The troubling and “inextricable” link between poverty and health has been laid bare in an eye-opening new study, as a food bank reveals more than two-thirds of its users are disabled.

A study from The Health Foundation published on Tuesday (4 June) found that more than a quarter of adults aged 18 to 55 (26%) who live in households in persistent poverty rate their health as “less than good”. This is higher than for adults in non-persistent poverty (22%) and not in poverty (16%). 

The research found that people living in persistent poverty had the worst health of any of the three groups between 2021 and 2022. 

The study authors explained that the experience of “prolonged periods of poverty” can have long-term effects, for example the “build-up of chronic stress”. 

Food banks have corroborated this research, with The Trussell Trust explaining that “living on a very low income often leads to people’s mental and physical health worsening over time”. 

Helen Barnard, director of policy at The Trussell Trust, told Big Issue that more than two thirds (69%) of the people referred to its food banks are disabled, and that disabled people face hunger at a rate of two and a half times that of non-disabled people. 

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Charlotte White, a former food bank manager in the Independent Food Aid Network (IFAN), added that living in poverty can exacerbate poor health, as “often small health issues become big ones, as things are left untreated”. 

She told Big Issue: “At the food bank I ran for four years, we definitely had a disproportionate amount of people with health issues, both physical and mental. I would estimate that over 50% of our guests had some kind of health issue.”

She explained that poverty and health can go hand-in-hand, as some food bank users “had long-term chronic health issues that they had been struggling with for a long time, resulting in them being unable to work, and often battling the system to get PIP [personal independence payments]”. 

On the other hand, she says, “there’s also a big barrier for people in poverty accessing healthcare, especially with the ‘digital as default’ system.”  

“Who can wait for hours on a mobile phone when you barely have any data and can’t afford to charge the phone, as there’s no electricity in the meter? Who can book on the online appointment system with no WiFi or perhaps language issues?”

Previous research has highlighted that poverty can affect health in numerous ways – not being able to afford period products, for example, can lead to the use of unsuitable products like old clothes and sponges, which can then cause infections.

Barnard added that without the next government tackling poverty after the upcoming election, “we risk these unacceptable levels of hardship becoming baked into our society.” 

“The next government must prioritise tackling poverty if it is to improve the nation’s health, reduce pressures on the NHS and other public services, and reinvigorate the UK’s economy,” she said. 

“We have to see reform to universal credit so it gives better protection from going without the essentials, and improved support for disabled people with faster access to disability benefits.”

White added: “More GP appointments are desperately needed, and an easier, more inclusive way for anyone to access them. And when there is a health issue impacting the ability to work, the process for PIP needs to be much smoother and quicker.”

Big Issue is demanding an end to poverty this general election. Will you sign our open letter to party leaders?

Do you have a story to tell or opinions to share about this? We want to hear from you. Get in touch and tell us more.

The Liberal Democrats have promised to extend free school meals to all primary school children, challenging Labour to match the pledge made by party leader Ed Davey. 

The Lib Dem leader announced the policy on Friday (31 May), which would ensure all primary school children have access to free school meals – beginning with those in poverty, estimated to be 4.2 million children in the UK. 

Currently, the government only provides free meals for children in reception, year one and year two, and to children who meet family income conditions in year three and above. 

The Child Poverty Action group estimates that 900,000 children living in poverty in England miss out on free school meals, a figure which Davey said should make Conservative MPs “hang their heads in shame”. 

I might not be making it to Bake Off anytime soon 👨‍🍳

Today I announced the Liberal Democrats' plan for free school meals, which would save parents money and transform the future for millions of children. pic.twitter.com/utv0qkxpOb

— Ed Davey (@EdwardJDavey) May 31, 2024

“Across the country, I hear heartbreaking stories of children going to school with empty packed lunch boxes as parents struggle to cover even the basic costs,” Davey said in a statement, adding that the pledge would “transform the future for millions of children”. 

“Children cannot be expected to learn on empty stomachs with no guarantee of a hot meal when they get home.”

Davey added in an interview with the Guardian that the case for free school meals for primary-aged children is “overwhelming”. 

“We believe in social justice… If we can get some Liberal Democrat MPs in the next parliament, many more of them, these are the things we’ll provide for.”

The £500m cost of the promise would be covered by introducing a 4% share buyback tax, which the party estimates would raise £1.4bn. 

• Free school meals: Who is eligible? And how do you apply? Here’s all you need to know
• 90,000 people sign open letter to Rishi Sunak demanding free school meals for all

The Liberal Democrats’ pledge on school meals is mirrored in the Big Issue’s Blueprint for Change, a call for whichever party that comes out on top at the general election on 4 July to introduce policies to help those living in poverty in the UK. 

Each of the Big Issue’s calls comes under one of the five poverty prevention pillars we believe will help dismantle poverty and change lives through enterprise – housing, health and wellbeing, learning and employment, financial and digital inclusion, and environment and community.

The Blueprint for Change goes one step further than Ed Davey’s pledge, however. We’re calling on politicians to provide universal free school meals to all school-age children, including outside of term time. As well as providing a lifeline to children in poverty, research has found that expanding free school meals could generate billions for the economy across health, education and social sectors. 

Big Issue is demanding an end to poverty this general election. Will you sign our open letter to party leaders?

‘Parties must invest in the health and futures of young people’

While child poverty charities have welcomed the Lib Dems’ policy proposal, many have claimed it does not go far enough, and free school meals should cover all ages. 

“The Childhood Trust welcomes the Liberal Democrats’ proposal for free primary school meals,” Laurence Guinness, CEO of The Childhood Trust told Big Issue. 

“While this is progressive, with child poverty levels at an 11-year high, it needs to be for all school children, not just primary aged pupils. 

“Ensuring all children receive proper nutrition throughout their education supports children to focus on learning and developing instead of going hungry and failing academically, with disastrous life consequences. 

“We urge all parties to make universal free school meal provision a top priority to invest in the health and futures of our young people.”

Commenting on the free school meals pledge, Daniel Kebede, general secretary of the National Education Union, said: “The NEU welcomes this commitment from the Liberal Democrats to extend free school meals to all primary children. There is a growing political consensus about the benefits of universal free school meals – we have seen Labour’s London mayor, the Welsh Labour government and the SNP in Scotland all take a lead on the matter.

“The NEU is calling on all political parties to commit likewise in their election manifestos.

“A hot, healthy school dinner helps children concentrate better in class and thrive in school. It removes the stigma from families who need this vital support and helps foster strong community relationships in the dinner hall – and it has taken welcome pressure off parents who are trying to make ends meet. It is about time that all children across England have access to a free school meal.”

Do you have a story to tell or opinions to share about this? We want to hear from you. Get in touch and tell us more.

Labour has the “historic opportunity” to “reverse” NHS privatisation in its first term in government.

Some 94% of NHS outsourcing contracts are set to expire during the next parliament, according to analysis by public ownership campaign group We Own It. The next government will inherit 7,452 outsourcing agreements – of which 6,983 will expire before 5 July 2029. 

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Actor and comedian Stephen Fry has described it as a “historic opportunity” to take these contracts back into public hands.

“As We Own It’s analysis shows, they can make a serious difference in reinstating the NHS as the fully public service their party founded it to be, if they choose to,” he said.

Big Issue is demanding an end to poverty this general election. Will you sign our open letter to party leaders?

“Politicians have historically presented outsourcing as a neutral choice, but it clearly isn’t. It’s resulting in billions leaving public services in the form of profits, which could instead be used to provide a better service to everyone. And as we see with water, the railway and the NHS, it has not worked.”

Labour recently unveiled plans to take almost all private railway contracts back into public ownership as they run out. Campaigners are calling on the party to do the same with the NHS.

“Only the NHS has A&Es, trains doctors and treats everyone however complex their case may be. Building up the NHS to treat everyone who needs care is the most efficient and effective reform a Labour government could introduce,” said Johnbosco Nwogbo, lead campaigner at We Own It.

“The first step is to take back NHS outsourcing contracts when they expire. Labour will get a chance to do right by the NHS, and the public is looking to them to protect the NHS.”

How much of the NHS is privatised?

In 2014, a Commonwealth Fund study ranked the NHS as the best healthcare system in the world and the second-cheapest of those analysed. But years of underfunding have wrecked its track record.

Around 7.61 million people are on elective waiting lists in England alone, while a staggering 1.5 million patients in England waited 12 hours or more after arriving at A&E over the past year.

Privatisation, Nwogbo says, is largely responsible for this decline.

The NHS was launched in 1948, with the aim of providing medical care for everyone, “rich or poor.” For decades, this principle was politically unassailable; in 1982, Margaret Thatcher’s suggestion of compulsory private insurance prompted a revolt.

Nonetheless, the 1980s saw non-clinical services – like cleaning, catering and laundry – put out to competitive tender. In the 1990s, Tony Blair’s new Labour further sped up privatisation, allowing private companies to borrow money to build hospitals, charging the NHS trusts ‘rent’ for them.

Nonetheless, health care remained the responsibility of the publicly owned NHS – until everything changed in 2012.  

The 2012 Health and Social Care Act required that all NHS contracts be put on the ‘open market’ for private sector bidding.

It’s worsened healthcare, research shows. A recent University of Oxford study published in Lancet Public Health has linked NHS privatisation to the preventable deaths of 557 people.

Dr Ben Goodair, a University of Oxford public policy researcher, said that the new government should reconsider the “ongoing privatisation” if it wishes to “prioritise the best quality healthcare“.

“This newly presented analysis by We Own It highlights the huge scale of NHS outsourcing, which has been rising consistently over the last two decades,” he added.

“The latest academic evidence, in part produced by me and my colleagues at the University of Oxford, suggests this is a concerning trend for quality of care – as for-profit provision of NHS services is linked with worse patient outcomes, including higher mortality rates.”

For-profit private companies stand to make more than £1bn in profits from the 7,452 contracts the next government is set to inherit. We Own It claims this money could help the NHS hire more than 27,000 NHS nurses at £37,000 each per annum, or cover the cost of knee replacement surgeries for at least 71,000 NHS patients on waiting lists.

Christine Cooper, professor of accounting at the University of Edinburgh, said that the plan for the government to take back control of private contracts was “sensible and workable”.

“The rationale presented in support of privatisation was that the provision of public services by the private sector would mean better, more efficient services at lower cost and investment to modernise old-fashioned systems.

“The evidence suggests that measures to bring back outsourced contracts would enable better public services at lower cost. Whether to outsource to the private sector is no longer a question of ideology, it is a question of economic interest and empirical evidence.”

Women experiencing homelessness face such difficulty in accessing period products that they are forced to use “unsafe alternatives” such as old clothes and sponges, charities have warned.

This is not only “uncomfortable and embarrassing” but can put them at risk of “serious health issues”. In some cases, people have reportedly resorted to stealing sanitary towels and tampons.

Women who took part in the recent women’s rough sleeping census talked about how difficult it was to access period products and manage their personal hygiene.

• Women who are sleeping rough are often hidden. It’s a much bigger problem than anyone thinks
• Where to find free toiletries, period products and nappies in the UK

The census is a pioneering project which saw women’s organisations and homelessness charities trace the number of women sleeping rough in London, showing that the true levels are far higher than official statistics suggest.

Lucy Campbell, head of multiple disadvantage at the Single Homeless Project which helped organise the census, said: “Managing their periods while having nowhere safe to sleep or wash compounds what is already a dangerous and life-limiting situation.

“Women report struggling to access toilet and bathroom facilities, having nowhere to wash their clothes and no access to products.

“This means they have to rely on unsafe alternatives such as old clothes or toilet paper. This is not just uncomfortable and embarrassing – it puts women at risk of serious health issues.”

Single Homeless Project, alongside other homelessness and women’s sector organisations, is calling on the next government to do more to resolve women’s rough sleeping and prevent it from re-occurring.

It suggests that a practical measure that could be immediately is creating walk-in, 24-hour staffed, gender-informed women’s centres in all local authorities providing support to access accommodation as well as clean toilets and washing facilities and free period products.

Homelessness among women is often hidden. It is dangerous for women on the streets so they turn to other methods: sex work, sofa surfing, sitting in fast food restaurants and cafes or riding buses. These women, out of sight, are largely missed from official homelessness statistics.

That is why the women’s rough sleeping census was launched, and it is also why there is relatively little research into period poverty among people facing homelessness.

Researchers at the University of Southampton, Polly Hardy-Johnson and Stephanie Barker, are seeking to change that. They recently published a study which looked into the experiences of women facing homelessness during their periods.

Its review of research found that women are being forced to use sponges, old clothes and used menstrual products during their periods.

Hardy-Johnson said: “Even when you have an abundance of products and they’re good quality products, periods can be difficult enough. I’ve interviewed teenage girls who have spoken about the embarrassment of coming on your period at school, and then to think that if you can’t then go home and stick your clothes in the washing machine or soak them in water, then what do you do?”

Women facing homelessness are sometimes refused entry to public bathrooms, the study showed, and they are having to rely on charities and local authorities to get period products.

Barker added: “I think what shone out to me was that women might be making themselves more vulnerable by, for example, stealing menstrual products because it’s a necessity. It’s something they need rather than something they are choosing to need.”

Now, Barker and Hardy-Johnson want to go further and create a project which smashes taboos about menstruation for people facing homelessness.

Barker said: “We’re going to give people cameras and ask them to document visually what it is like to menstruate while you’re homeless. We’re planning to have an exhibition around November time to showcase that and then also have some policy recommendations, because I suspect that there are few if any existing policies.”

The Marylebone Project is the largest women’s homelessness charity in the UK. Its executive manager, Amy Hull, explained that women and people experiencing homelessness who also menstruate are at a “huge disadvantage when accessing menstrual care”.

Even with the scrapping of the tampon tax, period products remain expensive, but the problem extends beyond affordability.

“Many lack access to proper facilities for changing products or showering, and they often feel uncomfortable managing ‘period admin’ in male-dominated, mixed-gender hostels,” Hull said.

“Menstrual health is further complicated by menopause, conditions like PCOS and endometriosis, and overall gynaecological health. Many delay seeking medical care for cycle-related issues due to sexual trauma, shame, or stigma.

“The lack of proper facilities exacerbates these challenges. Stress, poor sleep, and inadequate nutrition can cause some people to stop menstruating altogether while others may experience heavier, more unpredictable periods, reflecting the instability of their living situations. These issues have a spiral effect, impacting mental health and dignity, often pushing individuals further away from community, employment, and support, and deeper into homelessness.”

The Marylebone Project is open 24/7, 365 days a year. Its facilities include pads and tampons in our toilets and a full range of products at reception, from menstrual cups to period underwear. It also offers various healthcare support services, including workshops on menopause, PCOS, and endometriosis, as well as connections to GPs and gynaecological services.

The Single Homeless Project also has advice on where to get help.

Big Issue is demanding an end to poverty this general election. Will you sign our open letter to party leaders?

Picture the scene. You’ve had a long, hard day at work, and you reach for your phone – who doesn’t? – for a bit of mindless downtime.

Cue the content avalanche.

World War Three, cost of living crisis, climate breakdown. A video of an adorable bunny eating some lettuce. Then a dispatch from a war zone.

If you can’t look away, you’re not alone. Some 43.8% of people exhibit ‘severely or moderately problematic’ habits of news consumption, according to a 2022 study – and their physical and mental health suffers as a result.

It can be overwhelming, says Rosie Weatherley, information content manager at Mind.

• How can you cope with money worries in the cost of living crisis? We asked experts at leading mental health charities

“With the increase of digital media and the 24/7 nature of the news cycle, people are exposed to a constant stream of information, some of which can be negative or sensationalised,” she said.

“Coverage can seem constant and for many of us these issues aren’t only in the headlines – they impact our daily lives. This can heighten feelings of anxiety, hopelessness, grief and feeling unable to stop scrolling, particularly when faced with repeated exposure to distressing events.”

The deluge of negative headlines shows no signs of abating. But there are, according to experts, some ways that you can cope.

Limit your news intake

The simplest option is turning off your phone. But ‘doomscrolling’ – compulsively scanning through terrible news – is addictive. It’s also ubiquitous: the average person spends three hours and 15 minutes per day trawling negative content. Over the course of 12 months, this adds up to a whopping 1,149 hours – or 47.9 full days.

It’s unpleasant, anxiety-inducing – and strangely addictive, explains Campaign Against Living Miserably (CALM) CEO Simon Gunning. “Our brains are sponges for negativity,” he says.

Humans evolved to assess and mitigate threats. It’s this wariness that kept our hunter-gatherer ancestors alive – but it’s utterly overwhelming in the age of the smartphone.

Barraged with threats, scrolling gives us a “false sense of control”, writes Dr Jade Wu.

“When we scroll endlessly through the news, even when it’s bad news, it makes us feel like we’re gaining information or that we’re creating a plan,” she explains. “This may be true for the first few headlines, but once you’re on the seventeenth article about spiking cases or race-related riots, how much value is each one adding?”

Stepping away from your phone is hard, Wu concedes. But it’s really important. She advises setting time limits on apps, and going to newsfeeds with a specific purpose. Noticing what prompts the tendency to scroll is useful, too – are you more likely to reach for your phone when you’re already feeling anxious? Observing patterns can help you check the impulse.

Stopping scrolling is hard. But it’s worth it, says Gunning.

“Limit the time you spend doom scrolling, make sure this isn’t the last thing you’re doing before you go to bed, and balance the negative with some positivity by looking at a ridiculous video of a dog riding a skateboard,” he says.

Focus on what you can control

The news is often relentlessly terrible. And when ‘World War Three’ trends on X, formerly known as Twitter, it’s normal to feel helpless.

Mind urges people to focus on what they can control. They recommend ‘focusing your thoughts’ by making a list of the things you can change, and the things you can’t.

“Try to notice positive things in your life that are staying the same, despite other things feeling uncertain,” they advise. “[And] try to distract yourself from the things you can’t control – for example with a relaxation exercise.”

Weatherely suggests practicing self-care activities such as mindfulness, exercise and getting out in nature.

Exercises like this can help you maintain perspective, Gunning adds.

“It is actually healthy to allow yourself time to worry, but it’s also important to let it go. And then focus on the things you can control – see your mates, write yourself a to-do list or get involved with a charity that’s doing something you care about.”

Get involved with a cause you care about – but know when to ask for more help

Indeed, engaging with the news healthily doesn’t mean switching off from the issues that matter to you. You can channel some of your feelings of despair into positive actions.

A 2022 paper from the Yale School of Public health found that “engaging in collective action” can “buffer the effects of climate change anxiety and prevent it from leading to feelings of sadness and hopelessness that would be consistent with major depression”.

Coping with negative news doesn’t mean fully disengaging from society, Wu says.

“The goal here is not to crawl under a rock and pretend that everything is peachy and never look at the news again,” she explains. “Nor is it to disconnect from the social and political happenings that require our participation now more than ever.”

“Being informed and participating in civic life is important. Interacting with friends is important… but let’s do it in a way that is intentional, that creates value for our lives.”

Positive ways to channel stress about the state of the world include volunteering and campaigning, which is also a great way to meet likeminded people. You can find a list of volunteer organisations here.

If you are particularly stressed about global human rights breaches, GOV.UK has some advice about how to safely donate or volunteer to aid humanitarian disasters.

Engaging in meaningful activities that contribute to our community can provide a sense of purpose and agency, Weatherley said. But It’s not your responsibility alone to tackle big problems.

“It might not always feel possible to do this [volunteering] and that’s OK. Remember, it’s not your sole responsibility to tackle big societal problems,” she said.

“If your feelings are very upsetting and long lasting, or are preventing you from enjoying your life – you might want to reach out for support. It’s always ok to ask for help.”

Mind have more information about seeking help here.

Tessa thought she was going to die when giving birth to her son. It happened quickly. She screamed out in pain but was hushed by midwives. She pushed the baby out herself without anyone but her husband by her side, tearing through her body and losing blood.

“It was honestly complete fear,” the 36-year-old recalls. “My only thought was that I didn’t think we were going to make it. I just recall expressing to the midwives that this pain is too much for me to bear. I was in extreme pain. It accelerated so quickly. 

“I didn’t know it was the end of the labour. I felt like this was the beginning and I thought if I had to go on any longer trying to get this baby out, I was not going to survive it.”

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Tessa believes her pain was dismissed because of racial prejudices. Black women are nearly four times more likely to die during pregnancy, childbirth and six weeks after birth in the UK, according to official maternal mortality rates.

Clotilde Rebecca Abe, co-founder of grassroots organisation Five X More which is on a mission to change Black maternal health outcomes in the UK, said: “This a devastating figure, but just five years ago, this number was even higher. There are still too many Black women experiencing traumatic births, and sometimes heartbreaking birth outcomes.

Tessa was induced at 39 weeks when her son was born five years ago. The labour progressed very quickly and she gave birth within an hour. She repeatedly told her midwives that it was moving faster than she had expected and it was hurting deeply. She says she was only offered paracetamol.

“They were not listening to me,” she says. “They were saying: ‘You still have some time left. We’re going to go around and check on everyone else.’ I was about 4cm dilated. Within a few minutes, I started screaming because the pain was so intense. I just looked at my husband and I was like: ‘I literally don’t know if I can continue with this.’ The other midwife came over to me and asked me to be quiet. ‘Can you stop shouting?’”

Tessa was in triage at this point. She had not even made it into the labour ward at the Royal London Hospital yet.

“She asked me to stop screaming because there were women in the waiting room and I was scaring them,” Tessa recalls. “I was in so much pain I didn’t care. The midwife said she was going to go and get a room ready. The other one walked across the other side of the room. I just held on to my husband and screamed and I pushed my son out myself. The midwife ran over. She was in shock.

“The baby was fine. The baby was safe. I didn’t feel right. They whispered to each other and pressed the emergency alarm. A lot of people came running into the room. Everyone was saying there was a tear. I lost a lot of blood. There was no reassurance. No one told me that it was going to be OK. I didn’t know what was going on. I just thought I’m gonna die.”

Tessa was taken to another room to have stitches, and she was hooked up to a catheter and a drip. She claims she was left unattended for hours, from around 1pm until the night shift, except for the odd person coming in to offer them food.

“I was just given a tonne of medication with no other explanation to it,” Tessa says. “We came home on the Saturday and midwives normally attend the next day. No one came. I had to call them and tell them that no one’s come to check on us. I was someone who had lost a lot of blood. I was just told to take iron tablets. I was basically unwell for four months after.”

Tessa believes there were racial injustices at play. “Most of my midwives were Black women,” she says. “But it’s almost like a slave mentality, like a Black woman is strong. You’re a Black woman, you can handle it, your body is strong. You’re made for this. No, my body’s not. If I feel pain, I feel pain. We don’t have to pander it down like I can handle it. I clearly couldn’t. And I clearly expressed that. I was told that it was all in my head.”

A Barts Health NHS trust spokesperson said: “We are sorry to hear that Tessa was unhappy with her experience giving birth at the Royal London Hospital. We encourage parents who have had a traumatic birth or who have complaints about their care to use our birth reflections services, we can also refer patients to birth trauma services for more specialist care.”

Tessa has been supported by Five X More, who raise awareness about the disparities in Black maternal health, advocate for change, and educate Black mothers on their maternity rights so they can advocate for themselves and get the right support when they are at their most vulnerable.

Tessa’s experience put her off having another child until very recently. Her son is now five and has an autism diagnosis, and she still has to fight to have her voice heard and advocate for him, but the birth of her youngest daughter six weeks ago was enormously positive. She was reassured throughout the whole process that this would not be allowed to happen again.

“There just needs to be care,” she says. “That’s it. Just care, consistency, continuity of care, and for us to be treated like any other individual.”

Do you have a story to tell or opinions to share about this? We want to hear from you. Get in touch and tell us more.

People from all backgrounds and identities sell The Big Issue, especially in the multicultural melting pot that is London. The pair currently donning the iconic red tabards on a bright spring day around King’s Cross station, however, are among the more unusual you’re likely to meet. They are John and Dame Mary Perkins. Dame Mary, along with her husband Doug, co-founded Specsavers in 1983. The company has grown to become the UK’s leading high street opticians and audiologists, a partnership of almost 2,000 locally run stores, with each store part-owned and managed by its own directors. Dame Mary and Doug’s son, John, is Group CEO and Head of Sustainability.

Partnership Goals

They are here to gain a deeper understanding of the challenges faced by people who sell The Big Issue, and to shape Specsavers’ ongoing initiative to support one of the most vulnerable groups in our society. Specsavers has partnered with Big Issue Group to give our vendors free eye tests, glasses and ear health checks. It’s part of a larger initiative by Specsavers to make an impact on homelessness in the UK, working with charities Vision Care for Homeless People (VCHP), Crisis and Simon Community, alongside Big Issue Group.

Lobbying for Change

In addition to providing practical, on-the-ground solutions like eye tests and free glasses, the company is also working with Big Issue founder Lord John Bird to lobby parliament to improve community-based eyecare and improve accessibility for everyone.

A Day as Vendors

Spending a day in the shoes of Big Issue vendors and working alongside people who do this day in, day out, is an eye-opening experience for the Specsavers team. “This is tough; have no qualms about it,” admits John. “You are out on your feet all day, you have to be vulnerable and have conversations with strangers as they walk past. This is really difficult.” For Dame Mary, a qualified optometrist with over 50 years of experience, the most shocking part is how invisible someone perceived to be in poverty can be, even in a distinctive red tabard. Often, people don’t want to acknowledge her at all. “I’ll put my hand up here and say I did try to give one away for free. I told them they didn’t need to pay, and they didn’t want a free one. It’s not easy to do this,” she says.

The vision I had was that we were there to change people’s lives through better vision, and that we were there for everyone

Dame Mary Perkins, co-founder of Specsavers

Fortunately, two experienced vendors, Lee Gibbs and Mick Morrow, are on hand to show Dame Mary and John how it’s done. Their crash course in selling The Big Issue syncs neatly with the philosophy in which Dame Mary founded Specsavers. “The vision I had was that we were there to change people’s lives through better vision,” she says. “And that we were there for everyone.” This commitment to inclusivity is at the heart of Specsavers’ partnership with Big Issue Group.

Addressing Accessibility

John explains: “It’s really important for us. We want to improve the accessibility of eye and hearing care for people experiencing homelessness. We believe that access to better care is a fundamental human right for everyone.” However, as Dame Mary and John discover during their day selling the magazine, there are significant barriers for some to access the care they need. Big Issue vendor Lee, who has been selling the magazine for two and a half years, shares the problems people can face accessing eyecare. “I have a number of friends who are almost off-grid, which means they’re not known to the system. So if they have to go somewhere and give their details, they won’t go. If the second question is, ‘What’s your address?’ that’s the end of the conversation.”

The Impact of Support

We believe it’s our responsibility as a market leader in optics and audiology to make a difference and to improve the accessibility of care. And that, fundamentally, businesses that have the ability to act, have the responsibility to act

John Perkins, Specsavers Group CEO and Head of Sustainability

John explains why Specsavers is taking action to address issues like these: “We know that one in three people experience problems with their eyesight if they’re also experiencing homelessness. But we also know that it’s very difficult to break that cycle if you’re having trouble seeing or hearing the things around you.” Lee highlights the importance of the Specsavers voucher scheme, which entitles all our vendors to free eye tests and ear health checks, and free glasses: “For me, the Specsavers voucher gives me a little bit of independence.” And he appreciates how welcome he felt when going into a store. “It felt like, ‘OK, Lee. They’ve got time.’ I was treated as normal.”

Responsibility

For John, his experience of selling the magazine reinforces Specsavers’ commitment as part of a wider ambition. “We believe it’s our responsibility as a market leader in optics and audiology to make a difference and to improve the accessibility of care. And that, fundamentally, businesses that have the ability to act, have the responsibility to act.”

Learn More

Find out more about how Specsavers is working to tackle homelessness across the UK at specsavers.co.uk/homelessness.

A new map has exposed the “enormous number” of NHS services that have been privatised across the UK.

Each of the 2,495 pins on this UK map – released by Medic-led campaign group EveryDoctor – represents an outsourced healthcare service run by an external provider.

“Funnelling money into private companies” compromises healthcare, warned the group’s chief executive Dr Julia Patterson.

“NHS privatisation introduces a profit motive into the delivery of healthcare, and that’s bad for everyone apart from company shareholders,” she said. “If we want to rebuild the NHS, politicians need to support NHS staff properly to deliver excellent care to patients.”

• ‘Fund the NHS properly’: Private sector is not the answer, Wes Streeting told, amid funding row
• Social care is on its knees. It’s no wonder public dissatisfaction is at a record high

The London School of Economics has estimated that there are 53,000 private contracts within the NHS, worth around £29bn a year. These constitute about a fifth of the entire health service budget.

Why is the NHS in crisis?

After years of Tory underfunding, the NHS is in crisis. Around 7.61 million people are on elective waiting lists in England alone, and the Royal College of Emergency Medicine estimates that lengthy A&E waits killed around 300 people per week in 2023. An eye-watering 1.5 million patients in England waited 12 hours or more after arriving at A&E over the past year.

Earlier this month, Labour shadow health secretary Wes Streeting reiterated his plans to introduce more widespread use of private resources in the NHS if Labour form the next government.

“Pouring more money in without reform would be like pouring water into a leaky bucket,” he wrote in the Sun.

But a growing body of research suggests that privatisation leads to adverse health outcomes.

A 2022 University of Oxford study linked privatisation to avoidable patient deaths, warning that outsourcing between 2013 and 2020 corresponded “with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of health-care services”.

Last month, the Lancet Medical journal conducted a global study of privatisation, concluding “at the very least, healthcare privatisation has almost never had a positive effect on the quality of care”.

But despite consistent adverse findings, UK health privatisation has been steadily increasing since 2012. The 2012 Health and Social Care act made it much easier for private companies to acquire NHS contracts, raising the maximum share of their income NHS foundation trusts can raise from private patients from an average of 2% to 49%.

In 2011, just 3% of NHS patients were treated by private companies. In 2022, this had jumped to 10%.

Earlier this month, Streeting’s comments sparked an impassioned backlash from anti-privatisation campaigners.

“Increasing outsourcing to private healthcare providers is not the answer. The solution is funding the NHS properly and investing so that it can develop its own capacity,” Johnbosco Nwogbo, lead health campaigner at We Own It, told the Big Issue.

Labour shadow minister Wes Streeting has warned that the NHS will get no extra funding from Labour without “major surgery” – but campaigners and unions warn that the plans could see doctors “spread even more thin.”

The shadow health secretary has said would not be put off by “middle-class Lefties” who accuse him of “betrayal” for using the private sector to bring down waiting lists.

“The NHS is a service, not a shrine. It is judged by how well it serves the public, not how heavy a price we’re paying for failure,” he wrote in the Sun.

Streeting said that a promised £1.1bn of funding will only come with an agreement to get the NHS operating throughout the weekend to slash lists.

He also vowed to use “spare capacity in the private sector” to the same end, and to digitise health records through the NHS app

But unions and focus groups have criticised his comments – urging him not to “leak out NHS profits” by ramping up privatisation.

“The NHS is not solely the concern of so-called ‘middle class lefties’, it concerns absolutely everyone,” said Johnbosco Nwogbo, lead health campaigner at We Own It.

“And increasing outsourcing to private healthcare providers is not the answer. The solution is funding the NHS properly and investing so that it can develop its own capacity.”

Dr Julia Grace Patterson, chief executive of the Every Doctor campaign, described the comments as “incredibly inflammatory.”

“It’s divisive and unhelpful to try and pit one group of voters against another,” she said. “Particularly at a time when millions of people are unable to access the treatment they need in the NHS.”

“If Wes Streeting is seeking solutions to the problems in the NHS, he should commit to a significant pay rise for NHS staff, he should commit investment to fix crumbling buildings, and he should commit to ending private outsourcing.”

What has gone wrong with the NHS?

As recently as 2014, a Commonwealth Fund study ranked the NHS as the best healthcare system in the world and the second-cheapest of those analysed.

After years of of Tory underfunding, the NHS is in crisis. Around 7.61 million people are on elective waiting lists in England alone, while A&E wait times are creeping up.

The median waiting time for all patients increased from two hours nine minutes in May 2011 to three hours four minutes in November 2023. And a staggering 1.5 million patients in England waited 12 hours or more after arriving at A&E over the past year.

Labour has promised to fix these issues if they are elected, with proposed reforms including requiring doctors to work weekend shifts and using spare capacity in the private sector.

“Pouring more money in without reform would be like pouring water into a leaky bucket,” Wes Streeting wrote in the Sun.

Nwogbo agrees that the current system isn’t working – but says that using the private sector is not the answer.

“Outsourcing leads to poorer quality care for patients,” Nwogbo said. “A recent University of Oxford study published in Lancet Public Health has linked NHS privatisation to the preventable deaths of 557 people.”

Labour could “reclaim its mantle as the party of the NHS,” Nwogbo said, if it pledged to reverse private profiteering in the NHS by bringing all contracts back in-house, supported by £40bn more per year in annual funding.

This sounds like a staggering amount, but the campaigners claim it would bring us on par with our European counterparts.

“According to Health Foundation and analysis, France spends £40bn more per year on health care than we do. Germany spends around £73bn more than we do. We must catch up,” Nwogbo said.

The British Medical Association agreed that the NHS needs to be reformed, but questioned the focus of Streeting’s reforms.

“At a time when waiting lists are at near-record highs, we recognise the need to use all available capacity, but increased use of the independent sector must be time-limited and cannot be a replacement for a longer-term credible plan to increase NHS capacity,” said Dr Latifa Patel, BMA representative body chair.

“There are workforce shortages and pressures across the board, with both the NHS and the private sector drawing from the same limited pool of doctors. Therefore, suggestions of ‘spare capacity’ need to be handled with a dose of realism. It should not be a case of shifting the problem to the private sector while making little difference to the overall backlog.”

More operations at weekends is a “fine ambition,” Patel added – but “where will the extra staff come from?”

“The doctors and healthcare workers needed are the same people exhausted from working all week – would Mr Streeting’s plan be to spread us even more thinly than we already are?”

“This is my happy place,” says Big Issue vendor Jack Osborne-Richardson, sitting on a bench and looking out over Bristol’s Berkeley Square, a small Georgian park that overlooks the city. Jack sells the Big Issue on nearby Park Street and returns to his favourite bench in the Square most days, to read, think, and feed his beloved crows, who all know him by sight and will literally eat out of his hand. “It’s amazing for my mental health,” he says. “It’s like regenerating sanity.”

If it wasn’t for his glasses, it’s a daily ritual that would be simply impossible for him. “My eyesight has always been terrible,” he says. “When I was younger, they didn’t realise my eyesight was bad and I was actually put in remedial classes. Then they did an IQ test and I scored off the charts and they realised the problem wasn’t my intelligence, it was my eyes. Since then, the first thing I’ve done every morning is put on my glasses, and the last thing I’ve done every night is take them off.” 

Being able to read books is of fundamental importance to Jack. “There was literally a time in my life where I was feeling intensely suicidal,” he tells us, “and the only reason I didn’t act on it was because the last book in [Robert Jordan’s fantasy series] The Wheel of Time was due out. Literally being able to read has saved my life on occasion.” 

Being able to see clearly is fundamental to quality of life. The problem is that glasses, or at least glasses with the correct prescription, aren’t always easy to come by if you’re living in poverty and always moving. Jack, who spent time sleeping rough before he sold the magazine, knows first-hand how scary and disorientating life on the streets can be if you have vision problems. “When you experience violence and things like that, they [your glasses] can get damaged which is terrifying — without being able to see you feel intensely vulnerable. If you don’t know who’s around you and who’s approaching you, then you’re not safe. Even if you’re not actually in danger, you still feel like you’re in danger. It’s a horrible feeling. You feel very vulnerable. Very alone.”

Eyesight is a critical aspect of well-being that we often take for granted. The ability to see clearly is intertwined with navigating daily challenges, recognising familiar faces, and engaging with the world meaningfully. Living without this clarity means not just a loss of detail in the world around you, but a profound impact on safety and mental health. The world becomes a place of unseen risks; every step outside is a venture into the unknown.

Specsavers’ partnership with the Big Issue provides a service for vendors that is both very simple and very profound. The partnership gives Big Issue vendors like Jack vouchers for full eye tests, including advanced eye health scans and glasses, at no cost. It also includes a full ear health check. These are simple things, but the benefits to someone’s quality of life are incalculable. This is especially significant because the free eye care available on the NHS can be difficult to secure for someone with a more transient lifestyle. It’s something Jack himself has found. “Eye care for me has often been very difficult to access,” he explains, “because I’ve never stayed in one place long enough.” 

Many homeless people tend to overlook their eye care needs for long stretches of time. A 2020 study  of 100 residents in Cardiff’s homeless shelters found that 50% hadn’t seen an optometrist in over five years. A survey of 168 people by Vision Care For Homeless People (VHCP), a charity that provides essential eye care services to people experiencing homelessness, found that 57% said they needed eye care. Over a quarter of those surveyed had lost or broken their glasses or had them stolen, with the average time spent without glasses being nearly a year.

Jack recently used his Specsavers vouchers for an eye test at a Specsavers store in Bristol. “They made me feel really welcome,” he says. “I genuinely felt like a VIP guest. They took me through the whole process. I was treated like a human being, and that’s not always the case everywhere.” 

For Jack, getting the right glasses has been transformational. “Having decent glasses makes all the difference,” he says. “You feel so much safer, you feel so much less vulnerable.” The right prescription also makes all the difference when he’s selling the magazine. “If you can recognise customers, you can properly react to them,” he tells us, “rather than treating everyone as fuzzy blobs that just walk past you.” 

And for Specsavers, this is about far more than donating glasses; it’s about working towards removing barriers in accessing eye and ear care, recognising the humanity and worth of every individual and ensuring they are not relegated to the periphery of society. It’s an embodiment of a community coming together to uplift its most vulnerable members, offering not just better vision, but a renewed sense of belonging and hope . 

Watch Jack in our new film below, and find out more about how Specsavers supports people experiencing homelessness at specsavers.co.uk