Health, welfare must be protected from cuts, says WHO

Ireland ranks high for inequality and alcohol consumption, new report finds

Welfare policies must ensure that the vulnerable do not bear a disproportionate share of the burden, the lead author of the WHO report said. Photograph: Cyril Byrne
Welfare policies must ensure that the vulnerable do not bear a disproportionate share of the burden, the lead author of the WHO report said. Photograph: Cyril Byrne

Social welfare and health spending should be protected from International Monetary Fund and European Union-led demands for austerity, a major report from the World Health Organisation (WHO) argues.

The consequences from “the financial crisis threatens a public health emergency, and inaction will lead to a worsening of social, economic and health burdens”, while youth unemployment “is a public health time-bomb waiting to explode”, it warned.

However, the lead author of the WHO report, London-based academic Prof Sir Michael Marmot, has drawn a distinction between Greece, Spain and Portugal, on one hand, and Ireland – saying the first three countries should "stand up to the people who are telling them to make cuts".

Ireland, he said, was different: “My impression is that for the vast majority of Irish they are not quite as depressed as they were a year ago, or two years ago. Then there was doom and gloom and a feeling that there was no way out.

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“People are feeling a little more upbeat and that they are coming out the other side,” he said, but he added that welfare policies must ensure that the vulnerable do not bear a disproportionate share of the burden.

Ireland is one of the most unequal countries among the 53 countries in Europe examined by the WHO, where the top 20 per cent have on average almost five times the income of those in the lowest fifth. Ireland ranked fifth most unequal, according to the Gini coefficient league table on income distribution.

Heaviest drinkers

The Irish also remained among Europe's heaviest drinkers, coming behind Bosnia and Herzegovina, Belarus, the Czech Republic, Luxembourg and Republic of Moldova, but just in front of Lithuania, Romania and Latvia.

Citing 2009 figures, the WHO found that child poverty numbers fell in Ireland by about five percentage points on 2005, despite austerity – compared with Bulgaria, Greece, France, Germany and Sweden, where it increased.

However, this meant that nearly one in two Irish children in 2009 were still born into homes which had less than 60 per cent of median income – the international definition of poverty, though this number fell to 17 per cent once the impact of welfare benefits was felt.

Refusing to accept declarations from politicians in Europe that they are strapped for money, Prof Marmot quoted the WHO’s slogan for its Health 2020 campaign by saying that each should “do something, do more, do better”, because every action improved the situation.

Slovenia has used welfare payments better than most other countries to cut child poverty, beating countries such as Sweden: "You have to make a decision that you want lower rates. Slovenia has shown that it can be done," said Prof Marmot.

A child's early years are crucial, since the research gathered over three years shows that a child who does not attend pre-school is still behind peers who did attend even when he or she is 15 and 16 years old, he said in London.

Suicide figures

“These are children we are talking about, forget about left, or right, or whatever else. We have the evidence to make a difference in our children’s lives,” he said. He pointed out that suicide and homicide figures rise in more difficult times.

Life expectancy across Europe varies wildly: with a gap of 17 years between the best and the worst countries for men and 12 years for women. Ireland is placed in the second of four categories, alongside Germany, Norway, Finland, the Benelux countries and Austria.

Predictably, the worst figures are found in eastern Europe, Turkey and the Balkans. National wealth, however, is not a guide in all cases, since Georgians, with $4,774 (€3,467) average GDP, live an average of 73.8 years, while Ukrainians, with $6,318 (€4,588) average GDP, live for three years less.

Mark Hennessy

Mark Hennessy

Mark Hennessy is Ireland and Britain Editor with The Irish Times