Section 2: Economic inequality in Gateshead

Mandy Cheetham, Embedded Researcher 

It is the role of the Director of Public Health to understand how national policy is impacting on local people and to capture evidence of that impact and its health outcomes. Gateshead Council was a pioneer and early adopter of embedded research as a promising way to integrate evidence into public health practice. (. Cheetham M, Wiseman A, Khazaeli B, Gibson E, Gray P, Van Der Graaf P, Rushmer R. Embedded Research; a promising way to create evidence-informed impact in public health, Journal of Public Health, Volume 40, Issue suppl_1, 1 March 2018, i64-i70, https://doi.org/10.1093/pubmed/fdx125 (opens new window)) This work has ensured that we understand and hear the voices of local people as well as looking at the reported statistics.

A place-based, community-led study undertaken in 2017 in an area of East Gateshead which faced significant inequalities, identified community members' concerns about the forthcoming roll out of Universal Credit (UC). Senior managers and leaders in Gateshead Council were keen to understand the health and social impact of the government's new policy to 'simplify the benefits system' and 'encourage people in to work'. The study was commissioned by public health to examine the impact of UC on community members and staff. A research team from Teesside University and Newcastle University interviewed 33 UC claimants and held interviews and focus groups with 37 staff supporting them.

The findings were a stark wake-up call and made for harrowing reading. The research showed the profoundly detrimental impact which UC was having on vulnerable claimants, including people with long term health conditions and disabilities, their financial resilience and employment prospects. The UC claims process was experienced as complicated, difficult to navigate, hostile and demeaning. The wait for payment of five to 12 weeks pushed many into debt, rent arrears and reliance on foodbanks, increasing the shame people felt. 

The impact was so severe that some claimants said they had considered suicide.

One claimant felt UC "cuts the feet from under you at a time when you need it most". Concerns about the increased risks of poverty and destitution among vulnerable claimants were voiced by staff and placed additional pressures on the wider health and social care system.

The research was published in an exclusive in the Guardian (The Guardian. Exclusive: universal credit linked to suicide risk) and in an academic paper. (Cheetham M. Moffatt S. Addison M. and Wiseman A. (2019) Impact of Universal Credit in North East England: a qualitative study of claimants and support staff, British Medical Journal Open:9:e029611. doi:10.1136/bmjopen-2019-029611) 

Members of the research team met with Phillip Alston, the UN Special Rapporteur on Extreme Poverty and Human Rights, who cited the research in his final report. (Alston P. et al (2019) Report of the Special Rapporteur on extreme poverty and human rights on his visit to the United Kingdom of Great Britain and Northern Ireland) Local and national press coverage followed, including radio and TV interviews with the Director of Public Health in Gateshead.

A presentation to Gateshead's Health and Wellbeing Board in January 2019 prompted a jointly signed letter outlining concerns to be sent to the then Secretary of State for Work and Pensions, Amber Rudd, but received no response. The research team, meanwhile, continued to receive emails from claimants and staff across the UK highlighting similar concerns. 

Having submitted written evidence to the Work and Pensions Select Committee enquiry in to the five week wait for Universal Credit in Feb 2020, Mandy Cheetham was invited to give evidence in response to MPs questions alongside a colleague from Liverpool University on 16 June 2020. (Cheetham M. (2020) Evidence to Work and Pensions Select Committee enquiry on the Impact of the Five Week Wait for Universal Credit, Wednesday 17 June 2020)

In July 2020, the work and pensions secretary, Thérèse Coffey, announced changes to the ways vulnerable claimants are to be treated by DWP.

"In academia, we are encouraged to think about the impact of our research, but rarely is the complexity of this process acknowledged. Co-located, embedded research (ER) has enabled me to build trusting relationships with colleagues in local government and VCS organisations. Together we have explored the possibilities of different ways of working. ER has opened my eyes to the possibilities and challenges of using evidence to inform policy and practice in situ. I have gained enormously from being rooted in different bits of the system in which evidence is used, seeing how people and systems interact, working alongside community members facing the greatest inequalities. I am enormously grateful to those who shared their lives and for the opportunity to investigate the effects of government policy, and share these at local, national and international events. Valuable moments have been created to share insights and affect change, frustratingly slowly and in small ways."
Mandy Cheetham, 2020.