Unhealthy Housing: Cost to the NHS

Rachael Maskell Excerpts

Tuesday 26th February 2019 Westminster Hall

[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.