Reports into the death of Mark Wood, an Oxford man who starved to death after his benefits were cut when he was declared ‘fit for work’, have added ripples of shock to a debate about food poverty that took a while to reach the Westminster press. The debate has so far been framed as religious organisations stepping in to fill a gap created by welfare reform with food banks, and is held by a political media culture disconnected from a complex functioning society and the real economy.
The details of Mark Wood’s death tell a complex story of a preventable political, social and economic catastrophe opening up. His death will now be slotted into a debate about food poverty, which is only serving to hide a much bigger picture and which may prevent this catastrophe being addressed until it is too late.
Mark Wood was a vulnerable young man, with Obsessive Compulsive Disorder, Asperger’s Syndrome, cognitive behavioural problems and phobias toward many foods. He likely would not have had the resources to cope with food poverty even without the cut in income caused by being declared fit for work. Few employers could meet the needs of someone like Mark Wood, even with the best of intentions, and asking a man like him to exist within the frameworks of paid employment would be a struggle for either business or employee.
Public spending 101 — you cut what people want, you can save money; you cut what they need, the cost multiplies and displaces elsewhere. There is always a social, economic and political cost that comes with failure to protect the vulnerable from harm and allow people to meet their basic needs.
Market-driven welfare reform focused on people with existing health problems and disabilities guarantees health problems that can result in tragic consequences like the death of Mark Wood.
Our understanding of the needs of people like Mark Wood is highly developed within professional and academic knowledge bases in health, education, and social care. The timebomb being created by Britain’s food poverty epidemic is a direct result of the invisibility of all that knowledge to facile political and economic debate. The continuing failure of welfare reform subject to political consensus is only the first cost to this epidemic opening up.
Malnutrition is a guaranteed multiplier of cost to the public and private sector purse, long and short term. Erosion of the human body and mind through inadequate nutrition increases support needs exponentially and will have a significant impact on potential for growth in the wider economy as well as future public spending. Malnutrition cannot be addressed by emergency food aid to stave off hunger. Malnutrition and hunger are very different. Malnutrition is the long term erosion of the body and a malfunctioning in the ability to even process food, a result of long term and sustained problems which can only be addressed by people having access to an adequate sustainable nutritious diet. Becoming malnourished once can leave the human body at risk of significant health problems for the rest of its life.
Admissions to hospital for malnutrition soared from 2008 to 2013. There were 5,500 hospital admissions for malnutrition in 2012/13, compared to just over 3,000 in 2008. The nature of malnutrition and its symptoms mean that hospital admissions are the tip of the iceberg. It can go undetected for a long time and can be confused with other things. Very conservative estimates put 3 million people in the UK at risk of malnutrition, and malnutrition is increasingly being found in people admitted to hospital for other reasons, with older people particularly vulnerable.
GPs are expressing concern at the numbers of people visiting surgeries with illnesses that are a direct result of not eating, and prescription of food supplements has grown. A local GP I spoke to told me of the pressure within her surgery to adhere to guidelines for prescription of oral nutritional supplements, as NHS budgets are not there to subsidise deficits in household food budgets. The NHS has no choice but to cover the cost of the very serious illnesses and health problems malnutrition and under-nutrition exposes people to.
Emergency food aid is not new in this country. In 2003 Bradford, like most cities, had a rough coalition of voluntary and religious agencies co-ordinating so there would be somewhere in the city available every day to provide a meal or a food parcel. At this point adequate calories were affordable within most budgets. While our benefit system was punitive, and problems at the intersection of health, social care and criminal justice created some of this need, the highly efficient DWP social fund system of small interest-free crisis loans, recouped through benefit payments, still existed for emergencies and a complex web of services existed to provide some sort of safety net for all but the most chaotic and vulnerable. Local authority funding cuts passed to the voluntary sector by stealth mean many of these services no longer exist.
Emergency food aid was only really required by the most marginalised and vulnerable people. Those who had really slipped through the net – chaotic drug users, rough sleepers, people with severe mental health difficulties.These people are now pushed further away from emergency food aid, as it becomes normalised in the wider population. Undisrupted consistent income at Jobseekers Allowance levels would not be enough to buy adequate calories for the human body to function at full activity levels seven days a week. That both parties have planned labour market transformations based on the idea that people on this income level can do a full time job, in return for this income level is astonishing in its short sightedness, even without consideration of the further downward pressure this puts on wages.
The timebomb Mark Wood’s death is a symptom of cannot be remedied by food banks. The economic problems his death signifies go a lot deeper than problems with work capability assessments and benefit sanctions. Malnutrition and the effect of rising food prices and shrinking household incomes across the board will not be helped by occasional parcels of processed and dried food as a replacement for a cash crisis loans system. The debate about food banks and benefit sanctions is keeping us busy while a much deeper problem develops.
Sharply declining wages, rapid food price rises, growing fuel costs and deliberately-created deficits in the households of welfare dependent working families with children, have affected nutritional spending profoundly. IFS research shows the number of calories households have purchased has steadily decreased since the 2008 recession, while households have clearly been making substitutions in their shopping for cheaper, less nutritious calories, and more calorie dense foods.
Food banks are overwhelmingly reporting use by working people, not just the unemployed or ill and certainly not the marginalised people who until recently were the only people who needed food aid. The human body cannot function at full capacity without sufficient fuel, and the cost of this goes directly to businesses that employ people as their performance is undermined. This is as unsustainable as the use of emergency credit to plug household deficits.
The decrease in purchased calories has been more evident in households with young children, especially single parent households. It has always been understood that mothers will act as shock absorbers of poverty within households. Anecdotal evidence and surveys showed that up to 20% of UK mothers were missing meals in the first year of the austerity programme Britain is now four years into. The deficits in these households are being deliberately increased year on year to political silence. There is currently political consensus on the exploitation of gender inequality for austerity, with both the Big Society and Blue Labour providing ideological justification for the continued attacks on women’s incomes.
The effect on the ability of adults within these families to maintain care of their children again displaces the cost of this outside the household. Kate Belgrave has reported on the fear mothers have of social services. The overwhelming fear of accusations of breaching their responsibilities to their children under the Children Act (1989), because they cannot afford to feed themselves as well as their children, mean these are women who are very unlikely to approach food banks.
Children’s services departments in turn have borne a disproportionate burden of the cuts required under austerity, and this has ensured a change in climate so thorough assessments are less likely, and mothers can easily find themselves subject to suspicion of neglect. There have been instances of housing authorities and local authorities using child protection threats to maximise revenue collection, especially for bedroom tax arrears. The stress being deliberately created has a long term impact on health budgets, especially already stretched mental health budgets. Not to mention the effect on the long term wellbeing of the economy, and our most important seeds of future growth, our children. Maternal behaviour patterns to food are passed directly to children, as are health problems which develop as a result of under-nutrition during pregnancy.
When Nick Clegg described the checklist for growth used to decide political priorities for austerity, the ignorance to the way our political economy actually functions was evident. In the political debate that has afflicted the left and right of our political press, while they maintained consensus on austerity, it has become apparent that this ignorance to how our political economy function is widespread within that culture. While an efficient food bank franchise with a remarkable ability to match its plans to government expresses concern at the unfathomable expansion of food poverty, anxious professionals are fully aware of the consequences opening up and of the response that will eventually be required.