King’s Speech

Lord Best Excerpts

Thursday 9th November 2023 Lords Chamber

[Lord Best (CB)]

My Lords, I declare my various housing interests on the register, including as chair of the Devon Housing Commission, whose work informs my comments today. I welcome the Government’s proposals in the Renters (Reform) Bill and the announcement of important legislation on leasehold reform. I am sure that there will be significant work for your Lordships when these legislative measures reach us in the months ahead. But today I will concentrate on the bigger picture and the need for a longer-term national housing strategy to address a housing situation that, I believe, has taken a serious turn for the worse, even in the last few months.

I suggest that there are three areas crying out for long-term forward planning. First, we must dramatically increase the amount of new accommodation created each year; the 300,000 homes per annum target is a start. Secondly, we must have a plan for upgrading the standards and energy efficiency of outdated existing properties to address health inequalities, fuel poverty and climate change imperatives. Thirdly, in respect of building new homes and upgrading existing homes, we must target that half of the population where incomes are below the median.

My starting point for believing that the situation has become more urgent over recent months is the evidence from the temporary accommodation statistics. The numbers in this predicament have seen an alarming increase. We have the extraordinary statistic that one in 50 Londoners, and one in 23 children, are classified as homeless. But this phenomenon has spread nationwide. For example, the position in the unitary council covering Cornwall demonstrates the crisis: from having to house 200 households in temporary accommodation before Covid, the figure today is around 800. This has a drastic impact on local authority finances at a time when, as we all know, these are badly stretched. The national bill for temporary accommodation—which is often entirely unsuitable and far from friends and family—is now approaching £2 billion per annum across the country.

Of course, housing shortages, while most painful for those on the lowest incomes, also affect many people who have expected to become home owners. The number of first-time buyers has fallen by 22% this year. The cost of becoming a home buyer has doubled as a percentage of earnings, now compounded by higher interest rates. But, because of supply shortages, prices have not fallen. Overall, home ownership has declined to around 64%, from its peak of over 71%. Some 4.9 million people in the 25 to 34 age group are now living with their parents. Even where a couple have been able to purchase on their combined income, the price has often been paid in being unable to start a family.

Private renting will be the only option, but there is recent evidence that even the private rented sector is proving unable to help the next generation. Although rents are up 27% since the pandemic, the industry reports an average of 24 would-be tenants for every vacancy. For 23 of the applicants, there is nothing but disappointment if not the horrors of homelessness. The reason is that demand has risen but landlords are exiting the market. This is because of taxation arrangements rightly intended to deter speculative investors, necessary requirements for higher standards, the higher interest rates that affect the two-thirds of PRS properties that have mortgages, and much-reduced prospects of making capital gains.

I should add, drawing on the work of the Devon Housing Commission, that the decline of private renting has been exacerbated by the advantages of switching to short-term lettings of the Airbnb kind. This is hastening the loss of homes for locals to rent in almost all rural and seaside locations. Although remedies are in the pipeline, they will close the stable door only after this horse has, I fear, bolted.

This is the background to my contention that we need a long-term plan to massively increase production of new homes, while embarking on a programme of modernisation of poor-quality existing accommodation. Although these are necessary measures, they are not sufficient to ensure that the benefits reach those in the lower half of earnings. It is the not-for-profit sector—the housing associations, councils and community-led housing providers—that has the potential to step up new production and, indeed, to acquire and modernise existing substandard properties, but even this sector faces new challenges. It must invest heavily in its own existing housing stock to rectify building safety problems, to upgrade outdated council housing of yesteryear and to decarbonise homes. It is hit by both inflation, with building costs rising by more than rents, and escalating interest rates, so, regrettably, boosting this sector will not come cheap.

In conclusion, there will be valuable changes for this House to make to improve forthcoming housing legislation, but a much more ambitious, longer-term national housing strategy is required to address the underlying issues of land acquisition, planning, construction skills and so on—a road map with a timeline to chart progress over the next 25 or 30 years. Action to bring this together desperately needs to start now.

Health and Care Bill

Lord Best Excerpts

Committee stage
Thursday 20th January 2022 Lords Chamber

[Baroness Greengross (CB)]

My Lords, I am in favour of the amendments in this group in the name of the noble Lord, Lord Howarth, specifically Amendments 59, 67, 71, 77, 80 and 82. My own Amendment 290 will be debated in group 41 and specifically addresses the importance of social prescribing for people with a dementia diagnosis and how this can form part of a wider care plan.

Social prescribing plays a very important role, not just for people with diagnosed conditions but generally, as part of wider brain health. Research by Arts 4 Dementia found that music-making provides a tool for a total brain workout and improves plasticity in the cortex, which enhances the ageing brain’s cognitive abilities, perception, motor function and working memory. It also improves cardiovascular strength while reducing stress. The Coda Music Trust provides a range of musical social ensembles and bands, as well as courses and classes for learning and well-being. In other studies, drama and poetry have been found to improve concentration and cause new neurons to develop and adapt.

Social prescribing has been recognised as playing an important role. It is part of the NHS long-term plan, and the Department of Health and Social Care has allocated funding to establish a national academy for social prescribing. This growing recognition of the role that social prescribing, specifically of music and art, can play in overall health is a welcome development because many of the programmes that exist at present rely on the voluntary sector.

During the pandemic, these programmes, like most of the voluntary sector, have struggled with funding and with being able to continue their work under Covid-19 restrictions. We also know that many arts venues have struggled through this time and many theatres and music venues now face an uncertain future. This sector therefore needs much more support right now if it is to continue its work. It is crucial that integrated care boards are empowered to promote social prescribing and can work with organisations that provide these services.

Although the evidence for the benefits of social prescribing is growing, more work is needed to research what types of social prescribing are successful for specific conditions, a point that I will elaborate on when we debate my Amendment 290, which addresses social prescribing and dementia. To help promote social prescribing, we need more training for GPs and other health professionals on how and when to prescribe these services. We also need to include arts awareness for mild cognitive impairment in the medical and social care educational curriculum.

There also needs to be greater availability of these services, with links to every GP. The current NICE guidelines for dementia recommend referring patients for these services only post diagnosis when, in fact, to promote overall well-being and brain health, we should encourage them much earlier from the onset of symptoms. For this, we need training, and integrated health boards must prioritise the availability of these services.

I thank the noble Lord, Lord Howarth, for these amendments and fully support their inclusion in the Bill. I look forward to the Minister’s response. I also want to take this opportunity to thank the noble Lord, Lord Kamall, whom I have often heard recently. He confirmed that his blues band, Exiled in Brussels, will play at an event supporting Music for Dementia later this year.

[Lord Best (CB)]

My Lords, I thank the noble Lord, Lord Howarth of Newport, for his inspiring speech. I declare an interest as a vice-president of the Local Government Association. I also chair the University of Oxford’s Commission on Creating Healthy Cities, which brings together academics, policymakers and practitioners. We hope to support city leaders and their citizens by shedding light on the policy interventions that are most likely to be effective in enhancing the health of their cities.

The Oxford commission is not due to report until later this year, but it is already clear that the two core issues raised by the noble Lord, Lord Howarth, in this group are likely to be central to our conclusions. The first relates to the wider determinants of health creation that take us beyond the integration of health and social care services towards recognising the relationship of public and personal health to other non-clinical services, including those affecting the built environment. The second issue relates to the value of engaging local and community organisations in a variety of ways in achieving health outcomes.

Elderly Social Care (Insurance) Bill [HL]

Lord Best Excerpts

2nd reading
Friday 16th July 2021 Lords Chamber

[Lord Best (CB) [V]]

My Lords, I congratulate the noble Lord, Lord Lilley, on bringing forward this Bill and on seeking to address the long-running concern of home owners that care costs could necessitate the sale of their home and deprive their heirs and successors of their inheritance. I declare my interest as a vice-president and past president of the Local Government Association.

I have three points to share with your Lordships. First, drawing on the extensive work of the APPG on Housing and Care for Older People, I would emphasise that the best way to address rising care costs is to prevent or postpone the need for personal care and, in particular, the need to move into residential care. The APPG has spelt out the significance of ensuring that older people have a manageable, accessible home through adaptions to their existing accommodation or through rightsizing to somewhere more suitable. So, my first point is that the most positive way of tackling care costs comes from investing in better housing for later life.

Secondly, if a care insurance scheme is to be considered, this Bill’s version seems to have some flaws. The voluntary nature of this scheme may mean a low take-up for multiple reasons, and it may be unworkable because of adverse selection—take-up mostly by those who feel fairly sure that they are going to need personal care, perhaps because they have underlying health problems, are overweight, are smokers, have early signs of dementia and so on. However, insurance could be a practical solution to meeting not the costs of care but the “hotel” costs, which, at around £25,000 per annum, are roughly half the total charges for living in a residential care home. But these costs are outside the scope of the scheme proposed by the noble Lord, Lord Lilley.

Thirdly, in supporting the excellent report from your Lordships’ Economic Affairs Committee, chaired by the noble Lord, Lord Forsyth, I would both affirm the urgency of an immediate injection of additional funding for local authority adult care services and underline the core recommendation for free personal care in the future in place of the current unfair, complex, underresourced arrangements. To illustrate just how long these same conclusions have had widespread support, I must quote from a Joseph Rowntree Foundation inquiry—incidentally with Sir Andrew Dilnot among its members—which reported exactly 25 years ago. This inquiry concluded that artificial

“distinctions between ‘health care’ and ‘social care’ … should be rejected. Both should be free at the point of delivery”.

The inquiry spelt out how national insurance contributions could help fund this. So, a quarter of a century later, my third point is that the Bill proposed by the noble Lord, Lord Lilley, must not distract, postpone or undermine progress towards our Economic Affairs Committee’s radical but affordable conclusions.