if you look back to the work I was involved in on the COVID-19 impact inquiry, we know that people in the most deprived groups, people on the lowest incomes had the worst experience of COVID. We know that inequality got greater as a result of that, and we need to be addressing that and trying to reduce those inequalities.

Bim Afolami: Could I just take on Clare's point about we've got to be a bit more sophisticated about how we think of helping people. I agree with that. Clare knows better than I, in terms of how Whitehall operates but I think too often, we think in silos in terms of, we think of one budget, which is say tax, you're dealing with tax and spend and all the treasury type things, and then we're dealing with health and we think, well that's a separate budget. Whereas actually, and I've seen, and before coming onto this, discussion I went and looked up the amount of money we've put into mental health support and mental health hubs and young people and various other things we're trying to do. But we need to try and think of health in that broader economic context as well. And I think that we need to think much more like that in politics. It's not just in relation to mental health and money. We can talk about all sorts of other things. But I think having that sort of approach can really benefit because I think we all know that, and I know this I'm involved with a local mental health charity in my own constituency, I'm involved with The Money and Mental Health Policy Institute as well, that financial difficulty drastically reduces recovery rates for mental health conditions. If we can think of mental health as being partly related to the financial resilience that people have, we might be able to apply the budgets that we have in a broader, longer term of sophisticated fashion. I think that thinking of those things in a less siloed, it can really be beneficial.

Jennifer Dixon: Yes, exactly. And obviously the link between health and wealth has absolutely been brought to the fourth, hasn't it? With the pandemic. And indeed has been mentioned by the health secretary, particularly as they develop the disparities white paper that we'll see later on this year. So I was going to move on to ask you both actually given where we are given the Spring Statement, what do you think the government particularly the treasury might do next later on in the year to help?

Bim Afolami: I think that what is really, really hard about wholesale rise in energy prices that are many, many times greater than we've seen since the oil shock of 1973, is that the government can't make everyone whole. The government can't be in a position where we just keep prices for everybody at the price that it was, 18 months ago, a year ago. That is just not a feasible scenario. There just needs to be an acknowledgement that we are going through a very tough time at the moment. I think that the budget in the autumn will be very important. I do think that targeting, increasing take-home pay to increase the resilience of people on the poorest incomes is really important. There are lots of different ways of doing that. Obviously, I'm talking about pay, but also the benefits system. I also would like us to start to think a bit more radically around policies around childcare, which is a huge part of cost, so as to fundamentally increase the amount of money people have in their pockets to deal with the vicissitude of life that are not controlled by anybody. That would be my focus in the budget, in the Autumn on top of all the other things.

Jennifer Dixon: And Clare, what would you like to see?

Clare Moriarty: So can I just come back first on this point that Bim was making about the government can't make everyone whole, and I suppose my response to that would be, of course the government can't make everyone whole, but it shouldn't leave people broken because it's morally wrong to leave people broken and it's economically wrong if we don't address issues that are leaving people with just impossible choices to make. That is going to turn out in all sorts of different ways that we'll need to be addressed later. So what is it that the government does need to do? And I come back to the point I was making earlier that we have to recognize and respond to the plight of people who don't have options in terms of cutting back on spending in particular areas, who've got to the point where they have pared back everything and they are having to do things which we would all recognize are they're wrong. You know, people shouldn't have to turn off the heating and not be able to bath their children and be in a state of constant anxiety because they just don't have enough money to make ends meet, for reasons which are not, this is not people's fault. We are all living in this very extraordinary situation but as a society, we need to look after people who are on in the least good circumstances, I would say, that this is going to have to involve putting some money in the direction of the people who are really struggling. In many ways, the creation of Universal Credit was an acknowledgement that the best way to make sure that money was targeted to people on the lowest income was through a national system, Universal Credit has achieved things in terms of being much more responsive. So the taper rate, which was announced in the Autumn Statement, I think, was able to be implemented within four weeks. So we do have the capacity to use the benefit system to get money to people. And I think I we would say that's something that government needs to do. And then these wider issues, investing in all the elements of the social infrastructure. I mean, I completely agree that early years... So early years is much more than childcare. Childcare enables people to go to work. Early years is the most important point at which we support the development of children so that we improve people's life chances in a very good value-for-money way, by investing in early years support and actually addressing some of the underlying things, the longer-term investment that is needed to enable the objective of more people in higher-paid, high-skilled jobs. Those are the sorts of things that would really make a difference.

Bim Afolami: So let's just talk about the central government, local government did issue here. So the Chancellor chose to put money in the support fund, which is going to be administered by local authorities. My colleague, Paul Maynard, who is an MP for a very different constituency compared to my own in Blackpool North a much, much poorer one of the poorest in the country, in fact. He said recently to me that there is something like 14 different government programs supporting some of the most vulnerable people. And there is a case for saying all of that money that we've put in docks of different ways, can that be streamlined and done more effectively? Now, I don't know where it could be done more effectively. There is a big school of thought that say, we should give much more support to local authorities because they know their area is best. They know the people in their towns and villages who are able, who need the support the most, but I think there is a case to say that having lots and lots of different, smaller, targeted programs all over the place is a less efficient way of doing things, rather than putting all that money into maybe one predominant way of supporting the most vulnerable people. I think that's the sort of thing we could definitely look at.

Jennifer Dixon: Well, this is a big feature, isn't it? Of all the leveling up work where I thought there is a quite a big consensus to say that central government control of lots of different parts, which local authorities have to bid for, it's just the completely inefficient system and far better to increase the bottom line of local authorities who, as you say Bim, can see more clearly locally what's needed. But also they simply don't have the staff to keep applying for all these grants that are siloed and vertical programs. They're not actually connected on the ground. So I thought that argument had been won. Clare is that your understanding?

Clare Moriarty: So, I hope it. I hope it has been. And I think there is a distinction between whether or not local authorities are the best people to administer another pot of money versus whether local authorities are the place where you can bring together a broad understanding of populations and what they might need. So I'm personally very much in favour of putting local authorities in a position where they can think ahead on behalf of their population. Interestingly, one of the characteristics of citizen advice is that we have a very holistic approach and people who come to us for help, they may come through the door with what appears to be a problem, but usually it's not a single problem, it's the straw that's broken the camel’s back in terms of kind of tripping a whole series of issues. And the fact that we are able to sit with people, help them peel back the layers of issues, understand the interconnection between, there may be a benefit issue, there may be a tax issue, there may be a council tax issue, there may be a pension issue, there may be a debt issue. And almost certainly there will also be interconnected mental health and often physical health issues as well. And that ability to look at that in the round and then support people to try and mobilize the resources. But we definitely need more of thinking starting with people, and then thinking about how we mobilize resources around people, rather than starting with lots of programs with individual objectives, which may not be terribly well aligned.

Jennifer Dixon: Yes, and I think we've seen in the pandemic, haven't we? That a lot of local agencies have been working very effectively together on the ground in places. So although we've been focusing a lot of our discussion on government, obviously there are other actors, local councils as has been mentioned, but also the voluntary sector and a whole set of other businesses indeed, locally, who've been trying to help. I was reading something it was nice piece in the Financial Times, a couple of days ago about the voluntary sector and how it's created new ways to tackle the cost of living crisis. So I don't know whether a bit more Clare you've seen any of this locally and what you can report on that.

Clare Moriarty: I think it has been really interesting. One of the things that I've heard a lot from our local Citizen's Advice is that they have worked in partnership with other local organizations more through and following COVID than ever before. I think it did really create, brought people together. And that has led not just to some specific things around COVID, but also wider partnerships between different parts of the voluntary sector. I mean, we have some sort of big national level partnership, so we work with the Trussell Trust. We run a help through hardship, help line for people who've been referred to a food bank to help them get the broader support that ideally means that they don't need to go back to the food bank because we've been able to help them with making sure they're getting the money they're entitled to. There are some places where I know there are very, very strong partnerships that go across kind of public sector and voluntary sector boundaries, as well as the voluntary sector to voluntary sector. And that has to be. We are always going to get better outcomes if people come together.

Jennifer Dixon: Yeah. I mean, if you think of the least the immediate future being very challenged, we really have to mobilize as many assets as possible, don't we? And also Bim, I wondered what you have to say here about local innovation in particular, perhaps local businesses. I've noticed that the CBI has really made a big player in the pandemic, ‘Seize the Moment’. It has that initiative, doesn't it? To try to engage local businesses far more in the health and wealth agenda.

Bim Afolami: People have cultural, historical, personal, emotional links with organizations, their area the people that live near them. And that's why often doing things at a highly localized level can have the biggest positive impacts in both health and wealth and the things we're talking about. So I think of a couple of things. Star House working with young people are entirely integrated with the local NHS. They're entirely integrated with CAHMS, they're entirely integrated with the local schools. Local businesses are big sponsors. The local rugby club is also very involved. I just use that as one example because those sorts of links all work more effectively. But I also think of the sort of macro government policy, because the question is how does government enable and incentivize these sorts of partnerships to work? And things like the Community Ownership Fund that was put in recently, and I forget when, and it was at think about £150m, and hopefully that money will be increased at the next budget.

Jennifer Dixon: Thank you. So we'll just finish with one last question. Where is the hope in the next couple of years I'd like to see happen next?

Clare Moriarty: Just thinking about the hopeful things. There's certainly two, which are front of mind for me. One is about partnership working, because as I say, I think that's somewhere where the pandemic has really kind of turbocharged things that people kind of knew they needed to do, but there were always reasons not to do partnership working and I think it's really brought people together and I'm certainly seeing lots of appetite and enthusiasm. I think the second thing, which certainly from where I sit I'm really interested is how we have a good conversation about health and that in this wider sense, not just health as in health services, but you know, all of the determinants of health, and the things that we can do in other areas that actually will make that contribution. If we can achieve. If we can get the best from the move to integrated care systems and avoid them falling into the trap of being yet another version of all the money goes into the acute sector and really get that focus on prevention, early intervention, upstream work, and that broader, opening our eyes to the things that are involved in health and then bringing the people together and giving them the right tools, resources, and encouragement and empowerment to do something. I think that could be a real turning point.

Clare Moriarty: And the last thing and just put my plug in around advice. Because good advice can make such a difference to people's health because good advice targeted at the things which affect people's wellbeing, their living circumstances, all of the burdens they're carrying around with them, good advice can make such a difference to people. It really is a contributor to health. And I think if we can, again, tell that story, connect up the way in which the partnership approach to things, the focus on health, and put advice at the heart of that, we can make a difference to people's lives.

Jennifer Dixon: Wonderful. Thank you. Bim.

Bim Afolami: The first is we just need to see increased money, take-home pay for the lowest paid. We've grown that, but we need to do more and we need to continue doing more. The second is simplified support for the most vulnerable. The government has a put a lot of money into lots of different programs for lots of different groups of people. Let's try and simplify that and put that in as easy a way and make sure that that money goes to where it's needed as simply as possible. And the third is really, we need to have a concerted effort to improve the financial resilience of the people of this country, particularly at lower and middle incomes. That means ultimately, policies deliberately designed to reduce the debt burden and personal debt for people. I've reduced the debt burden, I should have mentioned I'm involved in credit unions not just in my area, but nationally and I chair the APPG. Let's reduce debt, let's increase people's equity in what they do in their homes and other things, and just give them savings. And part of that, I'm afraid is also bearing down on inflation as best we can whilst protecting the most vulnerable. They're the three things that I think we need to do to improve the lives of people in this country.

Jennifer Dixon: So we must leave it there. Somehow, I think these issues will run very hot for the next year or so. Thank you very much, Clare and Bim for all your reflections. As ever more information could be found in the show notes to this podcast, so do take a look. In the meantime, thank you for listening. Next month, we'll return to public services and with the pressure set high, we'll be reflecting with Norman Warner on reforms over the last 50 years and what we need to know now. Until then stay well, and bye for now.

The Health Foundation (2022) Response to the Spring Statement

Resolution Foundation (2022) Inflation Nation: Putting Spring Statement 2022 in context

Institute for Fiscal Studies (2022) Analysis of the Spring Statement

The Health Foundation (2022) Debt

The Health Foundation (2022) Debt and health

The Health Foundation (2020) Living in poverty was bad for your health long before COVID-19

Financial Times (2022) Chancellor provides minimal help to households on cost of living crisis

The Trussell Trust (2022) Debt to government, deductions and destitution 

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The first comprehensive map of young people’s health inequalities in the UK

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Rachael McKeown writes about new AYPH work showing the scale and complexity of young people’s health...

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Inaction on cost of living suggests government hasn’t grasped that health and wealth are intertwined

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Health Foundation response to the Royal College of Physicians (RCP) survey highlighting the impact...

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Government must go further to level up the health recovery

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Health Foundation response to the Queen’s Speech 2022. 

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