Dr Koldo Casla, Institute of Health and Society, Newcastle University – Written evidence (FPO0012)
- The Select Committee has been appointed by the House of Lords to “consider the links between inequality, public health and food sustainability”.
- This submission focusses on questions no. 3 (factors or barriers affecting people’s ability to consume a healthy diet), 13 (existing research on the links between poverty, food insecurity, health inequalities and the sustainability of food production), 14 (lessons from other countries) and 15 (additional policy changes that could help).
Questions no. 3 and 13: The negative health impact of a feeble social protection system
- As a Party to the International Covenant on Economic, Social and Cultural Rights (ICESCR), the UK must take steps to the maximum of its available resources to achieve progressively the realisation of economic, social and cultural rights, including the right to social security, the right to health and the right to an adequate standard of living (Art. 2(1), 9, 11 and 12). To comply with human rights standards, adjustments that lower the protection of the welfare system have to be temporary, necessary and proportionate, cannot be discriminatory, must mitigate inequalities and ensure that the rights of most disadvantaged people are not disproportionately affected.
- As pointed out by several international human rights bodies and research groups, tax and social security cuts since 2010 have not met the mentioned requirements of non-retrogression and have therefore breached the human right to social security: a) The measures have not been justifiable in terms of the goals they were meant to achieve, b) they have disproportionately affected poor families with children, lone mothers and non-white families, among other groups, (c) the effects have been discriminatory in relation to income and protected characteristics, d) the weight of local government funding cuts has fallen on people at risk of harm, discrimination and disadvantage, and e) benefit sanctions have been harmful and largely ineffective.
- The Select Committee is interested in the existing research on the links between poverty, food insecurity and health inequalities.
- There is evidence that the UK’s austerity programme on social security has had a disproportionate impact on the health of individuals in a vulnerable situation, including children, and people on low income or in receipt of welfare benefits. Reductions in local authority social care budgets may be a causal factor in the stalling of life expectancy in England. The gap in infant mortality rates between the most deprived local authorities and the rest of England narrowed by 12 infant deaths per 100,000 births per year between 1999 and 2010, but since 2011 the gap has been increasing at a rate of 4 deaths per 100,000 births per year. According to the Office for National Statistics, life expectancy for women born in deprived areas has declined in recent years.
- The Health Foundation has documented how poor health can have significant social and economic consequences. People with a long-term health condition have an economic activity rate of 68%, a fifth lower than for those without a long-term health condition, and those of working age in poor health are 50% more likely than healthy individuals to experience income poverty. Health status also has important implications at an aggregate level for the national tax base and economic dependency ratios, namely, the number of non-working people for each person in paid employment. Avoidable poor health carries a high financial cost for society, manifesting across several different areas of government spending, including the costs of treating illness in the NHS, the costs of supporting people whose poor health means they need assistance from the social care system, and the costs to the social security system through a range of benefits. The Institute for Fiscal Studies estimates the total cost of all of these at around £200bn, or 7% of GDP in 2016/17, and these costs have risen considerably in recent years.
Questions no. 14 and 15: Respect, protect and fulfil the right to food and other socio-economic rights
- Many of the issues with the food system are not caused by a physical lack of enough food in the UK, but rather by issues around its production and accessibility, especially for those on low incomes. Undernourishment says nothing about the quality of the food consumed on a macronutrient level, nor where the food was obtained from, nor whether it was actually sufficient to the needs of the individual.
- In a recent response to a written PQ, the Parliamentary Under-Secretary of the Department for Environment, Food and Rural Affairs (DEFRA), Zac Goldsmith, admitted that “DEFRA is not responsible for the supply of food and drink to the population in an emergency, and the expertise, capability and levers to plan for and respond to food supply disruption lie within the industry”. This denial of responsibility is the living expression of the lack of a human rights-based approach to food.
- The Select Committee is interested in policy recommendation potentially based on examples from other countries and jurisdictions.
- If and when the UK leaves the European Union, EU Law on consumer rights, equality, environmental protection or workers’ rights will no longer apply as it has applied so far. Parliament, and in some circumstances Government through statutory instruments, would be able to amend and lower or erase the level of protection currently provided by EU Law.
- It is now more pressing than ever to bring into national law international treaties on socio-economic rights, including the right to food as part of an adequate standard of living (Article 11 ICESCR). Like virtually all other countries around us, the UK has signed and ratified ICESCR and other international conventions. However, unlike other countries, the UK has failed to recognise the rights contained therein at the domestic level.
- There are several models of incorporating economic and social rights into a country’s legal system that the UK could learn from. Over 90% of the world’s constitutions recognise at least one socio-economic right. In around 70% of them at least one of these rights is explicitly enforceable in court, and 25% recognise ten or more socio-economic rights as judicially enforceable, particularly those relating to education, trade unions, healthcare, social security, child protection and the environment. The Finnish constitution, for example, imposes the obligation on parliament to legislate for the protection of socio-economic rights, and a widely respected parliamentary committee leads a thorough oversight of this constitutional responsibility. Canadian courts have the power to strike down legislation if it contravenes the constitutional bill of rights, and courts normally give parliament and government a period to comply with judgments. The South African system creates the expectation that public authorities will adopt reasonable measures to improve the enjoyment of the rights to housing, health and food. In some circumstances, people in South Africa can claim compensation in court if they think they have been victims of public decisions that do not meet that principle of reasonableness. The Spanish constitution establishes that the constitutional bill of rights must be interpreted in accordance with international human rights law, which is part of the domestic legal order.
- Parliament could consider adopting a horizontal piece of legislation that either incorporates ICESCR, or another international treaty, into national legislation or recognises a set of socio-economic rights, including food, social security, education, housing and health, in light of international human rights law. Beginning with a requirement for public authorities to have due regard to these rights, over time it could be elevated to a requirement of compliance (“sunrise clause”). This is the model proposed by the Advisory Group on Human Rights Leadership of the First Minister of Scotland. This Act of Parliament would compel public authorities to assess the cumulative impact of their policies on socio-economic rights (food and others), and it would give judges the power and the responsibility to hold public authorities to account.
- Alternatively, or at the same time, Parliament could adopt a piece of legislation specifically on the right to food. The Scottish Government has recently restated their intention of bringing forward a Good Food Nation Bill in 2019/20. While it is too early to tell what the Bill will look like in practice, if done properly it could provide a new framework for a coherent food policy, facilitating a transition to a fair, healthy and sustainable food system that ensures access to nutritiously adequate, accessible and affordable food, as expected in international human rights law.
- Austerity-driven social security reforms of recent years have had negative effects on health inequalities and food insecurity in the UK. Recognising the right to food and other socio-economic rights in law and policy could contribute to improve health outcomes.
This submission is made in an individual capacity by Dr Koldo Casla, Research Associate, Newcastle University.
11 September 2019
 UN Committee on Economic, Social and Cultural Rights (CESCR), Letter by the Chairperson of the CESCR to States parties to the ICESCR, 12 May 2012. See also CESCR, Public debt, austerity measures and the ICESCR: Statement by the CESCR, 24 June 2016, UN doc: E/C.12/2016/1, para. 4.
 UN Special Rapporteurs on Housing, on Rights of Persons with Disabilities, on Extreme Poverty, and on the Right to Food, “Joint letter to the UK Government”, UN doc. AL GBR 1/2016, April 2016, p. 12; CRC, Concluding Observations: UK, July 2016, UN doc. CRC/C/GBR/CO/5, para. 66 and 69-70; CESCR, Concluding Observations: UK, July 2016, UN doc: E/C.12/GBR/CO/6; para. 40-42 and 47-48; CRPD, Inquiry concerning the UK, 2016, UN doc. CRPD/C/15/R.2/Rev.1; ECSR, Conclusions XXI-2 (2017) United Kingdom, January 2018.
 Find references in: Just Fair and others, Welfare Safety Net Inquiry – Written submission to the HC Work and Pensions Committee, December 2018.
 Clare Bambra (ed.), Health in Hard Times: Austerity and Health Inequalities, Bristol University Press, 2019.
 Lucinda Hiam and others, “What caused the spike in mortality in England and Wales in January 2015?” Journal of the Royal Society of Medicine, 2017, Vol. 110, No. 4.
 Tomos Robinson and others, The impact of New Labour’s English health inequalities strategy on geographical inequalities in infant mortality: a time-trend analysis, Journal of Epidemiology & Community Health, 2019, Vol. 73, No. 6.
 Office of National Statistics, Health state life expectancies by national deprivation deciles, England and Wales: 2015 to 2017, March 2019.
 Health Foundation, Creating healthy lives: A whole-government approach to long-term investment in the nation’s health, September 2019, Chapter 3.
 Koldo Casla and Imogen Richmond-Bishop, “UK: Only a drastic change in direction will bring about the SDGs”, Spotlight on Sustainable Development 2019, edited by Social Watch.
 Written question 281010 by Caroline Lucas MP, of 23 July 2019, answered on 6 September 2019.
 Katie Boyle, Models of Incorporation and Justiciability for Economic, Social and Cultural Rights, SHRC, 2018.
 Courtney Jung and others, “Economic and Social Rights in National Constitutions”, American Journal of Comparative Law, 2014, Vol. 62, No. 4.
 Koldo Casla and Peter Roderick, “The UK must protect economic and social rights with a new law – here’s what should change”, The Conversation, April 2019.
 https://humanrightsleadership.scot/ See also the consultation and background documents on the Draft Bill on Economic, Social and Cultural Rights drafted at Newcastle University with colleagues from other universities and civil society: https://research.ncl.ac.uk/article22/
 Scottish Government, Programme for Government 2019/20, September 2019.
 CESCR, General Comment No. 12: The right to adequate food, 1999, UN doc: E/C.12/1999/5.