Profit Before People: The commercial determinants of health and lessons from the tobacco epidemic (2023)

The following examples were provided by Citizens Advice Gateshead. 
Names have been changed to protect anonymity.

Michael's story

Michael is a 39 year old disabled veteran. He lives alone in a council tenancy and receives Universal Credit and Personal Independent Payment.

He is struggling to afford food and has contacted us several times within the last few months for food support.

On this occasion it looked likely that the food bank would refuse our referral as there did not seem to be any explanation for Michael's need for help - he was in receipt of a qualifying benefit and did not disclose any circumstances that would have made food unaffordable.

Our adviser explored his affordability issues in more detail and discovered that Michael had been gambling. He did not consider this an issue - he was not in debt and felt he could stop whenever he wanted. However, on further discussion he admitted that on more than one occasion he has spent his last penny on gambling, even though he knew he had no food in and had no other way of buying food.

We discussed gambling harm with Michael and provided him with information and sources of support. He agreed to consider this and return to us in the future should he need further help.

James' story

James is retired, in receipt of State Pension and Pension Credit and lives alone in a property which he rents from a social landlord. 

He is disabled and suffers from both mobility issues and mental health conditions. James requires overnight care and has two carers who come in on a rota basis to support him. 

James contacted us for advice about debt as he is £15,000 behind with his care costs and cannot afford to repay this in full. He needs the care and was worried that the care package would be withdrawn. 

During our exploration we discovered that James had been gambling. This has been getting worse and he is losing money, leaving him unable to pay for his essential care. 

James is worried about his inability to control his gambling. 

We provided James with advice but determined that further intervention was needed. With James' consent we helped him to access Gamcare and seek to self-exclude, as well as referring him for counselling support. 

We also referred James for debt support and, by explaining his circumstances, we were able to negotiate a repayment plan on his behalf.