Blog – Unison Report 2019: “in-work poverty & deprivation among healthcare workers” by Dr Claire Preston

When you next need medical attention from the NHS, spare a thought for the nurse or healthcare worker looking after you. Our new report uncovers shocking levels of poverty and deprivation among public-sector healthcare workers in Cambridgeshire. And yet dozens of millionaires live in Cambridgeshire. Inequality is clearly thriving in the very places where we are ill – hospital wards and healthcare clinics.


UNISON commissioned the research behind the report and The Cambridge Commons (TCC) and a Masters student at Anglia Ruskin University carried it out independently. The study comprised a survey of 239 healthcare workers, followed up by in-depth interviews with a representative sample of 13 participants.


One of the starkest findings is that 84% of respondents face financial difficulties, with more than half that number saying those difficulties are significant or very significant. Worryingly, a small proportion of respondents have even resorted to using pay day loans and foodbanks.

Over one third say they have no money left over for savings and many regularly borrow from family and friends. One interviewee explains the situation this way:

“Every month I put £100 into my savings account and every month it’s gone. I make the joke now that it’s not my savings account, it’s my back-up for when I know I’m going to run out of money!” [Interview respondent]

The cost of housing is a particular problem. About half of respondents are paying over £750/month for their accommodation and many have difficulties securing and servicing mortgages.

“The rents are also so high that currently I live in a very run-down house that is full of damp and mostly single glazed, in the winter it gets unbearably cold. And the costs of heating an uninsulated property are extortionate. I don’t mind living in a house share, and I love my current housemates, but I know I will never be able to afford my own property anywhere near Cambridge, either renting or buying.” [Survey respondent]

Those who have been able to buy a house have often done so at the cost of moving out of Cambridge:

“I’ve had to leave Cambridge; can’t afford to live there. Broke my heart. I’ve had to leave my Dad. I would have liked to have lived at lot closer to my Dad in Cambridge, just forced out. Don’t get me wrong some of my other friends, you know, they are miles away. But a lot of us, all around here, who all grew up here are all over the place”. [Interview respondent]

Travel costs are another drain on resources, taking a relatively bigger toll on lower-paid workers and contributing to their sense of despair.

“The cost of living and transport and then parking all add up and make it almost financially impossible to continue to work at CUH (Cambridge University Hospital).” [Interview respondent]

The impact of these conditions on people’s relationships and emotional well-being was particularly clear from the interviews. Families with children face immense difficulties: juggling work, childcare and the need for quality time together. This was epitomised by one couple who wanted relationship counselling but simply couldn’t fit it into their hectic lives. People can see the way out of their difficulties but are unable to take it. One woman explained this in relation to job opportunities:

“He [my husband] saw a new job, it was a lot more money and I just looked at it and I was like, ‘Well how are you gonna get the children to school?’. We can’t, we’re both stuck. And then the other thing I could do was drop my hours down but then I don’t want to do that cause that’s gonna affect my pension.” [Interview respondent]

With or without children, most people maintain a constant vigilance over what they spend, economising and cutting back where they can, particularly in response to unforeseen expenses. Coupled with pressures at work, this brings high levels of stress and anxiety:


“I’m OK for a while and then I do have this anxiety coming in and I’m like oohhh, you know and then, I go through it again [telling myself that I can only pay off whatever I can pay off] and calm myself down. You need to be able to manage your own stress levels. I did have counselling. But I try not to think about [money problems].”  [Interview respondent]

The level such anxiety can reach is clear from recent calls for an inquiry into the alarming rate of suicide among nurses. While this situation is dreadful enough in its own right, it has obvious knock-on effects on healthcare workers’ ability to do their jobs efficiently and compassionately. But perhaps the biggest downside is the waste of human potential, the lost opportunities for people to live happy and fulfilled lives. As one person put it:


“In light of the information I have provided, it is also worth noting that I do not even have children. And to be completely honest, it is clear that I cannot afford to have children. It is absolutely appalling how people, particularly in the healthcare industry, are expected to live off an income whereby they are barely surviving. To put it differently, it doesn’t exactly motivate people to work in jobs which promote the well-being of their fellow members of society.” [Survey respondent]

This situation raises the question of what should be done. One recommendation we make is that CUH takes steps to ameliorate the high cost of living in Cambridge, focusing on housing, travel and childcare. An alternative or additional measure would be the introduction of a high-cost-area supplement for Cambridge staff, similar to that applied in London. Either way, this evidence of in-work poverty among healthcare workers in a city more often sold as a thriving centre of high-tech entrepreneurship makes uncomfortable but urgent reading.

You can read the full report here.

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