Our Claire Tyler has written an essay for a Make Every Adult Matter publication on the next steps for policies to tackle multiple disadvantage. These issues are important to think about as we head into the General Election on 4th July.

Claire wrote about the need for local, joined up services alongside a much stronger safety net.She set out the problem:

The accepted post-war norm has been for successive generations to experience better lives than their parents. That is not true anymore for the younger generation, as they are experiencing worse outcomes in terms of pay, security and housing. And the two-child limit for benefits continues to hold many families in poverty. The Marmot Review: 10 Years On highlighted that in the past decade, people can now expect to spend more of their lives in poor health. This is a crisis that will grow rather than fade without radical intervention.

What would the Liberal Democrats do about this?

Liberal Democrats would finally put mental health on the same footing as physical health, and invest in public health and prevention so that fewer people get ill and need treatment. We would break the cycle of reoffending by improving rehabilitation in prisons and on release. We would commit to building 150,000 social homes a year by the end of the next parliament. And we would set a target of ending deep poverty within a decade with a major anti-poverty strategy. Crucially, Liberal Democrats also understand that radical reform will take more than just good policies in each government department. We also need to reform our public services, taking a coherent, joined-up approach so that they work for those who are most in need. In tackling multiple disadvantage, this means committing to action in three key areas: leadership from the heart of government, local autonomy and co-production, and shared outcomes that endure for the long term.

And decisions being made locally is really important:

If people experiencing multiple disadvantage are to have real opportunity, more power needs to be transferred away from Westminster and Whitehall. Leadership that sits closer to communities is far more likely to deliver the change that is needed. Place matters. As far back as 2008, the London Health Observatory identified that every two London Underground stops travelling east from Westminster represents more than a year of life expectancy lost – and this pattern has persisted over time. In 2019, I was privileged to chair the Enfield Poverty and Inequality Commission, which highlighted that levels of poverty and deprivation in Enfield are now more comparable to historically poorer neighbouring inner London boroughs. Local government plays a critical role in helping to tackle multiple disadvantage, but local leaders are far too often hamstrung in their efforts to create sustainable change to public services for people experiencing multiple disadvantage. They face threats of bankruptcy and enormous cuts to public services. Where funding is available, this is frequently handed out piecemeal by government, making it difficult for local leaders to plan for the long term

And we need to think about how we create “long term, sustainable services”

Instead, we need to support and encourage genuine multiagency working, bringing together statutory, voluntary and community organisations working towards delivering long-term, shared outcomes. There are already many positive examples of this in action, for example the development in association with local authorities of a range of public health clinics within community spaces (for example pharmacies, libraries, job centres, debt advice and community centres) to reach those who are less likely or less able to seek health care from their GP. This encourages better communication among professionals, easier access, and better integrated, person-centred care. However, imbalances between the power and representation of health bodies, local authorities and voluntary, community and social enterprise organisations (VCSEs) and people with lived experience is a barrier to progress. Changes to commissioning practices are needed to ensure that multidisciplinary and system change focused work is incentivised and funded, supported by proportionate reporting requirements based on what works for people rather than what works for central government. Across the health landscape, integrated care boards are intended to be part of the solution, but the jury is out about the extent to which they will be able to step into this role

You can read her essay here alongside contributions from, among others, Jess Phillips and Andy Burnham.

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