Homes and Buildings: Levelling Up Health and Wellbeing

Richard Foord Excerpts

Thursday 20th October 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the role of homes and buildings in levelling up health and wellbeing.

As always, it is a pleasure to serve under your chairmanship, Mr Hollobone. This is a very important issue. I understand from others that some other statements are being made at this moment in time, or thereabouts—well, people cannot always be in this Chamber when other things are perhaps more engaging.

We have not had a debate on this issue in Westminster Hall or, indeed, in Westminster for a year and a half, maybe even two. I chair the all-party parliamentary group on healthy homes and buildings and we wanted to refresh the House’s awareness of the issue, so Westminster Hall seemed the obvious place to come to do just that. I thank the Backbench Business Committee for agreeing to my application and I am delighted to have secured a debate to discuss the very important role homes and buildings play in levelling up health and wellbeing.

I came into the House in 2010, when the independent Marmot review was taking place. Let me set the scene with a quote from a House of Commons Library paper:

“The causal link between poor housing conditions and poor health outcomes is long established. The independent Marmot Review (2010) said housing is a ‘social determinant of health’ meaning it can affect physical and mental health inequalities throughout life. The Marmot Review 10 Years On—Health Equity in England, recorded an expansion in research on the relationship between poor housing and health”.

We cannot divorce the two. Quite simply, wellbeing, health and housing are intertwined. Today’s debate is important because, as the Government move forward with their policies and strategies, we need a clear strategy that takes up the issue of housing and health. The 10-year review of Marmot said:

“Poor-quality housing harms health and evidence shows that exposure to poor housing conditions (including damp, cold, mould, noise) is strongly associated with poor health, both physical and mental. The longer the exposure to poor conditions, including cold, the greater the impact on mental and physical health. Specific physical effects are morbidity including respiratory conditions, cardiovascular disease and communicable disease transmission, and increased mortality. In terms of mental health impacts, living in non-decent, cold or overcrowded housing and in unaffordable housing has been associated with increased stress and a reduction in a sense of empowerment and control over one’s life and with depression and anxiety. Children living in overcrowded homes are more likely to be stressed, anxious and depressed, have poorer physical health, attain less well at school and have a greater risk of behavioural problems than those in uncrowded homes.”

I also chair the all-party parliamentary group on respiratory health—I am wearing my two chairs’ hats. Furthermore, of the many all-party parliamentary groups on which we all serve, I also chair the all-party parliamentary group on vascular and venous disease. Again, these issues are key. That is why the debate is so important.

Let me spend some time on the hazards. Across England, Yorkshire and the Humber are the regions with the highest proportion of homes with category 1 hazards, at 15%. The east had pretty damning figures as well. The figure for Northern Ireland, which concerned me greatly, was that 9% of homes had a problem. The midlands was at 13%, the north-west 12% and the south-east and London had the lowest proportion. I find that hard to believe, considering some of the information I am aware of. I see that the hon. Member for Luton North (Sarah Owen) is present to speak on behalf of the Labour party, and some figures from others’ constituencies may contradict what is being said. An estimated 18% of homes in Wales had a category 1 hazard. Given the busy job that I do in my office as an elected MP, I know that mould growth in houses—be they Housing Executive houses back home, housing associations or private rentals—affects people’s health.

The hon. Member for Wansbeck (Ian Lavery) asked how the Government’s levelling-up policy planned to tackle

“illnesses directly linked to living in cold, damp and dangerous conditions.”

The then Parliamentary Under-Secretary of State for Health and Social Care, the hon. Member for Erewash (Maggie Throup), replied that it was an important issue and that a

“decent home can promote good health and protect from illness and harm.”—[Official Report, 19 April 2022; Vol. 712, c. 12.]

All those things set the scene for where we are today and why it is so important that we move forward in a constructive and positive fashion. Most of us spend over 90% of our time indoors, so the nation’s homes and buildings should positively contribute to our physical and mental health and wellbeing, and not in any way diminish it.

The covid-19 pandemic highlighted prevailing health inequalities in our society. The most vulnerable are more likely to live in unhealthy homes that are damp, energy-inefficient, noisy, poorly ventilated and crowded. The inextricable link between our health and wellbeing, and the homes and buildings where we work, rest and play, is clear—never more so than during the pandemic. There were a great many negatives to the pandemic, and it emphasised some of the areas where improvement can take place. Having to spend more time in our homes, with many more people working remotely, emphasised the impact that our homes and buildings have on our health. Unhealthy housing impacts on economic growth, business performance, educational attainment, life chances, climate change and our nation’s health and wellbeing. Therefore, it makes sense to join up policy thinking, frameworks and standards and to ensure that all future housing, net zero and health policies do not contribute to, cause or exacerbate poor health and wellbeing.

The current energy and cost of living crises will only increase the problems caused by unhealthy homes and buildings. It is like a double whammy, because as the energy crisis hits and prices increase, that puts pressure on landlords, tenants and families from sides that they were perhaps not expecting. Many charities and other bodies across the United Kingdom of Great Britain and Northern Ireland predict—I hope they are wrong—a record number of excess winter deaths this year linked to thermal inefficiency in the housing stock. We must try to prevent deaths and ensure that they do not become a critical issue, although all the pointers seem to indicate that that will happen. There is strong evidence to support the idea that poor-quality and unhealthy homes cause or exacerbate poor health, thereby placing more pressure on our NHS.

Like others in this Chamber, I believe that if we can have early diagnosis and stop things happening in homes, we can improve further down the line when we do not have the major health problems that come off the back of poor housing. The Building Research Establishment, or BRE, estimated that in 2010 poor housing cost the NHS £2.5 billion in first-year treatment costs—it is a big figure. Again, that indicates exactly where the issues are and why it is so important that every step is taken to address them. Building design, the retrofitting of buildings and the renovation of the current housing stock should adopt a holistic approach.

[Richard Foord (Tiverton and Honiton) (LD)]

I thank the hon. Member for securing this important debate. I agree with him that the places we call home can have a huge impact on our health and wellbeing, particularly given the amount of time that we spend in them. In rural areas such as my part of Devon, that is even more pronounced, as buildings tend to be older, which means that they are often less energy-efficient and lack modern insulation. Does the hon. Member agree that the key to protecting people’s health and wellbeing is to ensure that buildings, and particularly our homes, are properly insulated?

[Jim Shannon]

I fully support that. I am probably of a greater age than nearly everybody in this Chamber, and I remember when we had not heard of insulation. We know about it today, and it is clearly part of having healthy homes. I thank the hon. Gentleman for that intervention, which sets the scene for what we need to do. I look to the Minister for a positive response.

Energy efficiency, indoor air quality, ventilation, lighting and acoustics are all clearly big issues, and the health, comfort and wellbeing of residents should be placed at the heart of good building and infrastructure planning. I understand that the Government have a policy to ensure that new builds adhere to those conditions to ensure the betterment that we want to see, but we must also address the question of homes that do not have those things, which brings me to insulation. There must be a plan of action. Will the Minister give us some indication of what the Government are doing to help buildings that do not come up to that standard?

I am very pleased to see the shadow Minister in her place, and I look forward to her contribution. I also look forward to the Minister’s contribution, and I wish him well in his new role.

UK Green Building Council research found that 75% of new developments have poor thermal quality and performance—the very issue that the hon. Gentleman raised. To level up and reduce health inequalities, the Government must commit to deliver higher standards, and performance must be measured rather than just designed. It is very easy—I say this respectfully—to have a plan of action, but we also need the action. Again, I look forward to the Minister’s response.

We need to futureproof the built environment. New building and planning law must be designed and reformed to be fit for our long-term future. Some 85% of our homes will still exist in 2050. It is a sobering thought that the homes that are built today are there for a long time, so let us make sure energy efficiency, wellbeing and health implications are all part of an intricate system.

To level up, we need a national retrofitting strategy focused on delivering health and wellbeing. The Building Research Establishment estimates that poor housing in England costs £18.6 billion per annum. That affects the health of thousands of people. Again, that is really worrying.

The subject of the debate is critical for people’s health. Health and wellbeing must now be placed at the heart of Government housing, environment, skills, planning and energy policy in order to level up and reduce the UK’s health inequalities. There is a collateral burden on our healthcare, education and public services.

I thank the Library staff for their background notes, which greatly enhance my knowledge of the subject and add to the debate. They refer to a number of things, including housing and covid-19, which we all, as elected representatives, know about. We must also look at housing and dementia. I am sure it is no different for other Members, but I have more constituents than ever being diagnosed with dementia and Alzheimer’s. The population is living longer. That does not always mean that people with Alzheimer’s or dementia are of a certain age, of course, but the fact is that most of them are. There are some things that we need to do about housing and dementia. I have also never seen so many people with mental health issues. Covid-19, dementia and mental health are three things that need to be correlated with housing and health.

The all-party parliamentary group for healthy homes and buildings is calling on the Government and the Minister to take forward its recommendations in its “Building our Future: Laying the Foundations for Healthy Homes and Buildings” white paper, to adopt a more holistic and joined-up approach to tackle the problem of unhealthy homes and buildings in Britain, and to adopt Lord Crisp’s Healthy Homes Bill. I am sure that the Minister is very aware of that. He might wish to comment now. The white paper sets a clear direction and has a clear focus, which is helpful. I always make my comments in a constructive fashion; I am in the business, as we all are, of solutions, not negativity. If we highlight the issues, we can highlight the solutions.

Lord Crisp has called for a joined-up, holistic approach to healthy homes, health and wellbeing in the context of the Government’s levelling-up agenda—which I know the Government are committed to and which I welcome—the Government’s heat and buildings strategy, the decent homes standard review, the Building Safety Act 2022 and updated planning reforms. Those are five things into which the Government have a direct input.

We must also recognise the cost benefits of improving and levelling up our homes and communities, to remove health inequalities and positively contribute to the climate agenda. We cannot ignore climate change; it is a reality. When we build our homes, we must recognise that we need more energy efficiency. We want to meet the Government’s net zero 2050 target, to which this United Kingdom is committed.

We also want to commit to introduce legislation that addresses the growing health problems caused or exacerbated by the UK’s unhealthy homes and buildings. I watched a news story on flats in London. I just could not believe that anybody could ever live healthily in some of those properties, with the decay and mould growth. The danger to people was quite real.

We must also act to reduce health inequalities right across this great United Kingdom of Great Britain and Northern Ireland—I am ever mindful that the Minister is directly responsible only for England—and ensure that Britain’s homes and buildings do not cause or exacerbate poor health and wellbeing. The cost to society and the NHS is far too vast, and it is the poorest in our society who are particularly affected; it always is. I have a duty—we all do—to help those who need help most, and those are often the poorest in our society.

We must also enshrine a clear definition of health and wellbeing in future legislation. The healthy homes and buildings APPG white paper referenced the World Health Organisation’s definition of health as

“a state of complete physical, mental and social well-being”.

A healthy home is a safe home. However, at present, many homes are unsafe. I have some information from a group that I work with back home, Electrical Safety First, which gave me some stats for England. In England alone, there are five fires every week caused by electrical installations in homes. Electricity causes the majority of house fires, accounting for 53.4% of all accidental dwelling fires. I have also worked with a good friend, a fella called Michael Hilland, who was an electrical contractor. He no longer has his business, but he advises. I thank him and his organisation for the information.

Electrical Safety First believes that house fires can be reduced by mandating periodic electrical safety checks in homes across the United Kingdom. That is already the case for the private rented sector, and it should be for all housing associations, and indeed for the Housing Executive, which we have back home. However, enforcement measures do not go far enough. In the social rented sector, tenants will soon be protected. However, clarity is needed about whether electrical safety checks will cover installations and appliances, and also whether landlords will be given statutory powers to undertake electrical safety checks. I look to the Minister for some direction on that.

In the owner-occupier sector, there are currently no electrical safety protections. That is concerning, given that owner-occupied housing is likely to have the most dated electrical wiring, and houses a greater proportion of the elderly population, who are more vulnerable to electrical safety risks. The fact is, our mobility decreases as we get older. If we are living in a house that may be outdated or, indeed, where it takes time to get up and down the stairs or time to get out of the house, then, when it comes to electrical safety, more action needs to be taken.

The issue is particularly concerning because the owner-occupier sector makes up the largest housing tenure, accounting for some 65% of all households in England. As a result, the majority of households have no statutory protections from electrical safety risks. Again, I ask the Minister: what can be done? I know he will be positive in his response, and I appreciate that in advance, but I need to have the assurance in Hansard that the Government will take on board the things we are outlining. In total, across England, that means that some 15 million households have no statutory protection from electrical safety risks. That is a concerning figure. Data from the London Fire Brigade found that a greater number of owner-occupiers had experienced a fire than social and private renters combined. Again, that indicates a greater onus to try to sort out owner-occupiers and give them some guidance over what can be done to ensure they are safe and in no danger.

Separately, while there are provisions for vulnerable customers to receive free gas safety checks, no analogous provisions exist for electrical safety checks. I suggest that it is time to put electrical safety checks on the same level as gas safety checks for the simple reason of the number of fires and the dangers that are caused. I believe this must all be taken into consideration.

Health and housing are and always have been linked. That is why this debate is important. If we are to move forward and improve the health of our nation—which, as my party’s health spokesperson, I am happy to promote—housing must be an integral part of that. I do not think we can divorce the two issues; they come intertwined, hand in hand, together. If one defines a person’s basic needs, the right to a healthy home is surely fundamental.

Healthy homes and buildings are not simply those where there is a lack of ill health; a healthy home should mean homes and buildings that maximise the occupants’ physical, mental and social wellbeing. In a nation where mental health, anxiety, covid and advancing diseases have all grown in number, the focus of future housing policy must now shift to health creation. That is why this is an important debate. I hope the Minister will be able to give us some reassurance. We must not look at ill health prevention alone. Ill health prevention must become part of the strategy.

Delivering healthy homes and places is vital to levelling up our communities, towns and cities. This must be integrated together. Health and Housing—the two Departments must work constructively together in a positive fashion. Healthy homes and buildings will make Britain healthier, save money and contribute to increased educational attainment and wealth creation.

In conclusion, I urge the Minister to support the White Paper and the recommendations put forward by the APPG on healthy homes and buildings, and to place healthy housing at the heart of the Government’s levelling-up agenda. I know that the Minister will have had a chance to look at the recommendations made back in 2018; they are as relevant today as they were then. Those recommendations show a strategy and a way forward. I look forward to hearing from the Minister, the shadow Minister, the hon. Member for Luton North, and others contributing.