{"id":43934,"date":"2019-01-23T16:24:35","date_gmt":"2019-01-23T15:24:35","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=43934"},"modified":"2019-01-28T10:42:58","modified_gmt":"2019-01-28T09:42:58","slug":"nick-hopkinson-dynamite-the-sewers-the-uks-shameful-record-on-poverty","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/01\/23\/nick-hopkinson-dynamite-the-sewers-the-uks-shameful-record-on-poverty\/","title":{"rendered":"Nick Hopkinson: Dynamite the sewers!\u2014the UK\u2019s shameful record on poverty"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-38500 \" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/nick_hopkinson_2017-1-244x300.jpg\" width=\"170\" height=\"209\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/nick_hopkinson_2017-1-244x300.jpg 244w, https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/nick_hopkinson_2017-1-768x945.jpg 768w, https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/nick_hopkinson_2017-1-832x1024.jpg 832w, https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/nick_hopkinson_2017-1-300x369.jpg 300w\" sizes=\"auto, (max-width: 170px) 100vw, 170px\" \/><span style=\"font-weight: 400\">Installed in his first job in the poverty-stricken Welsh Valleys, young Dr Manson, the hero of AJ Cronin\u2019s 1937 classic <em>The Citadel<\/em>\u00a0is faced with a cluster of cases of typhoid. The water supply is contaminated by leakage from an adjacent sewer, but the authorities remain indifferent to this obvious, persisting threat to human health. Our frustrated hero embarks, with a dissipated-but-ultimately-redeemed older colleague, on a desperate plan to blow up the crumbling sewer and force the construction of a new one. It\u2019s a mining town so explosives are readily come by and under cover of darkness a series of sticks with varying fuses are sent floating off. The results are spectacular, the Councillor\u2019s new villa down the valley is inundated with sewage, and work on new and safer drainage is begun immediately.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The story is brought to mind by the <\/span><a href=\"https:\/\/www.ohchr.org\/EN\/NewsEvents\/Pages\/DisplayNews.aspx?NewsID=23881&amp;LangID=E\"><span style=\"font-weight: 400\">recent report by Philip Alston<\/span><\/a><span style=\"font-weight: 400\">, the UN Special Rapporteur on extreme poverty and human rights. Its 24 pages outline the extent and mechanisms by which poverty in the UK\u2014\u201cnot just a disgrace but a social calamity and an economic disaster all rolled into one&#8221;\u2014is created and sustained. Compassion for those who are suffering \u201chas been replaced by a punitive, mean-spirited, and often callous approach.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">One important element has been the introduction of Universal Credit. Alston\u2019s report sets out succinctly how the political choice to implement this \u201cstreamlining\u201d of the system while also cutting levels of support has both explicitly intended, and thoughtlessly punitive effects on the most vulnerable. Its architects want \u201cto make clear that being on benefits should involve hardship\u201d\u2014as if that was not apparent to people on low incomes already. This is the thinking of the workhouse, implemented through fixed delays to payments, clawbacks, lack of transparency in the system and a sanctions regime to immiserate people with disorganised lives. A digital by default service for people with the least digital literacy or indeed access to the internet. Employment does not anyway prevent poverty\u20142.8 million people living in poverty in the UK are in families where all adults work. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Speaking to local authorities and the voluntary sector, Alston is struck by how preparations for the rollout of Universal Credit resemble preparations for a natural disaster or epidemic; \u201cthey have expended significant expense and energy to <\/span><i><span style=\"font-weight: 400\">protect<\/span><\/i><span style=\"font-weight: 400\"> people from what is supposed to be a <\/span><i><span style=\"font-weight: 400\">support<\/span><\/i> <i><span style=\"font-weight: 400\">system<\/span><\/i><span style=\"font-weight: 400\">.\u201d Meanwhile, in his meetings with the government, \u201cit was clear to me that the impact of Brexit on people in poverty is an afterthought, to be dealt with through manipulations of fiscal policy after the event, if at all.\u201d<\/span><\/p>\n<p><a href=\"https:\/\/www.theguardian.com\/society\/2017\/jun\/15\/levels-of-child-hunger-and-deprivation-in-uk-among-highest-of-rich-nations\"><span style=\"font-weight: 400\">Unicef<\/span><\/a><span style=\"font-weight: 400\"> data show that 19% of children under 15 in the UK lived with adults who struggle to buy food. In 2019, in one of the richest countries in the world, we hear news reports of hungry children <\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/uk-england-lancashire-46827360\"><span style=\"font-weight: 400\">&#8220;eating from school bins.&#8221;<\/span><\/a><span style=\"font-weight: 400\">\u00a0Shamefully, Parliament\u2019s Environmental Audit Committee, is now calling for the introduction of a <\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/education-46810707\"><span style=\"font-weight: 400\">Minister for Hunger<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The dynamite is metaphorical, but in the face of such contrived cruelty and indifference, and as <\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/health-45638646\"><span style=\"font-weight: 400\">life expectancy stalls or indeed falls<\/span><\/a><span style=\"font-weight: 400\"> in some groups, patience seems less and less like a virtue. \u00a0<\/span><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Nick Hopkinson<\/strong>,\u00a0reader in respiratory medicine, Imperial College London, and medical director of the British Lung Foundation.<\/span><\/em><\/p>\n<p><em><strong>Competing interests<\/strong>: None declared.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Installed in his first job in the poverty-stricken Welsh Valleys, young Dr Manson, the hero of AJ Cronin\u2019s 1937 classic The Citadel\u00a0is faced with a cluster of cases of typhoid. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/01\/23\/nick-hopkinson-dynamite-the-sewers-the-uks-shameful-record-on-poverty\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":40116,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18889],"tags":[],"class_list":["post-43934","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nick-hopkinson"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Nick Hopkinson: Dynamite the sewers!\u2014the UK\u2019s shameful record on poverty - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/01\/23\/nick-hopkinson-dynamite-the-sewers-the-uks-shameful-record-on-poverty\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Nick Hopkinson: Dynamite the sewers!\u2014the UK\u2019s shameful record on poverty - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Installed in his first job in the poverty-stricken Welsh Valleys, young Dr Manson, the hero of AJ Cronin\u2019s 1937 classic The Citadel\u00a0is faced with a cluster of cases of typhoid. 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