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This essay will discuss what is meant by the term “Poverty”, how it affects individuals and the wider community as well explaining why it is important for Social Workers to have a clear understanding of these issues. By looking at the organisations in place in the UK, in areas such as education and health and social care establishments; this essay will demonstrate how the structures of these organisations both help and hinder Social Workers in their role and how it affects the workings of daily practice.
The UK has the oldest and biggest National Health Services in the world, so this essay will also go on to compare the provision in this country with that in the USA. As a first world country, the USA has an economy and culture not vastly different from that in the UK, which makes for some interesting comparisons of the care they both provide. Both the UK and the USA spend the same proportion of their annual budget on social services and education and have a similar rate of poverty.
Poverty is a common term which many people would define as simply being a lack of financial resources. This is a very constricted view which makes it difficult to determine how many people live in poverty because the definition is vague and subjective. To understand and measure poverty and its impact upon individuals and the community, it is important to define it further.
Instead of one main definition for poverty, sociologists have agreed there are two main types; absolute and relative poverty, as described by Giddens (2009). Absolute poverty is used to describe the inability to provide the basic human needs; food, accommodation and clothing, on a budget of around $1 US dollar per day. The idea of absolute poverty is a global one which can be applied regardless of country or culture and applies equally to people of similar ages and abilities. According to a recent study by UNDP (2010), as many as a third of the world’s population live in absolute poverty.
Due to the modern welfare state and benefit system in place in the UK today, no one is expected to survive on $1 per day. However, figures provided by The Poverty Site (2010) show that approximately 9% of the population in the UK have an income which equates to only 40% of the national median income. This has risen almost 7% in just over 20 years and suggests that poverty is on the increase in the UK. These statistics would also suggest that people living in the UK are affected by relative poverty as opposed to absolute poverty.
Relative poverty compares the income of individuals to the national or local average, and where it falls below 40-60% of that average, the individual is said to be living in relative poverty. There is still some debate about where the percentage rate should fall but many agree it should be 60% of the national median income (Giddens, 2010). This is referred to as the poverty line; those below this line live in relative poverty.
Certain groups of people are more likely to find themselves living in poverty, these include; children, women (particularly single mothers), people with disabilities, ethnic minorities and the elderly. Cunningham & Cunningham (2009), Giddens, (2010) and Llewellyn, et al (2008) all agree the reason these groups are more likely to suffer from poverty than other groups is a direct result of social exclusion.
Social exclusion is a term which grew in popularity in 1997 when New Labour was re-elected into government. Part of the pre-election campaign of New Labour was to tackle the root causes of the issues affecting those who were marginalised by main stream society (The Poverty Site, 2010). People, who for reasons including; age, race, gender and class are often denied access to service and opportunities making it easier to exclude them from society. This was evident when the BBC undertook a survey, and found that when considering job candidates, whose qualifications and experience were almost identical; those with a name traditionally given to people from non-white backgrounds were far less likely to be called to interview, proving that racism is still present in the workplace, (Cunningham & Cunningham 2009).
To tackle some of the inequalities present in mainstream society, New Labour introduced a number of initiatives and policy changes to improve the standard of life, these included;
The introduction of Tax Credits for families and individuals on low incomes,
Every Child Matters – a 5 point framework to improve the quality of life for all children,
Connections – an easily accessible advice point on a range of topics for young adults ages 13 – 19yrs,
SureStart – aimed at giving babies and young infants the best start in life by providing advice, drop in centres and child care for their parents.
People who face social exclusion often live in the same locality; council house estates for example, which tend to have a higher proportion of single parents and high rates of unemployment. These groups of people are frequently given negative labels, which over time can become self-fulfilling. For example, a young child growing up in a single parent family on an council estate as indicated above is more likely to be viewed negatively and given such labels as; ‘trouble’, ‘lazy’, ‘good for nothing’, which over time can have a detrimental effects upon the child who will begin to view themselves as the labels placed upon them (Llewellyn et al, 2008). This negativity can lead to an increase in truancy, which in turn will lead to a poor education and employment prospects, thus setting up a life in poverty (Mail Online, 2007).
According to Bebbington and Miles (1989), children from an impoverished background are 700 times more likely to be involved with social services than children from a wealthy background. This statistic alone shows how vital it is for social workers to have a strong understanding of the impact and experiences living in poverty can have. It is argued by Cunningham and Cunningham (2009) that many professionals in the social work field feel overwhelmed by the structural inequalities faced when tackling poverty, this tends to mean that poverty is dealt with on an individual case basis. Changes in policy, both at national and at local level can have an impact on poverty by the way services are implemented and delivered. As social workers are present at both the point of service and within the organisations where policies are made, it puts them in a prime position to affect change.
Understanding and recognising the factors that cause and keep poverty part of modern society will allow a social worker to understand how they can interrupt the poverty cycle encouraging positive change.
Placing some of the responsibility for poverty on society and within the structural inequalities that exist, can sometimes be viewed as taking responsibility away from the individual and the choices they have made, making them less accountable. A social worker should always maintain a positive and optimistic outlook and believe that despite the inequalities that exist, change is still possible regardless of the situation. It is important to understand how the education system and health and social care organisations are set up in the UK to recognise how this can impact the access to care.
Responsibility for education in the UK has become a devolved matter for each individual country and overseen by their own government. The Department of Education and The Department for Business, Innovation and Skills predominately oversee the education system in England, with involvement from Local Authorities. Since 2005/2006, Local Authorities are given a grant which is ring fenced for the purpose of education and with consultation from all schools under the Local Authorities control, the finance is distributed, (Department for Education, 2010). There are approximately 20,000 public schools in the UK; a growing number of these are faith schools, almost 7000 at present.
In addition to these state schools, there are a growing number of independent schools, almost 2600; responsible for the education of 7% of the population, (Independent Schools Council, 2010). There schools are funded primarily through tuition fees and in some faith schools, donations from the associated church. A large proportion of these schools are faith schools who do not take children outside the designated faith of the school within their catchment area.
Historically, health and social care has been provided by the private and voluntary sector. Until the introduction of the Poor Law Act 1930, the majority of care for those in need was provided by charities and the work houses. People who lived in poverty had to rely on hand-outs, if they were deemed worthy of charity, or would have to pay at the point of service. Often it was those most in need of the service that were unable to pay forcing them to go without. The Poor Law Act 1930 moved the responsibility of care from these sectors to the Local Authorities, who began to take over the work houses and Poor Law hospitals (Spicker, 2010).
The National Health Service was established in 1948 with the ideology that everyone should be entitled to the same level of health and social services which were free at the point of service. Today’s modern National Health Service is overseen by the Department of Health. The country is split into 10 Strategic Health Authorities who control the care provided by the trusts in its area. Care is split into two main areas, Primary and Secondary care. Primary care services include; GP’s, Opticians, Dentists and NHS Direct. Secondary care is acute health care and normally only accessed in emergency or extreme situations and includes; The Ambulance Trust, Emergency and Urgent Care Units, Mental Health, Care and NHS Trusts. (NHS, 2010).
The National Assistance Act 1948 called for Local Authorities to set up Health and Welfare comities, providing the first form of residential care. In 1970, The Local Authority and Social Services Act of the same year created the first Social Services departments including; children’s, welfare and mental health. (The National Archives, 2010).
The National Health Service remained largely unchanged until 1990 when the first major reforms took place. With the general population living longer, the cost of providing care was increasing and becoming unviable. The organisation of the National Health Service had also become unproductive and unyielding to those it was meant to help. Bureaucracy and red tape became the norm when trying to access any services or treatment.
The National Health Service and Community Care Act 1990 was the first step in the reforms to the health and social services departments. The introduction of the Purchaser/Provider split meant for the first time since the establishment of the National Health Service, government departments were no longer responsible for the provision of all services (Kirkpatrick et al, 1999). The reason for this was threefold; firstly, to lessen the financial responsibility of care provision, secondly, removal of public provision would allow the private and voluntary sectors to grow and expand, making the care market more competitive, and thirdly, to increase choice for service users. This act was also the start for a number of large care homes and institutions being closed and the care provided in the community.
The principles behind these changes were well intentioned; allowing people to be cared for within the community promoting independence and control over personal care. However, in reality what was offered were standard care packages and limited resources which did not deliver the true freedom of choice that was promised, (Llewellyn et al, 2008).
To supplement the care provided for under the new system, many people have turned to charities to help fill the gap left by the lack of financial assistance. Providing people with the finances to pay for their own care, rather than provide the care itself, has meant people are able to choose how and by whom the care is provided. Many people have chosen to pay friends and relatives for the provision of care rather than rely on agencies and strangers. For Social Workers, this gives an opportunity to think outside the box when producing care plans with individuals. In communities, people are now able to form groups and committees to address and tackle problems and difficulties to provide a tailor made solution. This not only gives people control over their own care but also encourages the community to take action and to help itself.
Although the UK has the biggest National Health Service in the world (NHS, 2010), the change in direct care provision and growing reliance on the private and voluntary sectors is more in line with the health and social care services in the United States of America (USA).
The USA has a minimalist National Health Service which provides the most basic of health care; caring for those on very low incomes and or in emergencies. Many people living in poverty will be eligible for “Medicaid” which is a healthcare programme paying for the whole cost of care, but poverty alone is not an automatic eligibility criteria. Many older people, 65yrs and over, are reliant on the “Medicare” system, which only covers 80% of the cost of care, the remaining 20% must be funded by other means. Anyone who is outside the eligibility for these benefits must pay for private health care insurance, unless it is provided for through employment, (US Department of Health & Human Services, 2010).
Another benefit provided by the USA government is food stamps; however this is being phased out and replaced by Temporary Assistance for Needy Families, which is a short term benefit aimed at getting families back on their feet, (US Department of Health & Human Services, 2010).
The health and social care system in the USA is structured much the same as the UK, in that the government provides each state (Local Authority) with a budget to spend on care. In addition to this, states in the USA are allowed to set its own tax rates on things such as Income Tax, Sales Tax and House Tax. The proportion of money put back into care differs between states, some providing a higher level of benefits than others.
The USA has a much higher dependency than the UK on voluntary organisations, namely the church; who provide care and financial assistance to those in their communities.
Comparing the UK and the USA, there seems to be a different attitude towards the provision of care. The UK system is geared up to help prevent poverty and social exclusion, whereas the USA system is designed to help people get out of poverty but placed a bigger reliance on the individual helping themselves. Both systems are becoming more reliant on the community, voluntary organisations and the private sector for the provision of care; lessening the financial burden on the state in the face of an ever aging population. Both countries seem to be unified in the attitude that people should “help themselves out of poverty”.
Although the role of the Social Worker will always be required, there is a strong shift in the role from the provision of direct care to one of care co-ordination. To provide the best possible level of care for both individuals and the community, Social Workers must maintain a high level of knowledge of both statutory and non-statutory providers of care and how best to access them.
This essay has demonstrated that poverty is a global problem which is maintained by the way society works by socially excluding people and keeping them impoverished. It has also shown how two similar countries differ in their approach to care; the UK government provides the majority of care with assistance from charities and the private sector, whereas the USA government provides only the most basic forms of assistance which a strong reliance on the church, charities and the public sector. Both countries are in agreement that with an increasing older population, each government needs to do more to lessen their contribution to the provision of care. During this time of change, Social Workers will need to find a way of providing the best possible care for those in their charge.
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