Summary
A BMJ opinion article compares programmes that connect families facing financial hardship with support services through healthcare. Its authors argue that referrals can help families access existing benefits and reduce financial stress, but cannot make up for inadequate income.
Healthcare services can help families facing financial hardship connect with benefits and money advice, but they cannot compensate when household income is insufficient, argue Anna Price, Anna Sarkadi and Claire Cameron in a BMJ opinion article published on 25 September 2026. Their comparison of programmes in Scotland, Australia, England and Sweden highlights how the results depend partly on whether families can access support that already exists.
Contents
How healthcare-linked support works
Known in several countries as Healthier Wealthier Families, these programmes use contact with healthcare services to identify families experiencing financial hardship and connect them with community-based financial support. That may include help claiming welfare benefits, negotiating debts, obtaining grants or concessions, and navigating complex systems. The approach is different from financial planning intended to build wealth.
The authors say families generally find conversations about money acceptable in healthcare settings, and that evidence suggests these approaches can improve household finances and reduce financial stress. They cite more than £36m generated for families by Scotland’s universal programme by 2020. An enhanced universal child and family health service in Australia reported average annual gains of more than A$6500 (£3500; €4000; $4500), while an English service for families using specialist neurodisability care reported gains of more than £6000 annually.
These are reported results from programmes operating in different settings, rather than a single like-for-like comparison. The examples illustrate the potential for advice and referrals to improve families’ access to financial support.
Why the model has different effects
The authors’ central argument is that referral programmes are most useful when families are missing support they are eligible to receive. In Scotland, Australia and England, families experiencing hardship may not be receiving all available benefits or other assistance. Advisers can help them find and claim that support, or work through debt and administrative barriers.
Sweden presents a different situation, the authors write. Benefits are generally already allocated to people who qualify, leaving fewer unclaimed entitlements for advisers to identify. Many families experiencing hardship are also not in debt, so debt counselling may have limited relevance. When families cannot meet basic needs despite receiving the support available to them, the problem is inadequate income rather than difficulty navigating services.
That distinction shapes what healthcare-linked programmes can achieve. Referrals may address administrative complexity, fragmented services or lack of awareness; they cannot resolve poverty where existing income support is insufficient.
What the authors recommend
The authors say effective programmes need trusted relationships between healthcare workers and families. Clinicians should be trained to ask about money confidently and without judgement, while taking account of differences in family structure, culture, language and financial decision-making. Referral routes should be simple and integrated into routine care; placing advisers in healthcare settings may also reduce barriers to engagement.
They also recommend that healthcare providers receive feedback on referral outcomes and that programme evaluations use routine and administrative data to assess reach, implementation and longer-term results. Their broader conclusion is that health services have a role in supporting families, but improving child wellbeing also requires social and economic policies that reduce poverty and provide adequate income.