Homes and Buildings: Levelling Up Health and Wellbeing

Sarah Owen Excerpts

Thursday 20th October 2022 Westminster Hall

[Sarah Owen (Luton North) (Lab)]

It is a pleasure to see you in the Chair this afternoon, Mr Hollobone. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this valuable debate on an area of importance to all our constituents, and one that too often flies under the radar. He speaks with compassion and experience about the link between health and housing. I also thank the other speakers this afternoon, the hon. Member for Tiverton and Honiton (Richard Foord) and my hon. Friend the Member for Coventry North West (Taiwo Owatemi), for their reasoned and insightful comments.

Whatever melodrama is happening outside, this issue matters to the people we represent. When it comes to the nation’s health, we know that prevention is unequivocally better than cure, in terms of the human cost and the toll on individuals, but also in terms of the sound management of public finances.

We see the impact of under-investment in social and primary care settings on our acute hospitals. We know that investment to tackle the scourges of public health, such as smoking and obesity, ultimately pays for itself in the long run, as well as helping people to live happier, healthier and longer lives. It should not be controversial to aspire to want that for our constituents. It is common sense, not nanny-statism, as some would have it. It is no different from other factors that impact public health and wellbeing, which are many, varied and not always immediately obvious, as we have heard today.

My hon. Friend the Member for Coventry North West spoke eloquently and passionately, from her considerable experience in the public health field. We know that diseases such as cancers, diabetes, cardiovascular disease and respiratory disease cause around 89% of deaths in the UK. The House of Lords Select Committee on the Long-term Sustainability of the NHS concluded that:

“These conditions are also, to a significant extent, preventable and the costs, in human, social and economic terms, are largely avoidable.”

The World Health Organisation has made it clear that poverty is closely linked with these diseases. Vulnerable and socially disadvantaged people get sicker and die sooner than people of higher social positions. As the hon. Member for Strangford rightly said, we saw that play out starkly with the covid-19 pandemic. We need to see action taken to close those health inequalities.

Risk factors associated with poverty and deprivation include tobacco use, physical inactivity, unhealthy diet and the harmful use of alcohol. Economic and social conditions contribute significantly to levels of preventable ill health. The levels of health inequality in the UK were already too great but, shamefully, they are just getting worse. According to the Office for National Statistics, in 2018 to 2020, males living in the most deprived areas were living almost 10 years less than males living in the least deprived areas, with the gap at around eight years for females. Both sexes have seen statistically significant increases in inequality and life expectancy at birth since 2015 to 2017.

This is not necessarily about regions, or differences from one end of the country to the other. In my constituency of Luton North, we see the difference in life expectancy from one end of the town to the other, and that is to say nothing of the consequences of poverty and deprivation for mental health. Being deprived is not just about a lack of money. It is a lack of quality of life. It is community insecurity and a lack of resources overall, whether that is about exposure to stressor such as violence and crime, or a lack of public green space.

Public Health England has stated that:

“Insecure, poor quality and overcrowded houses cause stress, anxiety and depression, and exacerbates existing mental health conditions. 19% of adults living in poor quality housing in England have poor mental health outcomes.”

I feel that figure might be a gross under-representation. We also know that the research shows that people with a mental health problem are much more likely to have preventable physical health conditions as well.

What can be done? It would be disingenuous of me to stand here and say that poor mental and physical public health could be remedied by action on housing alone, but it is a key part of the puzzle of reducing the UK’s entrenched geographic, ethnic and demographic inequalities. That being said, there are things that the Government can and should do now, which have the potential to have a rapid and significant impact on ending the creation of unhealthy homes.

In the longer term, we need to overhaul the complex, fragmented system that allows new homes and places to be built that do not guarantee that all new homes provide for residents’ basic human needs, such as access to green space and local services, and clean air. We need developments that are guided by communities, with input from public health professionals on design, and proper infrastructure to support them, whether that is about encouraging active travel, access to green space, public leisure facilities or even allotments and communal vegetable gardens—although do not let me anywhere near those, because I am not green-fingered.

We need to do much better in setting standards for developments across the country and looking at methods for how they can be delivered. Research by Public Health England in 2017 clearly demonstrated the relationship between the built environment and health and the positive impact provision of these basic amenities can have.

A matter of more immediate concern is the liberalisation of permitted development rights by the Government in 2013, which has had a significant detrimental effect on the quality of dwellings produced as a result. Ministers both past and present have claimed—and future ones possibly will—that liberalisation of planning and permitted development rights removes unnecessary impediments to development. However, the evidence overwhelming shows that the impact of extending permitted development rights to convert office, commercial and industrial units into supposedly residential spaces—although I think very few of them could be described as such—is negative.

We have seen a huge increase in poor-quality housing that lacks space and natural light, and there are accompanying implications for public health and wellbeing as a result. The Government’s own research has shown that schemes created through permitted development projects are far less likely to meet national space standards and far more likely to have reduced access to natural daylight and sunlight. Space and daylight are the very basics. The former Ministry of Housing, Communities and Local Government’s housing and safety rating system states that

“lack of space has been linked to psychological distress and various mental disorders”

and problems such as

“accidents and spread of contagious disease.”

Some residential conversions are as small as 13 square metres, which is a third of the minimum space standard recommended by Government. Terminus House in Harlow, a former office block converted into hundreds of dwellings, was described as a “human warehouse”. That sounds like something from the Victorian era, not 2022. The Government’s Building Better, Building Beautiful Commission’s final report also concluded that:

“In some instances, we have inadvertently permissioned future slums.”

The 2018 Raynsford review of planning also concluded in a reference to the liberalisation of permitted development rights that:

“Government policy has led directly to the creation of slum housing. Such slums will require immense public investment, either to refurbish them to a proper standard or to demolish them. Morally, economically and environmentally it is a failed policy.”

That is a damning indictment of this policy and the Government’s approach to housing. In the light of all we have heard in this debate and the examples I have outlined from reports commissioned by the Government themselves, I would be particularly keen to hear from the Minister what possible justification there is for retaining these liberalised permitted development rights in their current form.

Reducing socioeconomic and health disparities in this country cannot happen without serious consideration of the role of housing and planning in creating buildings and communities that promote healthy lifestyles. We owe it to communities up and down this country to make positive changes a reality. They will not be achieved by the proposed deregulation in planning in investment zones. We have seen from the experience of permitted developments that further liberalisation is a cowboy developers’ charter for poor-quality, profit-maximising estates. I look forward to hearing from the Minister how we will approach the issue of promoting health and wellbeing in new developments in these zones.