Monday, 4 August 2014

Poverty and the NHS

Many GPs say they know about poverty from their work, and some will have direct experience or stories from their own family background.

The doctor- patient consultation is a unique space; each participant getting  information across, making decisions and seeing  a way forward in a  tight time frame. So this brief meeting means a distilled version of the patient and the doctor is present in the room.

Being a commissioner

These were at the forefront of my mind being a commissioner with the Poverty Truth Commission, representing GPs at the Deep End over the past eighteen months.

I thought I knew about poverty- but getting to know the commissioners and listening to what they had to say about their day to day experiences was different.

Hearing what it is like to spend every day, every week- with little chance of respite-  ensuring  money for food, heating, clothing and children’s needs, can stretch enough.

Hearing  about how public organisations like the department for work and pensions, social work, housing, the police and the NHS can be so unthinking, stigmatising or even cruel when people who experience poverty use their services.

Hearing about the resilience of individuals and communities and the active steps commissioners were taking to change things and the progress that has been made.

I was also struck by many of the commissioners being surprised that despite being a doctor I seem to be a normal person. Is our society so divided that people who work as doctors and people who experience poverty can’t know each other as normal?


Poverty is not a ‘protected characteristic’ when it comes to equality legislation and it shouldn’t be -because poverty is not an intrinsic part of a person or a choice actively made. However this means that public organisations can ignore the fact of poverty in their service users lives when they are designing and delivering services.

The challenges for us all
  • Ensuring  the NHS and other public services do not discriminate against people experiencing poverty and actively involve the experts-people who experience poverty- in doing  this.
  • Ensuring  that all people who work in public services treat people who are experiencing poverty with respect and are sensitive to their needs.
  • Working actively to make Scotland a place where social and economic barriers do not exist between people.

Andrea Williamson

Andrea Williamson is a GP who works in homelessness health, addictions and at the University of Glasgow. She is a member of the GPs at the Deep End steering group.

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