Health

Lord Best Excerpts

Thursday 26th November 2015 Lords Chamber

[Lord Best (CB)]

My Lords, I am delighted to follow the maiden speech of the noble Baroness, Lady Redfern. She comes to us as a distinguished council leader whose insights, not least from North Lincolnshire, will add an important localist dimension to our deliberations, as she has so impressively shown today. Greg Clark, the Secretary of State, said last year that she was,

“one of the Conservative Party’s most effective politicians”.

Wearing my hat as a past president of the Local Government Association, I am particularly pleased to see the voice of local government strengthened by her presence here. We all look forward to her future contributions in your Lordships’ House.

I, too, am grateful to the noble Lord, Lord Crisp, for initiating and organising this debate, and for his insightful and excellent opening speech. I want to fasten on to the first words in the title of our debate—“building a health-creating society”—and to make a connection between the buildings we inhabit and the health we enjoy.

Housing and health have long been intertwined. For the first half of the last century the Minister for Health doubled as the Housing Minister, so close were the two issues. In the ageing society of the 21st century that linkage needs revitalising and reinforcing. Unsuitable accommodation carries with it a series of dangers to our health and well-being. Overcrowding and poor conditions can create endless ailments and mental health problems. All families have a fundamental need for a decent home in which children have the space and security to develop.

Speaking as chair of the HAPPI group—Housing our Ageing Population: Panel for Innovation—and as co-chair of the Housing and Care for Older People APPG, I want to concentrate on the housing and health equation as it affects older people. So many older people spend virtually every hour of every day inside their home. It can be a trap, a virtual prison, if mobility problems mean that steps and stairs become an insuperable barrier, or if your spouse or your carer must carry you upstairs for a bath. If your central heating has not worked for years because you cannot afford to replace the old system and if the two steps at the front door get icy in bad weather, sooner or later your home will let you down—or indeed, may be the death of you.

As research by Professor Sir Michael Marmot has shown so clearly, cold conditions in this country’s homes lead to respiratory and circulatory diseases and premature winter deaths, contrasting with the outcomes from the far better-insulated homes in Scandinavia, where mortality rates do not vary with the seasons. Trips and falls in the home account for a high proportion of hospital admissions by older people. It is the unsuitability of the home that prevents so many older people being discharged from hospital, or causes them to be readmitted after they have left. You may want to go home, and the hospital certainly wants the bed you occupy, but if your accommodation is totally unsuitable, you must stay in hospital and the NHS is left with an escalating bill for a service you do not want.

Conversely, decent, well-designed housing enhances our enjoyment of life and our ability to live independently and well for longer. If our homes are well insulated, warm and efficient, as well as being well ventilated; if they are light and bright, with sufficient space; if they are lifetime homes—fully accessible, even when we may need a wheelchair—we are unlikely to require hugely costly residential care, and our later years can continue to be fulfilling. I welcome the spending review measures to raise funds for social care, but the biggest savings can come from preventing the need for residential and other care.

Housing designed specifically for older people can also combat that scourge of later life referred to by the noble Baroness, Lady Redfern—loneliness from isolation and a lack of social contacts. Retirement villages, age-exclusive apartments, extra care and assisted living—today’s version by housing associations of the sheltered housing of yesteryear—are all housing solutions that can provide companionable, engaging communities for people with similar ages and interests.

In my five minutes I cannot spell out the range of steps that could be taken by central government in joining up housing with health and care, supporting the creation of new accommodation and funding grants for disabled facilities and home improvement; or by local government in planning policies on integrating housing, care and health, with joint assessment and commissioning, not just in new combined authorities with devolved powers but through health and well-being boards everywhere; or even by each of us past retirement age who should not just wait for a crisis before considering downsizing to sustain our own independence, free up our family homes for the next generation and save the resources of the NHS, social care budgets and our own funds. I must satisfy myself with simply making the plea that all those interested in the health of the nation should never forget the immense significance of housing.