Time to reunite housing and public health in Wales?
There is a growing body of evidence to demonstrate the spend-to-save benefits of investment in housing. According to research recently funded by Shelter Cymru and the Building Research Establishment (BRE) Trust, the costs to the NHS in Wales of dealing with Category 1 Hazards under the Housing Health and Safety Rating System (HHSRS) are around £67million a year.
The total cost to society, which includes factors such as children’s poor educational attainment and reduced life chances, is much greater and estimated at around £168million a year.
By focusing solely on the very worst hazards in the home, such as unsafe steps, electrical hazards, excessive cold, damp and mould, we have been able to put a definitive financial cost on poor housing in Wales.
The study shows that the total cost of bringing all poor housing in Wales to an acceptable condition would be around £1.5billion, with approximately half of this associated with addressing cold homes and a further quarter linked to reducing fall hazards.
The payback time to the NHS if all this work were carried out would be 22 years, however, some areas could be paid back in much less time. Investment in addressing dangerous stairs for example would be paid back in 5.7 years.
Around 20 per cent of homes with the most serious health hazards could be made acceptable for less than £520, and half for less than £1,600.
It has never been more important to make the economic case for decent housing and to show policymakers that efficiency savings can be achieved by focusing on better outcomes for people.
Care and Repair Cymru has calculated that the average cost of adapting a person’s home is £6,500, compared to £27,000 per year for residential care or £28,000 for hip replacement surgery.
The Rapid Response Adaptation Programme delivered by Care and Repair across Wales saves the NHS and social services £7.50 for every £1 spent, by keeping older people out of hospital and residential care and enabling them to return home quicker from a stay in hospital.
A joined-up policy approach needs to acknowledge the interrelationships between housing and other strategic areas. Importantly, it needs to ensure that cost-benefit effects are fully realised and exploited. Shelter Cymru is asking whether now is the time for a dramatic change in how we view housing as a political priority.
Historically, the political relationship between housing and public health was much closer, as we can see in the significant legislative changes and investment of the late 19th and early 20th century and, of course, in Aneurin Bevan’s post-war Ministry of Health and Housing.
Delegates at the launch of our report in April 2011 talked about the many ways in which housing and health need to work together more closely. For example:
- there is a need for more information for frontline workers in health and social care on the links between housing and health to enable them to identify problems and refer or signpost people for help
- Government should do more to facilitate joint working at a local level between health and housing services and departments
- funding streams should enable proactive work to tackle fuel poverty and prevent health problems rather than taking a reactive approach.
As we enter a new Assembly term, we need to have a debate over the best way of achieving the twin goals of efficiency savings and better housing.
Could linking housing much more closely with health – the single biggest spending department in the Welsh Government – be a way of securing that change?
The Road Ahead
Shelter Cymru’s conference
30 June / 1 July
Shelter Cymru’s 2011 conference takes place in a climate of unprecedented political change and is shaping up to be one of our best programmes to date.
Join us in our 30th birthday year as we debate the effect of the ‘yes’ vote in March’s referendum on Assembly powers, what we can expect from the new Welsh Government in Cardiff Bay, the impact on Wales of the coalition government in Westminster, and much more.
For further information on the programme and booking details, go to www.sheltercymru.org.uk