Unhealthy Housing: Cost to the NHS

Tuesday 26th February 2019 Westminster Hall

09:30

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the cost of unhealthy housing to the NHS.

It is a pleasure to serve under your chairmanship, Mr Robertson. I thank right hon. and hon. Members for attending the debate, particularly the Scottish National party spokesperson, the hon. Member for Linlithgow and East Falkirk (Martyn Day); the shadow Minister, the hon. Member for Great Grimsby (Melanie Onn); and the Minister. I look forward to positive contributions from all those able to participate.

I am grateful to have been allocated the debate. As chair of the all-party parliamentary group for healthy homes and buildings, I am delighted to have the opportunity to raise awareness and concerns about the cost of unhealthy homes to the NHS. I thank the background staff, who are in the Gallery, who have given information to us all, myself in particular, to help us in the debate.

Our APPG was created to shed light on the many problems caused to our nation’s health, wellbeing and economy as a result of people living and working in unhealthy homes and buildings. Given that most of us spend some 90% of our time indoors, it stands to reason that our homes need to contribute positively to our physical and mental health and wellbeing, not diminish it. This debate is so important because it pulls together the critical issues. It is perhaps not a normal Westminster Hall debate, but it pushes very much to the fore the effect of the homes that we live in on our health and, ultimately, on the NHS.

The APPG, following a weight of written and oral evidence received, launched a report, “Building our Future: Laying the Foundations for Healthy Homes and Buildings”, in October last year. It was a well addressed report, to which there were many contributions, and it brought together those with a deep interest in homes and those with a deep interest in health issues. It is good to have the report finished.

I have given the Minister a copy of the report, which contains a series of excellent recommendations that are helpful to the Government and will help us to move forward. I hope the debate will be a turning point, and that those recommendations will lay the foundations for change. The report sets out what needs to be done to ensure that new and existing homes do not cause or exacerbate health problems, because they often do. Many of us here, as elected representatives, will have people coming to us every week to complain about their home and, more often than not, the health problems related to that.

This debate is long overdue. It is time to raise awareness of the extent of the problem, and to recognise the human cost to the United Kingdom of Great Britain and Northern Ireland of doing nothing. It is clear from the White Paper that unhealthy homes cost the economy and our society each and every year. Living in or occupying unhealthy homes directly and negatively impacts on human health. Unhealthy homes that lack daylight, or are cold, damp, poorly insulated, energy inefficient, overcrowded, noisy, badly designed and generate poor indoor air quality can, in the extreme, lead to unnecessary deaths.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

The hon. Gentleman is an old friend of mine. I think he knows that those of us who campaign on carbon monoxide poisoning really welcomed his excellent report. I have lost three constituents to carbon monoxide poisoning, which is one symptom of an unhealthy home. I assure him that we will work closely with him to ensure that no more people die of carbon monoxide poisoning.

[Jim Shannon]

The hon. Gentleman is absolutely right. My hon. Friend the Member for East Londonderry (Mr Campbell), who is sat to my left, also had constituents who passed away a few years ago due to carbon monoxide poisoning. That was in a holiday home, but it was none the less a problem. We in the APPG will take the comments of the hon. Member for Huddersfield (Mr Sheerman) on board, and we look forward to working with him.

Let me detail some of my concerns arising from the evidence that we heard. The effects of poor housing are estimated to cost the NHS £2.5 billion per annum; that rises when we consider all housing throughout the United Kingdom of Great Britain and Northern Ireland. The true cost lies in human misery and lives lost. Some of the figures are quite extreme, but they underline the issue. Some 43,900 excess winter deaths occurred in England and Wales in the winter of 2014-15, with cold homes causing one fifth of those. That is more than the number of deaths caused by road accidents, alcohol or drug abuse, which puts into perspective the need to make sure that homes are healthy. Children in cold homes are more than two times more likely to suffer from a respiratory problem. Cold homes increase the incidence of cold and flu, and worsen conditions such as arthritis and rheumatism. Again, we see that every day in our constituencies.

One in four adolescents living in a cold home is at risk of multiple mental health problems, so we are not always talking about physical issues; there can be emotional and mental issues as well. Those in poor-quality homes that lack effective ventilation suffer from indoor air pollution, which has been linked to allergies, asthma, lung cancer, chronic obstructive pulmonary disease, cardiovascular disease and, more recently, dementia.

[Andy Slaughter (Hammersmith) (Lab)]

I congratulate the hon. Gentleman on securing the debate and on championing this cause. I apologise: I will not be here for the whole debate. I am double-booked. There have been steps forward on this issue, such as the Homes (Fitness for Human Habitation) Act 2018, which was recently taken through Parliament by my hon. Friend the Member for Westminster North (Ms Buck). However, are conditions not getting worse for a lot of people? My experience is that there are two principal causes—the failure to build social housing, and the benefit cap—that force people into substandard accommodation in the private rented sector. Given the hon. Gentleman’s party’s special influence over the Government, could he persuade them to change those two egregious policies, which cause so much human misery?

[Jim Shannon]

If only we had that power! That is not to take away from the importance of the issue of social housing, which I will touch on later. Let us be honest: many people go into the housing that their pockets allow. As a result, they end up in housing that is not particularly in the right category, the right condition or the right shape. The hon. Gentleman is right that the benefit cap also dictates where someone can go. I will give the Minister plenty of time to get her thoughts together on that. However, that is an important point, and I will touch on it later.

Poor indoor air quality has an annual cost to the UK of more than 204,000 healthy life years. It causes thousands of deaths per year, and gives rise to health costs in the order of tens of millions of pounds. One third of people in the United Kingdom suffer from mould in their homes and are at increased risk of respiratory problems, infections, allergies and asthma. Just last week, I saw three constituents with mould growth issues in their houses—mould not caused by condensation, but ingrained in the walls. Sometimes ensuring that the housing associations or housing executive take those issues on board is quite a job.

There are more than half a million overcrowded households. The issue affects one in 10 children—something we cannot ignore. Overcrowding is linked to health and development issues, including meningitis, respiratory conditions, slow growth rates, accidents in the home, stress, anxiety, depression and poor adult health. Occupants of poor-quality housing are more likely to suffer from restricted daylight and noise pollution.

We cannot ignore noise pollution. In the news this morning someone put forward the idea of building houses and flats over railway lines. I am not sure if any hon. Member saw that. The first thing that came to my mind was the noise of the trains continually going underneath. How could those homes be adapted to mitigate that? We need to address noise pollution. Natural light helps to improve the recovery times of long-stay patients and reduces anxiety and the need for medication. Noise pollution can cause long-term health issues and increase stress and the risk of cardiovascular effects.

It is clear that there is a lack of public awareness of these problems, and limited knowledge of the facts. Too often, the homes we live in are, in so many ways, causing or aggravating health problems.

[Mr Sheerman]

The hon. Gentleman is making a very good speech, and I am nervous about intervening again, but will he accept this point? He talks about the noise pollution from living over a railway, and we know that private rented accommodation is a real problem. On the other side of the equation, very modern and expensive housing that is totally hermetically sealed could be as dangerous, because it traps all the gases and pollutants within the home—not only carbon monoxide, but many other emissions.

[Mr Laurence Robertson (in the Chair)]

Order. I ask hon. Members making interventions to address the Chair, and not somebody at the back of the room, not only so that I can hear but, more importantly, so that the Minister can hear.

[Mr Sheerman]

Will you forgive me, Mr Robertson?

[Mr Laurence Robertson (in the Chair)]

I would not want to miss anything that the hon. Gentleman said; that is the point.

[Jim Shannon]

I thank the hon. Member for Huddersfield for intervening again. It is always good to have him adding his words of wisdom to any debate, at any time, in this Chamber or in the main Chamber. The issue is clear: too often, the homes that we live in are, in many ways, causing or aggravating health problems. That cannot be ignored. Given the plethora of health issues that I have identified as caused by unhealthy homes, and given the cost to the NHS, it is time to ask who in Government is responsible and accountable. We look to the Minister for answers.

[David Simpson (Upper Bann) (DUP)]

One issue that has been raised with me in Northern Ireland—I am sure that it affects the whole United Kingdom—is that when it comes to old and listed buildings, and particularly rows of listed houses, it is sometimes very difficult to get adaptations done, because they have to be done in a certain way.

[Jim Shannon]

My hon. Friend highlights one of the kernels of the debate. Our white paper calls on the Government to take a holistic approach to future housing and ensuring that people’s health and wellbeing is placed at the heart of the built environment. That is clearly what my hon. Friend is saying, and that is where we are. Our white paper states that there must be effective leadership, and recommends that there be one Department responsible for healthy homes and buildings to ensure, critically, that homes and buildings maintain the highest standards for health and wellbeing; to identify where homes and building are causing health issues; to measure the economic and social benefits of healthier homes and buildings; to reduce health inequalities, of which there are many across the postcodes of the United Kingdom; and to provide for a common definition and approach to policy, regulation and standards. That makes complete sense to me.

Furthermore, an interdepartmental Government committee involving all Departments and agencies responsible for health, housing and construction—including the Department of Health and Social Care, the Department for Education, the Ministry of Housing, Communities and Local Government, and Public Health England—should be formed to ensure that health and wellbeing is placed at the heart of existing and future housing provision.

If we are to build houses, let us build them right. Let us ensure that the issues to which the hon. Member for Huddersfield referred do not arise, whether the homes are very expensive or of a lesser quality. I have serious concerns about the standards and quality of new housing inadvertently being driven downwards, without consideration of the cost to human health. In the context of the Government’s very healthy ambition to build 300,000 new homes and their healthy new towns initiative, standards must be driven upwards. It is essential that the Government adopt a holistic approach to delivery that addresses safety, space, energy efficiency, ventilation, heating, noise, air quality and lighting. We must all want to see quality new homes and communities being built with health and wellbeing in mind. I hope that the Government will agree that maximising the occupants’ health and wellbeing must be placed at the centre of new housing provision and building design.

Of course, we live in homes that have already been built, most of us in the privately owned or privately rented sector, to which the hon. Member for Huddersfield referred. Renovation of existing housing stock must also become a Government priority. This is not just about building new homes, but about ensuring that the homes that we already have are up to standard. Our white paper calls on the Government to develop plans to retrofit existing homes to maximise health and wellbeing and improve health performance.

Today, I have set out the problems caused by unhealthy homes and buildings. I now call on the Government to take on board the recommendations in the APPG for healthy homes and buildings white paper, which are as follows. There needs to be greater public awareness of the health problems exacerbated by unhealthy homes, and the health benefits to be gained through simple improvements and behavioural change. Importantly, how we live in the homes we build becomes part of where we are. In building new homes, priority must be given to ensuring that people’s health and wellbeing is foremost, specifically at the planning stage and through the national planning policy framework. Again, we look to the Minister for responses on these issues.

The Government need to commit to building greater numbers of quality social and affordable homes to help to alleviate issues of overcrowding and poor physical and mental health, which are all part of this. The Government need to optimise the health performance of new and existing homes, and ensure that they are built or retrofitted to “full health”. There must be greater focus on enforcement and quality control of home renovation standards, so there is a role for councils to play when it comes to checking the work that is done and ensuring that it is done to an acceptable standard.

The Government must commit to building the evidence base and promoting the link between housing and health and wellbeing. That would result in considerable savings to healthcare costs, increased educational attainment, improved productivity, and people leading longer, healthier and happier lives. The exact cost of unhealthy housing to the public purse, and the human cost, in terms of health and wellbeing, educational attainment and social care, is unfathomable. To date, Government attention to and policy thinking about this problem have been—I say this respectfully—woefully absent. We ask the Minister to address the issue in her response. We are looking for constructive comments. That is what I am about—indeed, what we are all about in the House—but we do need answers on what we are putting forward.

Ultimately, the recommendations made in the white paper provide the basis for a step change in policy, which will drive up standards and help to reduce the health problems caused or made worse by living and working in unhealthy homes and buildings. That is the purpose of this debate: to consider how we can do this together, and better, across the whole United Kingdom. The white paper is testament to the need to build better quality homes and buildings, as well as to upgrade existing housing stock, which comprises the vast majority of the homes that people live in today. We need to do something with new homes and set the standards, and then we will have to do something with the homes that we already have to bring them up to the standard necessary.

It is beyond doubt that there is a problem that needs urgent action. There is a lot to be gained by building and retrofitting homes to the highest quality and standard to achieve health and wellbeing. These are the pluses: lower costs to the NHS and a healthier population; better finances; better educational attainment and workplace productivity; reduced emissions—the hon. Member for Huddersfield referred to carbon monoxide—lower energy bills and a lower carbon footprint; improved health, wellbeing and comfort; and greater life chances and independent living and care.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate my hon. Friend on securing the debate, and on the work that he continues to do on these issues. Does he agree that the subject that he is entering into—the need to renovate and upgrade housing stock—is particularly applicable in lower socioeconomic areas, in both Northern Ireland and, I am sure, across the UK? In those areas, health issues are even more prevalent than in the rest of society, so his point about the benefit to the NHS is even more applicable with regard to those socioeconomic groups.

[Jim Shannon]

My hon. Friend is absolutely right. Those are the cases that we deal with in our constituency offices each and every day. Those issues are the subject of the site meetings that we have with the executives of housing associations, and of the meetings that take place with councils’ environmental health departments, back home and over here. There is a greater impact on those at a certain socioeconomic level, as the hon. Member for Hammersmith (Andy Slaughter) also said. Benefits also come into the process; there is the question of what people can afford to purchase and deal with.

I call on parliamentary colleagues from across the House to join me in taking forward the recommendations in the white paper, and call on the Government to join together and provide the necessary leadership and focus. We look to the Minister to do those things. The cost-benefit and rewards could be significant. The economic burden and sheer human misery created by poor homes and buildings, to which other hon. Members have referred, are simply too great to ignore.

I thank all right hon. and hon. Members for being here, and thank those Members who have come along to make a contribution. It is so important for us to deal with this issue. We look to the Minister for a significant and positive response—no pressure, but we do think it is important that we air these issues.

09:49

[Derek Thomas (St Ives) (Con)]

I pay credit to the hon. Member for Strangford (Jim Shannon) for securing the debate and for all the work he does with the all-party parliamentary group, from which I have enjoyed gaining expertise and knowledge. The cost of unhealthy housing to the NHS is a fantastic subject to tackle, especially in the middle of winter. We have not had a particularly cold spell yet—that is still around the corner—but nearly a year ago, a few days of significant snow cut off my village, which is extremely rare in the warm south-west.

It is great to speak on this important and urgent issue, but it is not new for me. When I pitched up as a new MP, all sorts of people came to tell me how good or bad my constituency was. I met a representative of the Association for the Conservation of Energy—ACE—who came to see me and said that my constituency had the leakiest homes in England, and potentially in Europe, based on off-grid and poor-quality buildings. We were not good at cavity walls 30 or 40 years ago—perhaps longer. I took that seriously because I was concerned about the issue of fuel poverty—we are a low-wage area—and about people’s health.

Cornwall Council and others, including my colleagues and me, have worked together to find the money to improve our homes. As of January, we have improved 1,085 homes and taken them out of fuel poverty altogether by securing various bits of money from all sorts of funds, including social landlords. As I say, it is an urgent issue. In particular, I credit Anthony Ball and his public health team at Cornwall Council for leading on the issue and for their great expertise on how to resolve the challenge.

From the figures that the council has provided, it is estimated that 210 people in Cornwall die due to the cold every year; that poor health resulting from a lack of warm homes affects 31,000 households—74,000 people—in a population of just under half a million; and that a winter death in Cornwall is preceded by eight emergency admissions to our hospitals, which are already under pressure, and 30 social care visits. As is true elsewhere in the country, delivering social care in Cornwall is a challenge, because it is a large but sparsely populated geographical area with a lack of people working in it and a distance to travel between appointments.

If there are potentially 30 unnecessary visits for each individual because of cold homes, that puts pressure on an already strained system. It is estimated that that costs the health service in Cornwall and the Isles of Scilly £13 million each year, which could go to areas of health and social care where we would much rather spend our money, instead of collecting people because they are living in poor homes that can be fixed.

I have long campaigned on unhealthy homes and the need to fix them. As a newly elected MP, one of my early debates was about fuel poverty, in which I made similar points to those that other Members and I hope to make today. The previous Chancellor set aside £100 billion for infrastructure spending. I argued then, and I would still love the Minister to take it forward, that it would cost only £2 billion of that to improve UK homes and raise their energy performance certificate rating to C—if we trust those ratings. That would be £2 billion well spent, because of the saving to the economy, the saving of people’s lives, and the improvement in attainment and economic productivity.

The recently published 10-year plan for the NHS is a welcome vision that sets out how the NHS needs to adapt over 10 years to meet current and changing demands; how we need to change the way we treat people and bring healthcare to people where they need it; and how to help people to manage their conditions. We are waiting for the Green Paper on social care, which we understand will come out in April. If we do not include one of the driving factors for why people end up in health and social care in the first place, however, that 10-year plan will be weakened or compromised.

That is why the debate is important, because now is the time to look across Government. If we want to deliver the NHS that we are all committed to and want to see in 10 years’ time—if not much before—and if we want to make social care work for everyone who needs it, we need to look at how we improve our homes and the health and wellbeing of everybody in the country who lives in a home that is not up to the job. I call on the Minister to look at the issue across Departments to see what we can do to deliver a more sustainable health and social care service partly by improving the homes we live in.

In the 21st century, in the fifth-richest country in the world, we should have healthy homes that we can be proud of. We cannot tolerate the situation for much longer. I will give an example of how that could be achieved, because just to say, “There is £2 billion. Go and sort your homes out,” will be a challenge. Money will be wasted and it will not be delivered in the way we would like or expect.

My suggestion, as it was when I first spoke on the issue, is to use Cornwall and the Isles of Scilly as a pilot. Cornwall Council and the Council of the Isles of Scilly are well placed because they know the problem, the homes that need fixing and the skilled workforce in the area. There is also a challenge in Cornwall to drive up skills, to give people the opportunities they need and to drive up wages, which it could help with.

The pilot would improve all the homes in Cornwall and the Isles of Scilly, which are the leakiest in the country. It would be a good way for the Government to see if such a scheme works and how it works, and how we could improve homes, create skilled jobs and improve attainment in children. It is well proven that children learn better and are healthier in warm homes; it is not just older people who suffer as a result of leaky homes and fuel poverty.

That work could also reduce the carbon footprint, which is important. Cornwall Council recently voted to consider how it could make Cornwall carbon free in the next 30 years and achieve a net zero emissions target. Reducing the leaky nature of our homes and improving the carbon footprint with well-insulated homes is a significant part of that. As I said, improving homes will also reduce the demand on health and social care services.

I am grateful for the opportunity to speak. This urgent issue presents a real challenge and I would welcome the opportunity for Cornwall and the Isles of Scilly to demonstrate to the rest of the country how it can be tackled.

09:57

[Colleen Fletcher (Coventry North East) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate.

Housing is central to the wellbeing of individuals, families and entire communities. When people have decent, safe accommodation, which is suited to their needs, they have a strong foundation on which to build their lives and expand their life chances. That in turn has a stabilising effect on their families, local neighbourhoods and the wider community.

Poor housing has the opposite effect. It can have a detrimental impact on many aspects of personal and community life, and can significantly affect the mental and physical health and wellbeing of the occupiers. Every week, I hear about housing problems from constituents. Their properties are often in a state of disrepair—cold, damp and mouldy. Living in poor housing such as that can take a significant toll on the physical health of an entire household by increasing the risk of cardiovascular, respiratory, neurological and musculoskeletal conditions, as we have heard.

People with underlying health complaints are particularly vulnerable. Poor housing can act as a trigger that causes asthma symptoms to worsen, which results in hospitalisation, or exacerbates symptoms of arthritis and reduces the ability of sufferers to perform everyday tasks proficiently, thereby increasing the risk of falls and accidents.

Moreover, when an individual’s physical health deteriorates, their mental health is often affected. It stands to reason that if someone lives in a property that makes them physically ill, which fails to meet their family’s needs and which makes life more difficult on a daily basis, they are likely to feel depressed and anxious, and their self-worth is liable to plummet. When physical and mental health is affected in this way, because homes are unsuitable, that has an impact on someone’s wellbeing and their ability to participate in work, education, and social and other activities, and consequently impacts on public services such as social care and, of course, the NHS.

In Coventry, our local authority recognises the human costs for the individual of poor housing, as well as the economic costs for public services such as the NHS. That is why its new draft housing strategy places significant emphasis on improving the condition of the city’s existing housing stock.

The strategy prioritises integration of the housing and public health departments to deliver affordable warmth projects, tackle fuel poverty and improve residents’ overall health. It also aims to tackle rogue landlords who leave their tenants at risk as a result of poor maintenance, poor standards and poor management of homes, and it explores the option of introducing discretionary licensing schemes to improve standards. Moreover, it seeks to maximise the existing housing stock in the city and bring empty homes back into viable use.

Those are just a few steps that the council is taking to tackle the city’s unhealthy homes, but it could do much more if it was given the necessary resources. With greater resources, the council could employ more enforcement officers, fund partnerships between advice agencies and GPs’ surgeries, and fund for the long term “safe and well” checks, which would be conducted by the fire service when vulnerable people were discharged from hospital.

Sadly, the Government remain committed to their vicious austerity policies, which prevent the council from making long-term strategic interventions. Without proper funding, I fear that, despite my council’s best efforts, housing conditions will continue to deteriorate, damaging the lives and life chances of families and individuals, with the NHS of course picking up the tab.

10:01

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve with you in the Chair this morning, Mr Robertson.

I start by thanking the all-party parliamentary group for healthy homes and buildings for its report, which is excellent and so needed in the light of the serious housing situation in many of our constituencies. Consequently, I am delighted that the Under-Secretary of State for Housing, Communities and Local Government, the hon. Member for South Derbyshire (Mrs Wheeler), is here in Westminster Hall today. I had wondered whether a Health Minister would respond to this debate, but it is really important to get to the root of these problems. We hear that £2.5 billion is the cost of unhealthy housing, which I think is a very modest estimate. If we could shift that money into building and retrofitting homes into a better condition, what a better society we would have.

Of course, I look back to Michael Marmot and the report he produced when he looked at the social determinants of poor health and identified housing within them. The report by Dame Carol Black also emphasised the impact of poor housing. And, of course, we know from living experience the impact of poor housing on our constituents today.

So this is a timely debate and an important debate. We must look not only at physical health. We have heard about respiratory conditions; as a former physiotherapist who worked in that area, I certainly know the impact that poor housing had on my patients. However, we must also look at mental health, which is also incredibly important; I see that every week in my constituency.

We also know that there is the wider issue of affordability, and the stresses and strains that the failed housing market places on our constituents. In York, buying a property now costs ten times the average wage and therefore it is becoming completely inaccessible. People are having to up sticks and make a choice about their career or their living environment. Renting is also completely inaccessible in the private rented sector, and in the social rented sector the amount of stock has been reduced and therefore people’s options are also being reduced.

The quality of housing is also a massive issue. In York, 200 houses have a water course running under them—under the floorboards. As a result, there is damp, particularly at this time of year, which really impacts on the families in those houses. The council has a programme for those houses, but it is taking too long to move people out of their homes and make the changes that are required, which almost amounts to rebuilding the underneath of the property so that residents can move back in. So the quality of housing is a serious issue, including in York.

We have also heard about fuel poverty. I think we are all absolutely stunned into silence when we hear that 51,000 people in our country died prematurely last winter, with 46,000 of them being older people who were unable to afford to flick the switch and put their heating on. Those are unnecessary deaths and it deeply concerns me that we have not redressed this issue; it is essential that the Government put a real focus on it.

I will talk about one or two cases in my constituency that have completely appalled me. I have already shared the information about some of them with the Minister, and they have to do with the behaviour and the conduct of my local authority.

People will remember that a few weeks ago it was bitterly cold, with freezing fog. An 18-year-old woman in my constituency had not complied with all the obligations placed on her as a young person in housing; her complying with them was challenging, both for her and for the authority. Therefore, the authority removed her right to be in housing provision. Putting a young woman on to the streets is one thing; to do so in freezing conditions, when the temperature is minus 6° C, is another. So we really have to consider what was behind that decision. Thankfully, my office jumped in and secured that young woman a placement elsewhere, in the light of our holding up a mirror to that situation.

We also have to think about our homelessness services. I have spoken in many debates in this place about what has happened with homelessness. Again, dealing with homelessness is about the joining-up of services, to make sure, first of all, that Housing First is in place. I know that if Labour were in the administration in York, we would end homelessness within a term of being in charge of the council, because we believe that housing is a human right. We are a human rights city and we believe that it is a human right for people to be able to access a home. We know that not being able to access a home has a serious impact on people, including on their physical health. We know that 41% of the homeless population have serious physical health conditions and 45% have serious mental health conditions. However, there is also the tie-in with substance misuse and other issues that have a serious impact.

The case that perhaps shocked me the most was that of a woman whose partner had moved out of their home, for certain reasons. Initially she was left in the property, but because of the change in the tenancy she was then forced out of her property. A relationship breakdown is stressful enough for somebody, but being told that they have to leave their property because a tenancy—an arrangement—has changed, and having to move into another property, was incredibly stressful for my constituent. She became seriously ill: she lost two stone in weight; she developed anxiety and depression; and she became extremely ill. In fact, she could hardly speak, because the stress on her was so great that she could hardly talk. Her mental health was in a very poor place, and yet the council pursued her and continued to move her from her property. She lost her business, she lost her work and she ended up on benefits, and was finally forced to move over the Christmas period.

That kind of behaviour by our local authority is contemptible, and I say to the Minister today that we must have mechanisms by which we can put the impact of housing policy and housing policy decisions, not only on people’s physical health but on their mental health too, at the heart of decision making, because that situation with my constituent should never have arisen. As soon as she started becoming ill, the council should have started to pull back, but it did not.

I have seen that with another tragic case in my constituency. A young man has support needs. He had been living with his parents, but sadly one of his parents died and then the other. However, the Government policy about successor rights for property meant that this young man, whose home was his place of safety, was turfed out of his home and then placed in hostel accommodation. In that accommodation he lost his security, his surroundings and the neighbours who had kept an eye on him, and he ended up walking the streets during the day. He found that incredibly difficult. He was dealing with the double trauma of losing his parents and then his home. We need to put compassion back into housing policy, because not doing so makes people ill.

[Jim Shannon]

I thank the hon. Lady for her significant contribution. She has reminded me that in my office we have had three cases of homeless people over the past month, and the last one she referred to is very much in my mind. We seem to have people who slip under the microscope, with complex issues regarding health and losing their homes, contacts and friends. As the hon. Lady said, we need a better way of dealing with those issues. One way to ensure that those people do not fall under the radar would be to mark up any early-recognised physical or mental issues as a priority for the officer.

[Rachael Maskell]

The hon. Gentleman is absolutely right. A home is not just a physical structure of bricks and mortar; it is a whole environment in which someone lives and probably spends most of their time, whether asleep or awake. It is a security, a setting, and a place where the family is based, and it affects someone’s wellbeing.

We must take a more humane approach to housing, and York, as a human rights city, is determined to see that. Housing is a major issue in the city; we have a massive supply problem. Every time the Government say they are building more homes, I say, “But not in York”. Our council has completely failed on that front, and it now looks like the local plan, which has been prevaricated over, is in real danger of falling because sites are pulling away. We have overcrowding because we do not have the housing supply we need, which means we have families who have been living on sofas for months on end. I received a letter just this last week about a gentleman who is not well and has been sleeping on the sofa for three months. The council has not intervened in that kind of case. It is right that we get a local plan to build the housing the city needs to address future accommodation needs—not all those luxury apartments we see going up everywhere.

My final point concerns my role as chair of the all-party parliamentary group for ageing and older people, and the provision we are making for our older people, ensuring that we have the right environments for them to live in. Increasingly, older people live in the private rental sector, which provides insecurity in later life. Others in the sector also face that insecurity, but it is compounded in the later stages of life. It is really important to build secure housing for older people.

We know that isolation and loneliness have a massive impact on wellbeing, but it is also about the place and the environment in which people live. I urge the Minister to look at some of the impressive projects in the Netherlands, building villages that are safe environments for older people. In Hogeweyk, a dementia village, people have their independence, which keeps them on their feet, which then keeps them healthy, and they can move safely around a village environment while at the same time having a few people keeping an eye on them. Three or four people, at various stages of dementia, live in each house. There is a shop and a hairdressers on the complex, and other places that people can go, but it is a closed environment that keeps people safe. There are some good models out there of how we can build proper homes for life and ensure that people do not have the stress—we all know that moving home is stressful—of having to move at a fragile point in their life.

There is so much more we can do with this agenda if a real aspiration is there to change how we look at the complex dual issue of health and housing. Should Labour come into power in York in May, our plans are to build transformation, ensuring both that we have private rental sector licensing to drive up standards, and that we build the homes that people need in a healthy environment, place making as we go, so that everyone can enjoy the place where they live.

09:00

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

What a pleasure it is to serve under the firm but fair chairmanship of your good self, Mr Robertson.

I will not be very political in my speech; I might make a couple of swipes at the Conservative Government about one little item that worries me. In 1963, the enlightened Conservative Government asked Sir Parker Morris to look at homes for then and for the future. He came up with a very good report that was accepted as guidance by that Government, but it was not until 1967 that a Labour Government made that guidance statutory in the Parker Morris standards for housing and homes. Those standards guided us well and provided a framework for the quality of our housing. People had to build according to those good standards—cavity wall insulation, the size of the living room, the size and accessibility of the toilet, and all the stuff we took for granted.

Unfortunately, in the 1980s another Conservative Administration abolished the Parker Morris standards. That was an age when a woman I knew very well—Margaret Thatcher—believed passionately in the private sector leading and delivering more effectively than the public sector. At that stage, when that was fashionable—I am not blaming anyone who is around today—the standards were abolished and we have suffered from that for many years.

I chair both the all-party parliamentary carbon monoxide group and Policy Connect. We have taken a strong interest in carbon monoxide, and it hits home hardest when one of your constituents is affected, especially if they die. A little 10-year-old boy, Dominic Rodgers, was found dead from carbon monoxide poisoning by his mother when she went to wake him for school, in a little terraced house in the middle of Huddersfield. The poisoning was not from that home but from a faulty boiler in the house next door. The silent killer had seeped, as it does, across the passageway and killed the little boy. A few months later, a couple who ran a Chinese restaurant were sleeping over the premises and they too died from carbon monoxide poisoning—a cowboy builder had blocked the chimney. Like all good campaigns, the carbon monoxide one started at the constituency level, and I have been campaigning for many years with a very good all-party team to make people aware. The more research we do, the more we know that carbon monoxide issues are related to healthy homes.

As I said in my intervention on my very good friend, the hon. Member for Strangford (Jim Shannon)—what a good debate he has initiated—the fact of the matter is that there are two worrying sectors. Huddersfield is the average, classic British town on all the criteria; what happens in Huddersfield is a symbol of what is happening in the greater United Kingdom. We have two problems in the town, one of which is old social housing. Over the years, that housing has been progressively upgraded and renewed. The situation has not been helped by some of the poor effects and unintended consequences of right to buy, but social housing has a much better record than private rented accommodation regarding healthy homes and intervention to ensure that people live in a healthy, safe environment.

The real problem, in Huddersfield and elsewhere, is private rented accommodation. It is a sad fact that the standard of private accommodation is very variable. Until recently, many of the students who came to university towns—certainly my four children—found themselves living in rented accommodation that was pretty awful. A parent would not want their children living in accommodation of that quality, and they were certainly not healthy environments: I am talking about accommodation in Cambridge, Bristol and Edinburgh. However, we have had a revolution in the private rented sector for students. At one stage, I teased the housing Minister, because in Huddersfield we had cranes, new blocks, and wonderful, posh, modern accommodation for students. I kept asking the various housing Ministers who came and went, “If we can do that for students, why can we not build those sorts of buildings—modern, high-quality accommodation—for elderly people in our constituencies and in our country?”

The fact of the matter is that private rented accommodation is difficult, and one aspect of that difficulty arises when we want to look at smart metering. We want to go into a house to fit smart meters, in order to bring down the cost of energy and the amount of money that people on low incomes spend on heating. Getting in for that purpose, or to check whether there is a carbon monoxide detector or a smoke alarm, is very difficult in private accommodation. A lot of people do not want us to know how many people are living in that accommodation; they want to be private, which makes it difficult. We know that a high percentage of gas appliances in those rented homes are very dangerous indeed. They have not been serviced every year, and they could very well kill the people living in that accommodation.

I do not want to concentrate just on carbon monoxide, so I will finish my remarks by saying that this morning, when I was getting up early in order to speak in this debate at 9.30, I was startled when I turned on the radio to listen to the “Today” programme and heard someone from the housing sector—I have to say, a rather complacent person—being interviewed. Mr Robertson, as a working politician like me, you probably shout at the radio sometimes, because you want John or one of the other interviewers to really push a particular question. This morning, I wanted that representative of the housing sector to answer this question: “What happened to the Help to Buy programme?” We know that that money did not flow into Northern Irish homes and housing, and it did not flow into homes and housing in my constituency: it flowed into the coffers of the big housing companies. We thought that those tens of millions of pounds were going to regenerate the market and provide homes for people who needed them, but it all went wrong. It is another bit of public policy that started with brave intentions and went awry. Those tens of millions of pounds could have been spent on investing in healthy homes, improving them and bringing them up to what was the Parker Morris standard.

That is the most political thing that I will say today. I have found that, across the House and in this very Chamber, there is a lot of consensus that there is a problem, and that the problem can be solved. However, we have to start focusing our energy and, for goodness’ sake, both parties need to show some real leadership in providing what people in this country deserve—great standards for homes and housing. The 1960s were pretty good for music; I think the Beatles’ first album came out in 1963. Some very good regulation and legislation also came out in the 1960s. I beg the Minister to listen to a bit more Beatles music, and to have a spring awakening to the fact that she has the ability and capacity to lead on this issue, providing healthy homes for all the people in this country who deserve them.

[Mr Laurence Robertson (in the Chair)]

I remind the Front-Bench speakers that I would like to leave two minutes at the end of the debate for Mr Shannon to respond.

10:24

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Robertson, in what has been an interesting, consensual and informative debate that I am grateful to the hon. Member for Strangford (Jim Shannon) for having secured. All too often, we describe debates as important when they are not, but this debate is genuinely important, and it is good to see consensus about that across the Chamber. I thank the hon. Gentleman not just for his thorough opening speech, but for his work in chairing the all-party parliamentary group for healthy homes and buildings, and for the excellent report that it recently produced.

There is no doubt that housing is the foundation that connects people to their communities, or that healthy homes help empower full participation in community life. As the hon. Gentleman pointed out, healthy homes lead to better educational attainment, higher workplace productivity, reduced emissions, lower energy bills and a lower carbon footprint—objectives that we would all unite in supporting. Poor housing, on the other hand, detrimentally contributes to physical and mental health inequalities through the effects of housing costs, housing quality, fuel poverty and the role of housing in community life, and many Members have provided examples and case studies that have helped to illustrate that point. Many people do not live in a home that is warm, dry and affordable, and those on the lowest incomes are most disproportionately affected. The hon. Member for St Ives (Derek Thomas) made some good points about housing and fuel poverty, an issue that affects my constituency, and one that we should be doing a lot more to tackle in this modern age.

Income, wealth and the welfare system are undoubtedly at the heart of the relationship between housing and health inequalities. Poverty-related inequalities represent thousands of premature deaths every year. In Scotland, both housing and health are devolved. I have some Scottish figures that give a wee bit of flavour; they are pretty similar to those we have heard from Members from elsewhere in the UK. Figures from NHS Scotland show that men in the most deprived areas spend nearly 25 fewer years in good health than those in the least deprived areas; for women, the figure is 22 years. Housing clearly has the potential to reduce or reinforce those inequalities. In Scotland, all homes are required to meet the tolerable standard of habitability. It is estimated that 1% of all homes fell below that standard in 2017—that is down from 4% in 2012, so we are going the right way. Perhaps more worrying is that, as Members have mentioned, the private sector is lagging behind; the public sector is leading the way. Private homes, which are a different matter, are in between.

There is a lot of work that we need to do in all areas of housing tenure, and there are several linked factors in that, such as the number of properties available in an area. The quality of the homes is also a major factor—as is affordability, perhaps more importantly. In Scotland, the Scottish National party has delivered more than 76,500 affordable homes since 2007, and is investing more than £3 billion to deliver at least another 50,000 affordable homes during the current parliamentary Session. The Scottish Government continue to support the empty homes partnership, which has brought 3,200 empty homes back into use since 2010. There are empty homes all around our country that could be put to use in housing people. The Scottish Government have introduced the Fuel Poverty (Target, Definition and Strategy) (Scotland) Bill, which sets a target of no more than 5% of Scottish households being in fuel poverty by 2040. In my opinion, 5% is still too many, but if we can achieve that, it will be a step in the right direction.

Between 2007 and 2017, the average price of domestic fuel rose from £856 to £1,249 per annum—a rise of approximately 46%. That is a frightening figure over a decade; people’s wages certainly have not kept pace with that rise. Fuel poverty causes misery, ill health and debt, and living in a cold, damp environment can exacerbate health problems such as asthma and heart conditions, as a number of Members have mentioned. It is unacceptable in this modern age that any household should have to choose between heating and eating, yet people who are struggling to pay their bills often ration their use of energy, perhaps heating just one room, having to choose between cooking or heating their home, or limiting the use of washing machines and heating water for baths or showers, all of which can have an impact on people’s health and wellbeing. There is a correlation between fuel poverty and increased winter mortality, or excess winter deaths. Increased winter mortality is associated with low indoor temperatures, and the excess winter mortality figure for 2017-18 in Scotland was 4,800, a figure not significantly different from the English figures mentioned earlier.

To become a fairer and more just society, it is crucial that we end the scourge of fuel poverty. As technology moves forward, we should do a lot more on the “Big Mother” scenario, rather than the Big Brother scenario. Smart meters and other technology are growing all the time. It would not be impossible to have feedback from people’s homes on the temperature in their houses. Action could then be taken, particularly in areas where we know there are elderly people, or people with social conditions, to intervene and check why they are not heating their home properly. Perhaps we should even think about the health sector being able to prescribe heat. It may save money in the long run.

The worst housing position for anyone to find themselves in is homelessness. The health of people experiencing homelessness is significantly worse than that of the general population. The Library briefing provided for the debate highlighted a Local Government Association report that identified that 41% of homeless people have a long-term physical health problem, and 45% have a diagnosed mental health problem, compared with respective figures of 28% and 25% in the general population. That certainly fits with my experience locally; the people whom various homeless charities have been dealing with increasingly have mental health issues, as well as being homeless.

The last estimate of the healthcare cost associated with the homeless population was £86 million a year in 2010; the figure will undoubtedly be higher now. That shows that we can save money for the public purse by tackling homelessness. The Scottish Government are committed to eradicating rough sleeping in Scotland. They have allocated £21 million to rapid rehousing in the past year. The money came from their “ending homelessness together” fund. As a result of the Homelessness etc. (Scotland) Act 2003, local authorities in Scotland have a duty to find permanent accommodation for all applicants who are unintentionally homeless. Last year, The Guardian reported that the National Audit Office had stated that homelessness is

“likely to have been driven by welfare reforms”,

which brings us back to poverty, the issue at the heart of so much of the homelessness and housing issue.

It is not all bad news, though. A report authored by Crisis and PricewaterhouseCoopers estimated that allocating appropriate housing to homeless people improved their wellbeing, and increased economic output as a result of them entering employment. The same report stated that the Exchequer is projected to save a staggering £6,361 million as people are moved out of homelessness, through the reduced use of public services, ranging across everything from the NHS to criminal justice. We cannot afford to skimp on this. Austerity does not get us there. We need to spend money to save an absolute fortune by solving the problems.

Time is moving on, and there are so many aspects of the debate that I would have loved to have gone into. The debate is so wide-ranging, and the hon. Member for Strangford has picked a genuinely fascinating issue. I will touch briefly on overcrowding, which is at the opposite end of the homelessness spectrum. It has serious links to mental health, particularly for children and young people. Living in cramped conditions puts enormous pressure on family relationships. I have seen case studies in my constituency of marital break-ups and people forced to live with their extended family for an undue period. It causes depression, stress and anxiety. We need to tackle not only the extreme ends of the issue, but overcrowding. Fixing the housing problem is key to ensuring that everyone has their fundamental needs met and reducing pressure on our NHS. It can also bring in a huge amount of money for the public purse that we could put to better use.

10:33

[Melanie Onn (Great Grimsby) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I thank the hon. Member for Strangford (Jim Shannon) for bringing forward this important debate on a critical issue related to housing. It is reflective of the crisis in housing. From the contributions we have heard today, it is painfully clear that alongside the families left waiting for social housing, the young people unable to get on the property ladder and the thousands of rough sleepers on our streets, the NHS is suffering as a result of an ongoing housing crisis in which one in three people in the UK live in poor-quality housing.

If we take a short trip down memory lane, we will recall that the last Labour Government’s decent homes programme invested £22 billion and brought 1.4 million social homes up to a habitable standard. Contrast that with the position now: the English housing survey gave us data across the whole housing sector showing that 20% of homes in our country were considered non-decent in 2016. More than 500,000 social homes failed to meet the decent homes standard in 2017. That perhaps comes as no surprise when we consider that just £1.6 billion was spent on the decent homes programme between 2011 and 2015, when funding was stopped altogether, with the Government expecting councils, which are stretched to breaking, to pick up the pieces.

Cold and damp houses have a detrimental effect on health by increasing the risk of cardiovascular, respiratory and rheumatoid conditions. They can exacerbate the symptoms of arthritis and reduce dexterity among elderly people, thereby increasing the risk of falls. They cause mould, colds and flu. Being cold can impact a person’s ability to cook, shower and clean.

My hon. Friend the Member for Coventry North East (Colleen Fletcher) painted a clear picture of how poor housing also affects our mental health. Our homes are places where our children grow up, where we celebrate milestones and where we spend a great deal of our time, so it is completely understandable that the state of our houses can have such a detrimental effect on our mental health. Research by Shelter indicates that 20% of adults have experienced mental health issues in the past five years as a result of housing problems. Further research by the Sustain project has found that the physical condition of someone’s home is strongly predictive of their mental health. According to Mind, people with a mental health condition are four times more likely to report that poor housing has made their health worse.

The Government’s failure to build anywhere near enough new and appropriate homes—my hon. Friend the Member for York Central (Rachael Maskell) recognises this only too well from her constituency—ends up in a direct cost to the NHS: unhealthy homes affect our mental and physical health, leading to increased pressure on the health service, whether that is on GP appointments, hospital bed spaces or carers. The NHS even has a diagnosis code for inadequate housing, which was listed as a secondary diagnosis in almost 3,500 hospital episodes in 2017-18. More than half were among those aged 65 or over.

Poor-quality housing has particularly disastrous effects on those on low incomes, many of whom lack the means to replace out-of-date boilers and central heating systems, or end up renting off unscrupulous landlords who let their homes fall into disrepair. My hon. Friend the Member for Huddersfield (Mr Sheerman) made some excellent points about the difficulty of getting private rented sector properties up to standard, and reminded us all of the dangers of the silent killer that is carbon monoxide poisoning, which can often happen in homes of a lower standard. Those things all inevitably lead to avoidable GP appointments and hospital stays.

The cost of the lack of accessible housing cannot be overstated. Elderly and vulnerable people across the country struggle every day in homes that do not meet their needs. As Members have pointed out, some cannot afford to heat their homes properly. Just 7% of homes have basic accessibility features. Those who feel they can no longer live safely or comfortably in their homes are forced into care homes at a cost to their family, the state and their independence.

According to the Royal College of Physicians, falls cost the NHS £2 billion every year. However, many falls are not the inevitable result of ageing and could be easily avoided by removing hazards around the home. Fitting grab rails in bathrooms, building houses with walls strong enough to support grab rails, making sure homes have level access and building stairs with an easy-going pitch are all cost-effective ways to avert extremely damaging falls. Research by the Building Research Establishment indicates that removing category 1 hazards that lead to falls would save more than £400 million every year and would pay for itself within just five years. If we make those changes pre-emptively, the number of hospital bed days lost due to delays in hospital discharge while a suitable home is found will be dramatically reduced.

One of my constituents is a nurse at Scunthorpe General Hospital. She reported to me that she routinely has patients in her care who are forced to wait in hospital for up to three weeks longer than they should for changes to be made to their homes, or for a carer to be assigned. My local hospital trust says that one of the worst things for patients, particularly elderly patients, is to be in hospital longer than they should be. They are at increased risk of infection, and unfortunately that increases mortality rates. That really brings home how important getting housing right at every stage is to individuals’ life prospects, and NHS statistics reflect that.

An NHS annual report on delayed transfers of care in England in 2018 found that nearly 50,000 bed days were lost because of delayed discharges due to housing inadequacy, with patients waiting for major home adaptations, alternative housing arrangements, manual handling equipment such as a hoist, living equipment, a bed, deep cleaning, decorating, or basic decluttering.

The NHS is already on its knees. NHS doctors, nurses and workers deserve better than to be burdened by the failure of the Government to provide healthy homes. The Government cannot ignore the impact of their cuts to local government on the state of our housing. Environmental health departments have not been protected from very severe cuts, and many simply do not have the resources to enforce housing standards fully in their area. The hon. Member for Strangford raised concerns about people slipping out from under the microscope, and that is a prime example of ever-widening gaps in social policy. It is people, not statistics, who end up falling through those gaps.

The Homes (Fitness for Human Habitation) Act 2018, introduced by my hon. Friend the Member for Westminster North (Ms Buck), presents a real opportunity for tenants to take some control over their housing standards, but it will not replace the need for proper council enforcement, and the Government must consider whether cuts to local government truly offer value for money when they stop councils protecting tenants from unhealthy housing, and lead to less money in the pockets of our NHS.

We must take the health impact of our homes into account as we build for the future. The current state of affairs is unsustainable and places too much of the burden on the NHS. A change in the way that we build houses will reduce the cost of social care, give people a sense of independence, and allow the elderly to live an active lifestyle at home well into their 80s and 90s.

10:42

[The Parliamentary Under-Secretary of State for Housing, Communities and Local Government (Mrs Heather Wheeler)]

It is a pleasure to serve under your chairmanship, Mr Robertson. We have had an excellent debate. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate on the cost of unhealthy housing to the NHS. He is a long-standing advocate of healthy housing, and his knowledge and passion about the subject has been evident today. Indeed, I congratulate all Members who have spoken. The 11 contributors spoke with passion about the links between housing and health. I acknowledge and commend the amount of work that the hon. Gentleman has undertaken on behalf of his constituents and the public as chair of the all-party group on healthy homes and buildings. He has provided welcome scrutiny of one of this Government’s top priorities: safe, decent, housing. I have read the APPG’s white paper with interest and will use this opportunity to respond to that as well as today’s debate.

The APPG is carrying out very important work, and I commend my hon. Friend the Member for Walsall North (Eddie Hughes) and the hon. Member for North Tyneside (Mary Glindon) on their roles as co-chairs of the APPG, as well as my hon. Friend the Member for St Ives (Derek Thomas) and the hon. Member for Upper Bann (David Simpson) on their work in the APPG.

I cannot speak to figures relating to the cost of unhealthy housing to the NHS, because that is not within my gift as a Minister for housing, but that does not mean that the Government do not acknowledge the cost of poor housing on health, and the cost is enough to justify driving through changes. Everyone deserves a decent and safe place to live, and we have seen clear improvements under this Government. The number of private rented homes failing to meet the decent homes standard is down 15% since 2010, which is a record low, and the number of social homes failing to meet the standard is down 32% since 2010: a near-record low.

However, the Government want more action to be taken, which is why our recent social housing Green Paper asks whether we should reconsider what constitutes a decent home. We supported the Homes (Fitness for Human Habitation) Act 2018, introduced by the hon. Member for Westminster North (Ms Buck), which gives tenants the right to take legal action if landlords fail in their duties, freeing local authorities to focus on using their existing strong and effective powers against rogue landlords.

I want to speak about the actions that the Government are taking on each point of the system. Again, I congratulate all the Members who have contributed today. My Department is reviewing building safety regulations, mindful of the needs of people in fuel poverty and the importance of maintaining air quality in our homes, and we are working across Government to ensure an holistic approach to building regulations. To answer the question asked by the hon. Member for Huddersfield (Mr Sheerman), we take the risks and consequences of carbon monoxide poisoning very seriously, which is why we committed to review carbon monoxide alarm requirements. I am pleased to say that the first stage of the review is complete and we have gathered information on the falling costs of alarms and on uncertainty about the fact that carbon monoxide poisonings are perhaps under-reported. We are now considering the updated evidence and will respond shortly.

Local authorities have strong powers under the Housing Act 2004 to tackle poor property conditions that might impact on people’s health. They must take enforcement action where the most serious hazards are present, which are usually assessed through the housing health and safety rating system—the HHSRS, which I always have difficulty saying. Enforcement activity can range from informal work with the landlord to emergency repairs or even prohibition of the use of the whole or part of the property in extreme circumstances. The HHSRS is crucial to local authorities’ enforcement of decent standards and thereby the protection of people’s health. That is why on 26 October 2018 we announced that we were commissioning a review to assess how well the HHSRS works in practice and to ensure it remains fit for purpose.

To reply to the hon. Member for Strangford, in October we laid regulations to extend mandatory licensing of houses in multiple occupation, bringing a further 170,000 HMOs within scope. It is an important tool for preventing overcrowding and the harms associated with it. I again congratulate the hon. Member for York Central (Rachael Maskell) on her dedicated work on housing and her tenacity in fighting for her constituents.

Winter mortality is a result of many different factors, but it is clear that living in a cold home can lead to adverse outcomes for health and wellbeing. An investment of £3 billion a year demonstrates that it is not something that the Government take lightly. We have a comprehensive package of policies to support households over the winter months. All pensioner households receive winter fuel payments of £200 to £300, and more than 2 million low-income and vulnerable households receive a further £140 rebate through the warm home discount. Additional payments are made through the cold weather payment scheme during spells of cold weather. In addition, £640 million a year is currently available through the energy company obligation to upgrade homes, tackling fuel poverty in the long run.

[Mr Sheerman]

Can the Minister tell me what she thinks about going back to really firm standards, such as the Parker Morris standards? The review was originally a Conservative idea.

[Mrs Wheeler]

I congratulate the hon. Gentleman on managing to mention Parker Morris at least three times in this debate. We are looking at future standards. Sometimes we need smaller homes as starter homes, but equally we need better-quality homes all the way through. I will perhaps come on to that later in my speech.

The health impacts of cold homes and fuel poverty require action from a wide range of organisations across the health and social care sector. Partnership approaches are key. Local authorities are now able to work with the charitable and health sectors to determine which households should be eligible for support under a new flexible element of the £640 million-a-year energy company obligation energy efficiency scheme, which is focused on low-income and vulnerable households.

There has been significant improvement in the average energy efficiency of fuel-poor homes. The latest fuel poverty statistics showed that there were nearly 800,000 fewer fuel-poor properties rated E, F or G in 2016 compared with 2010. I can tell my hon. Friend the Member for St Ives that the role of housing will be a crucial part of our considerations in the forthcoming social care Green Paper. I also note his pitch for a pilot. That shows that the policies are working to help those living in the least efficient homes, who can least afford to keep warm.

There is no doubt that it is essential that buildings are well ventilated, as the hon. Member for Huddersfield mentioned, for the health of the people in the building, and the health of the building itself. It is not merely a means to resolve overheating, but a matter of air quality. For that reason, part F of the building regulations sets minimum requirements to provide adequate means of ventilation. As set out in the Government’s clean air strategy, we plan to consult in spring 2019

“on changes to standards in Part F of the Building Regulations relating to ventilation in homes and other buildings.”

In setting minimum ventilation standards, we take advice from across Government on indoor air quality, including from the Department of Health and Social Care, the Department for Environment, Food and Rural Affairs and Public Health England. Indoor air quality is a complex issue, and many factors determine the concentration of pollutants in a space. Ventilation is one such factor, but outdoor air quality, the location of the building, emissions from products and the activities of occupants in the building all play a role as well.

Health and wellbeing can be affected by what is outside as well as inside a home. The revised national planning policy framework therefore includes a dedicated chapter that deals with the creation of healthy and safe places. It states:

“Planning policies and decisions should aim to achieve healthy, inclusive and safe places which…promote social interaction…are safe and accessible…and support healthy lifestyles”.

At my Department’s recent national design quality conference in Birmingham, attended by more than 400 representatives of the community and housing sector, we had a dedicated session on healthy place-making, and we recognised the importance of creating places that have a positive impact on health and wellbeing. On that matter, too, there is extensive cross-Government collaboration. As the hon. Member for Strangford is aware, my Department has been part of the NHS England healthy new towns programme and sits on the steering group. I hope that he will be pleased to hear that in 2019-20, NHS England will build on that by working with the Government to develop a healthy new towns standard, including a healthy homes quality mark to be awarded to places that meet high standards and principles that promote health and wellbeing.

The Government recognise the importance of having safe and healthy homes and buildings, and provide common definitions and approaches to regulation and standards, consistently striving to ensure that they remain up to date and effective. MHCLG has taken the lead on many aspects, from undertaking a comprehensive review of building safety to strengthening consumer redress. There is extensive cross-Government work on healthy homes and buildings, from planning and place-making to design, delivery and standards and support. Again, we take on board the comment about Parker Morris.

Officials across all policy areas regularly engage across all levels of Government, industry and the third sector. For example, we are an active signatory of the memorandum of understanding on improving health and care through the home. That joins us up with 25 other signatories, including the NHS, the Local Government Association and the Royal Society for Public Health. We have positive relationships with our counterparts in the devolved Administrations, but always welcome the opportunity to deepen engagement.

Perhaps the APPG for healthy homes and buildings is the place to examine which specific relationships could be strengthened. However, the responsibility for ensuring that homes and buildings are safe and healthy is a shared one, lying with product designers, developers, building owners and managers and local authorities, as well as central Government and devolved Administrations. That is why the work that the hon. Member for Strangford has undertaken through the APPG is so valuable, and why Ministers from my Department would be pleased to meet the group, to ensure that no stone is left unturned in our mission to make the housing market fit for everyone.

10:53

[Jim Shannon]

I thank everyone for their valuable contributions. As the Minister said, it has been a constructive debate. Everyone who contributed, whether with a speech or an intervention, added important information.

The hon. Member for St Ives (Derek Thomas) referred to removing people from fuel poverty, winter deaths, delivering social care, and how children learn better in warm homes. My hon. Friends the Members for East Londonderry (Mr Campbell) and for Upper Bann (David Simpson), and the hon. Member for Hammersmith (Andy Slaughter), focused in their interventions on social housing and socioeconomic issues. Health and housing cannot be divorced, as the debate has reinforced.

The hon. Member for Coventry North East (Colleen Fletcher) referred to how house deterioration makes people physically and mentally ill, and to the issue of rogue landlords, which the Minister also mentioned. Tenants are at their wits’ end. The hon. Member for York Central (Rachael Maskell) referred to 200 homes with water rising under the floorboards. She is clearly in touch with her constituents when it comes to raising the standard and condition of older homes. She referred to the APPG for ageing and older people, and security in later life, which is important.

The hon. Member for Huddersfield (Mr Sheerman) referred to carbon monoxide and cowboy builders. Old homes need to be upgraded, but social housing, private rented accommodation, student accommodation and smoke alarms are also all critical issues. The hon. Member for Linlithgow and East Falkirk (Martyn Day), the Scottish National party spokesperson, spoke of the debate’s importance, and how homes must be warm, dry and affordable. He gave us a Scottish perspective on the issues. Again, overcrowding, pressure and family relationships are so important. The shadow Minister, the hon. Member for Great Grimsby (Melanie Onn), described how many homes are not up to standard. She talked about low incomes, renting from disreputable landlords, health and infections in homes. Those issues are all important.

I thank the Minister for responding so well to all our contributions and questions. It is always a pleasure to be in her company, and it was a pleasure to hear her response to the points that we made on cold homes, healthy place-making, and safe, decent housing. She responded by showing her commitment to those issues. I am very pleased that she suggested a meeting. It is very clear to me that on safety regulations, she answered the questions regarding healthy homes and buildings.

I thank the secretariat of the APPG for healthy homes and buildings, who are in the Gallery, for their valuable contribution to making this happen, and to the white paper inquiry and its conclusions. We have all contributed to a very important debate on healthy homes and buildings and the NHS. There is so much more that we can do. Today we demonstrated to the Minister, singularly and collectively, that there is so much more that we can do. We are all committed, alongside the Minister, to ensuring that we deliver on that.

Again, I thank all Members for their contributions, and for being here on a Tuesday morning. It is such a pleasure to be here on a Tuesday morning, rather than at 3.30 on a Thursday afternoon.

Question put and agreed to.

Resolved,

That this House has considered the cost of unhealthy housing to the NHS.