Without a doubt one of the key determinants of health is the home you live in. Is it a home or is it just a place where you have to live? Is it adequate to your needs? Is It big enough? Is it warm? Does the roof leak? Is it set in a nice neighbourhood which is clean, green and safe? If, you can say yes to all these features then it is likely that you will be in good physical and mental health.
Unfortunately, too many of our fellow citizens can only answer no to most if not all of these questions. That means that a large number of people in every part of the Country suffer unnecessary ill health because of their living circumstances.
This seems to me to be blindingly obvious and has done since I first took responsibility for dealing with Liverpool’s homeless way back in 1975. This lack of comprehension in certain quarters led me to attend a series of workshops yesterday on the theme of health and housing. Interestingly, it was not arranged and led by any housing body like the National Housing Federation or Shelter but by the doyen of the medical establishment the British Medical Association. I was there to represent the Local Government Association and was delighted to find other councillors there from councils or who were also GPs or otherwise in the medical profession.
The BMA arranged the event because they see the effects in a variety of ways of poorly housed or homeless people boomeranging in and out of the NHS. This causes huge stress within the NHS; huge cost and, even more importantly, distress to the people themselves.
We heard some appalling facts about the cost of homeless in financial and personal terms:
- We spend £1 billion every year on ‘temporary’ accommodation.
- Poor housing leads to conditions which cost the NHS £1.4 billion every year to treat.
- A man with long term homelessness is likely to die at the age of 44 and a woman at the age of 42.
- 1.5 million tenants of private landlords have some element of dementia and landlords are totally unprepared for the increase in the number of their tenants with this condition.
- If landlords were to evict these people there is nowhere for them to go.
- Over the last 30 years the cost of housing benefit to the Exchequer has risen from £4 billion per year to £24 billion.
- Governments of all persuasions have failed to meet their own new housing targets irrespective of tenure type for every year since 1974.
- Between 1997 and 2010 the number of social homes declined by 330,000.
We saw a video of just such a human boomerang. He went to a hospital and was admitted to it 4 times in one year. When he got better and was fit, he was discharged to his home – a shop doorway 200 yards from the hospital!
Of course, there are many other problems caused by zero or poor housing. A safe home is a fundamental platform for life. Without a good home your chance of a good education is reduced. Without an address your likelihood of getting a job is reduced. If your home is in a dangerous area you don’t go out so you become lonely and are likely to suffer from depression and other mental illnesses.
Last year a commission established by Shelter estimated that the Country needed 3 million more social homes. Crucially for those that need to persuade a reluctant treasury this housing investment paid off within 40 years by the savings it created inside public sector budgets of many types. It would also have the much-needed effect of bring down the cost of private housing as well as the pressure on the housing market as a whole was reduced.
If this is so blindingly obvious why haven’t we built the social homes we need over the last 4 decades and why won’t we do it now? The answer comes because of an obsession with home ownership. Ironically yesterday the Tory Government introduced yet another scheme for subsidising home ownership.
There is now an alphabet soup of projects and schemes with this intent although there is clear evidence than all this does is put yet more money into the hands of mass house builders like Crest Nicholson and Redrow and encourage even more the growth of buy to let schemes which have so disfigured my own City of Liverpool.
I advanced two ideas on behalf of local government:
The first was to support the Shelter call for an investment in social housing.
The second was for a mandatory licensing scheme for private landlords which would be established nationally but delivered locally. There is such clear evidence now that bad landlords are causing people to live in appalling conditions which has a major effect on their health and therefore become a major burden on the NHS. The scheme would be backed up by moves to ensure that at the end of, say, a 3-year period housing benefit would not be paid to tenants of landlords who were not registered and who could not, therefore, prove that their units of accommodation were habitable.
I was then challenged to say what I thought the BMA’s next steps should be. My answer was to ask them to make an offer to Government and the other major parties to provide a ‘safe place’ to build a consensus over two areas of concern which are closely related housing and the growth in the numbers of elderly and especially infirm elderly.
Both of these require long-term solutions and solution which will, therefore, stretch over a number of Parliaments which will inevitably be led by different political parties. The buy in must be achieved if there is not to be a chopping and changing of policies which will inhibit long term planning.
Is this such a big ask? Can’t we really as a society accept that everyone has a decent place in which to live. Can we really not, as a society, understand that the consequences of poor housing is a huge financial burden on the state and appalling health conditions for too many or our citizens? We have the 6th biggest economy in the World and are about the 25th wealthiest in terms of GDP per head. We have the cash to deal with these issues if we choose to. I don’t believe that we have a credible or moral alternative.