The findings, by Loughborough University’s Centre for Research in Social Policy (CRSP), also highlight a critical shift in public expectations of the health care system.

An annual budget of £200 to pay for private health treatments such as counselling or physiotherapy has been included in the annual Minimum Income Standard (MIS) for working-age adults for the first time in the study’s 16-year history.

MIS is calculated by adding up the cost of a basket of goods and services that the public agree are needed to meet material needs and to participate in society. These minimum baskets have been recalculated for all household types this year. [1]   

The Joseph Rowntree Foundation, who fund the work, said the research showed that the public feel they can no longer count on the NHS, and for millions with incomes which don’t reach this basic minimum, there is no spare cash to pay for treatment and little prospect of accessing necessary treatment before their conditions deteriorate.  

Drawing on their own experiences, members of the focus groups involved in the study said that accessing healthcare appointments was challenging and that languishing on NHS waiting lists can prevent people from working as well as affecting their wellbeing and ability to socialise. 

When comparing MIS to what households take home, the incomes of all households on out-of-work benefits and many on the National Living Wage (NLW) fail to reach MIS.  

The research also shows that our social security system leaves many households unable to afford everyday life. This is despite benefits increasing in line with inflation in September 2023 and increases to the NLW in April 2024. The NLW only gives households enough to reach MIS if they’re working full time and are in a couple with no children. 

None of the household types looking for work or unable to work can reach MIS:

• A single adult who receives out-of-work benefits has 28% of MIS, needing £218 more per week to reach MIS.
• A couple with no children where both adults receive out-of-work benefits have 27% of MIS, needing £363 more per week to reach MIS. 
• A couple with two children, one aged 2-4 and one primary school age, where both adults receive out-of-work benefits have 39% of MIS, needing £471 more per week to reach MIS.

For households earning the NLW, only couples with no children both working full-time can reach MIS:  

• A single adult working part-time on the NLW has 54% of MIS, needing £140 more per week to reach MIS. 
  • Switching to working full-time on the NLW would give a single adult 77% of MIS. They would need £69 more per week to reach MIS. 
• A couple with two children, one aged 2-4 and one primary school age, both working full-time on the NLW have 82% of MIS, needing £138 more per week to reach MIS. 
• A couple with no children both working full-time on the NLW have 115% of MIS, or £75 a week more than MIS.

Professor Abigail Davis, who leads the MIS research at Loughborough University, said: “Over the past 16 years, MIS has set out a clear vision of what people in the UK think everyone needs to live with dignity. This is about meeting those basic needs, but it’s also about being able to take part in the world, not feeling excluded or on the edge of society. 

“And yet meeting a minimum acceptable standard of living continues to be a real challenge for so many households. As this latest research has highlighted, the lack of investment in public services over the past decade has made meeting this standard even more difficult, as costs have shifted from the state to individuals.

“This adds to the pressure on already stretched household finances, but also has consequences for physical and mental health which can bring further costs for individuals, households and ultimately government. 

“There is much that needs to be done to improve living standards and to ensure a minimum for all – greater investment in our vital public services, a National Living Wage that is a real ‘living wage’, more genuinely affordable housing in the right places, and a social security system that protects and supports households when they need it most.

“Only by taking action to improve the lives of those on the lowest incomes will we move towards a society in which all are able to live in dignity.”

Peter Matejic, Chief Analyst at JRF, said: “In previous years it would have been unthinkable that cash to pay for health treatments would be necessary for a minimum standard of living.

“But, this research shows that the public feel they can no longer count on the NHS to provide a universal service that’s free at the point of delivery because some NHS services are now so difficult to access. 

“The reality is that many families don’t have enough to reach this minimum standard of living, including those on out-of-work benefits and many on the National Living Wage.

“They can’t set the money aside that the public think is necessary to avoid long waiting lists, and a health problem adds an extra financial insecurity to their lives. 

“It’s not right that people are unable to take part in our society and are living in poor health for years because of their low income.

“The government must improve our public services, make work more secure and reform our social security system so that we all have an adequate safety net to rely on if more people are to have a decent standard of living.” 

Notes to Editors

MIS is based on detailed research with groups of members of the public specifying what items need to be included in a minimum household budget. The groups are informed by expert knowledge where needed, for example on nutritional standards. Groups typically comprise six to eight people from a range of socioeconomic and ethnic backgrounds, but all participants in each group are from the household category under discussion.  

In 2024 budgets for all household types have been rebased (i.e. new primary research identifying the needs of parents and children, pensioners and working age adults without children, from scratch). This is the first time that all household budgets have been developed from first principles in the same year since the original MIS research was published in 2008. 

Waiting lists for NHS physiotherapy increased by over 30% between January 2023 and June 2024, comprising a total of 335,777 people. https://www.england.nhs.uk/statistics/statistical-work-areas/community-health-services-waiting-lists/ 

The Centre for Research in Social Policy (CRSP) is based in the School of Social Sciences and Humanities at Loughborough University. The Centre specialises in policy-focused research and analysis on issues related to living standards, poverty, wages and income adequacy in the UK and beyond. Further information on CRSP is available here. Contact us at crsp@lboro.ac.uk or call 01509 223372.

At the Joseph Rowntree Foundation, we work to speed up and support the transition to a future free from poverty, in which people and planet can flourish. Contact us at pressoffice@jrf.org.uk or call 01904 615 958. Follow us on X or LinkedIn