Unhealthy Housing: Cost to the NHS

I beg to move,

That this House has considered the cost of unhealthy housing to the NHS.

It is a pleasure to serve under your chairmanship, Mr Robertson. I thank right hon. and hon. Members for attending the debate, particularly the Scottish National party spokesperson, the hon. Member for Linlithgow and East Falkirk (Martyn Day); the shadow Minister, the hon. Member for Great Grimsby (Melanie Onn); and the Minister. I look forward to positive contributions from all those able to participate.

I am grateful to have been allocated the debate. As chair of the all-party parliamentary group for healthy homes and buildings, I am delighted to have the opportunity to raise awareness and concerns about the cost of unhealthy homes to the NHS. I thank the background staff, who are in the Gallery, who have given information to us all, myself in particular, to help us in the debate.

Our APPG was created to shed light on the many problems caused to our nation’s health, wellbeing and economy as a result of people living and working in unhealthy homes and buildings. Given that most of us spend some 90% of our time indoors, it stands to reason that our homes need to contribute positively to our physical and mental health and wellbeing, not diminish it. This debate is so important because it pulls together the critical issues. It is perhaps not a normal Westminster Hall debate, but it pushes very much to the fore the effect of the homes that we live in on our health and, ultimately, on the NHS.

The APPG, following a weight of written and oral evidence received, launched a report, “Building our Future: Laying the Foundations for Healthy Homes and Buildings”, in October last year. It was a well addressed report, to which there were many contributions, and it brought together those with a deep interest in homes and those with a deep interest in health issues. It is good to have the report finished.

I have given the Minister a copy of the report, which contains a series of excellent recommendations that are helpful to the Government and will help us to move forward. I hope the debate will be a turning point, and that those recommendations will lay the foundations for change. The report sets out what needs to be done to ensure that new and existing homes do not cause or exacerbate health problems, because they often do. Many of us here, as elected representatives, will have people coming to us every week to complain about their home and, more often than not, the health problems related to that.

This debate is long overdue. It is time to raise awareness of the extent of the problem, and to recognise the human cost to the United Kingdom of Great Britain and Northern Ireland of doing nothing. It is clear from the White Paper that unhealthy homes cost the economy and our society each and every year. Living in or occupying unhealthy homes directly and negatively impacts on human health. Unhealthy homes that lack daylight, or are cold, damp, poorly insulated, energy inefficient, overcrowded, noisy, badly designed and generate poor indoor air quality can, in the extreme, lead to unnecessary deaths.

The hon. Gentleman is an old friend of mine. I think he knows that those of us who campaign on carbon monoxide poisoning really welcomed his excellent report. I have lost three constituents to carbon monoxide poisoning, which is one symptom of an unhealthy home. I assure him that we will work closely with him to ensure that no more people die of carbon monoxide poisoning.

The hon. Gentleman is absolutely right. My hon. Friend the Member for East Londonderry (Mr Campbell), who is sat to my left, also had constituents who passed away a few years ago due to carbon monoxide poisoning. That was in a holiday home, but it was none the less a problem. We in the APPG will take the comments of the hon. Member for Huddersfield (Mr Sheerman) on board, and we look forward to working with him.

Let me detail some of my concerns arising from the evidence that we heard. The effects of poor housing are estimated to cost the NHS £2.5 billion per annum; that rises when we consider all housing throughout the United Kingdom of Great Britain and Northern Ireland. The true cost lies in human misery and lives lost. Some of the figures are quite extreme, but they underline the issue. Some 43,900 excess winter deaths occurred in England and Wales in the winter of 2014-15, with cold homes causing one fifth of those. That is more than the number of deaths caused by road accidents, alcohol or drug abuse, which puts into perspective the need to make sure that homes are healthy. Children in cold homes are more than two times more likely to suffer from a respiratory problem. Cold homes increase the incidence of cold and flu, and worsen conditions such as arthritis and rheumatism. Again, we see that every day in our constituencies.

One in four adolescents living in a cold home is at risk of multiple mental health problems, so we are not always talking about physical issues; there can be emotional and mental issues as well. Those in poor-quality homes that lack effective ventilation suffer from indoor air pollution, which has been linked to allergies, asthma, lung cancer, chronic obstructive pulmonary disease, cardiovascular disease and, more recently, dementia.

I congratulate the hon. Gentleman on securing the debate and on championing this cause. I apologise: I will not be here for the whole debate. I am double-booked. There have been steps forward on this issue, such as the Homes (Fitness for Human Habitation) Act 2018, which was recently taken through Parliament by my hon. Friend the Member for Westminster North (Ms Buck). However, are conditions not getting worse for a lot of people? My experience is that there are two principal causes—the failure to build social housing, and the benefit cap—that force people into substandard accommodation in the private rented sector. Given the hon. Gentleman’s party’s special influence over the Government, could he persuade them to change those two egregious policies, which cause so much human misery?

If only we had that power! That is not to take away from the importance of the issue of social housing, which I will touch on later. Let us be honest: many people go into the housing that their pockets allow. As a result, they end up in housing that is not particularly in the right category, the right condition or the right shape. The hon. Gentleman is right that the benefit cap also dictates where someone can go. I will give the Minister plenty of time to get her thoughts together on that. However, that is an important point, and I will touch on it later.

Poor indoor air quality has an annual cost to the UK of more than 204,000 healthy life years. It causes thousands of deaths per year, and gives rise to health costs in the order of tens of millions of pounds. One third of people in the United Kingdom suffer from mould in their homes and are at increased risk of respiratory problems, infections, allergies and asthma. Just last week, I saw three constituents with mould growth issues in their houses—mould not caused by condensation, but ingrained in the walls. Sometimes ensuring that the housing associations or housing executive take those issues on board is quite a job.

There are more than half a million overcrowded households. The issue affects one in 10 children—something we cannot ignore. Overcrowding is linked to health and development issues, including meningitis, respiratory conditions, slow growth rates, accidents in the home, stress, anxiety, depression and poor adult health. Occupants of poor-quality housing are more likely to suffer from restricted daylight and noise pollution.

We cannot ignore noise pollution. In the news this morning someone put forward the idea of building houses and flats over railway lines. I am not sure if any hon. Member saw that. The first thing that came to my mind was the noise of the trains continually going underneath. How could those homes be adapted to mitigate that? We need to address noise pollution. Natural light helps to improve the recovery times of long-stay patients and reduces anxiety and the need for medication. Noise pollution can cause long-term health issues and increase stress and the risk of cardiovascular effects.

The hon. Gentleman is making a very good speech, and I am nervous about intervening again, but will he accept this point? He talks about the noise pollution from living over a railway, and we know that private rented accommodation is a real problem. On the other side of the equation, very modern and expensive housing that is totally hermetically sealed could be as dangerous, because it traps all the gases and pollutants within the home—not only carbon monoxide, but many other emissions.

Order. I ask hon. Members making interventions to address the Chair, and not somebody at the back of the room, not only so that I can hear but, more importantly, so that the Minister can hear.

Will you forgive me, Mr Robertson?

I would not want to miss anything that the hon. Gentleman said; that is the point.

I thank the hon. Member for Huddersfield for intervening again. It is always good to have him adding his words of wisdom to any debate, at any time, in this Chamber or in the main Chamber. The issue is clear: too often, the homes that we live in are, in many ways, causing or aggravating health problems. That cannot be ignored. Given the plethora of health issues that I have identified as caused by unhealthy homes, and given the cost to the NHS, it is time to ask who in Government is responsible and accountable. We look to the Minister for answers.

One issue that has been raised with me in Northern Ireland—I am sure that it affects the whole United Kingdom—is that when it comes to old and listed buildings, and particularly rows of listed houses, it is sometimes very difficult to get adaptations done, because they have to be done in a certain way.

My hon. Friend highlights one of the kernels of the debate. Our white paper calls on the Government to take a holistic approach to future housing and ensuring that people’s health and wellbeing is placed at the heart of the built environment. That is clearly what my hon. Friend is saying, and that is where we are. Our white paper states that there must be effective leadership, and recommends that there be one Department responsible for healthy homes and buildings to ensure, critically, that homes and buildings maintain the highest standards for health and wellbeing; to identify where homes and building are causing health issues; to measure the economic and social benefits of healthier homes and buildings; to reduce health inequalities, of which there are many across the postcodes of the United Kingdom; and to provide for a common definition and approach to policy, regulation and standards. That makes complete sense to me.

Furthermore, an interdepartmental Government committee involving all Departments and agencies responsible for health, housing and construction—including the Department of Health and Social Care, the Department for Education, the Ministry of Housing, Communities and Local Government, and Public Health England—should be formed to ensure that health and wellbeing is placed at the heart of existing and future housing provision.

If we are to build houses, let us build them right. Let us ensure that the issues to which the hon. Member for Huddersfield referred do not arise, whether the homes are very expensive or of a lesser quality. I have serious concerns about the standards and quality of new housing inadvertently being driven downwards, without consideration of the cost to human health. In the context of the Government’s very healthy ambition to build 300,000 new homes and their healthy new towns initiative, standards must be driven upwards. It is essential that the Government adopt a holistic approach to delivery that addresses safety, space, energy efficiency, ventilation, heating, noise, air quality and lighting. We must all want to see quality new homes and communities being built with health and wellbeing in mind. I hope that the Government will agree that maximising the occupants’ health and wellbeing must be placed at the centre of new housing provision and building design.

I congratulate my hon. Friend on securing the debate, and on the work that he continues to do on these issues. Does he agree that the subject that he is entering into—the need to renovate and upgrade housing stock—is particularly applicable in lower socioeconomic areas, in both Northern Ireland and, I am sure, across the UK? In those areas, health issues are even more prevalent than in the rest of society, so his point about the benefit to the NHS is even more applicable with regard to those socioeconomic groups.

My hon. Friend is absolutely right. Those are the cases that we deal with in our constituency offices each and every day. Those issues are the subject of the site meetings that we have with the executives of housing associations, and of the meetings that take place with councils’ environmental health departments, back home and over here. There is a greater impact on those at a certain socioeconomic level, as the hon. Member for Hammersmith (Andy Slaughter) also said. Benefits also come into the process; there is the question of what people can afford to purchase and deal with.

I call on parliamentary colleagues from across the House to join me in taking forward the recommendations in the white paper, and call on the Government to join together and provide the necessary leadership and focus. We look to the Minister to do those things. The cost-benefit and rewards could be significant. The economic burden and sheer human misery created by poor homes and buildings, to which other hon. Members have referred, are simply too great to ignore.

I thank all right hon. and hon. Members for being here, and thank those Members who have come along to make a contribution. It is so important for us to deal with this issue. We look to the Minister for a significant and positive response—no pressure, but we do think it is important that we air these issues.

I pay credit to the hon. Member for Strangford (Jim Shannon) for securing the debate and for all the work he does with the all-party parliamentary group, from which I have enjoyed gaining expertise and knowledge. The cost of unhealthy housing to the NHS is a fantastic subject to tackle, especially in the middle of winter. We have not had a particularly cold spell yet—that is still around the corner—but nearly a year ago, a few days of significant snow cut off my village, which is extremely rare in the warm south-west.

It is great to speak on this important and urgent issue, but it is not new for me. When I pitched up as a new MP, all sorts of people came to tell me how good or bad my constituency was. I met a representative of the Association for the Conservation of Energy—ACE—who came to see me and said that my constituency had the leakiest homes in England, and potentially in Europe, based on off-grid and poor-quality buildings. We were not good at cavity walls 30 or 40 years ago—perhaps longer. I took that seriously because I was concerned about the issue of fuel poverty—we are a low-wage area—and about people’s health.

Cornwall Council and others, including my colleagues and me, have worked together to find the money to improve our homes. As of January, we have improved 1,085 homes and taken them out of fuel poverty altogether by securing various bits of money from all sorts of funds, including social landlords. As I say, it is an urgent issue. In particular, I credit Anthony Ball and his public health team at Cornwall Council for leading on the issue and for their great expertise on how to resolve the challenge.

From the figures that the council has provided, it is estimated that 210 people in Cornwall die due to the cold every year; that poor health resulting from a lack of warm homes affects 31,000 households—74,000 people—in a population of just under half a million; and that a winter death in Cornwall is preceded by eight emergency admissions to our hospitals, which are already under pressure, and 30 social care visits. As is true elsewhere in the country, delivering social care in Cornwall is a challenge, because it is a large but sparsely populated geographical area with a lack of people working in it and a distance to travel between appointments.

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate.

Housing is central to the wellbeing of individuals, families and entire communities. When people have decent, safe accommodation, which is suited to their needs, they have a strong foundation on which to build their lives and expand their life chances. That in turn has a stabilising effect on their families, local neighbourhoods and the wider community.

Poor housing has the opposite effect. It can have a detrimental impact on many aspects of personal and community life, and can significantly affect the mental and physical health and wellbeing of the occupiers. Every week, I hear about housing problems from constituents. Their properties are often in a state of disrepair—cold, damp and mouldy. Living in poor housing such as that can take a significant toll on the physical health of an entire household by increasing the risk of cardiovascular, respiratory, neurological and musculoskeletal conditions, as we have heard.

People with underlying health complaints are particularly vulnerable. Poor housing can act as a trigger that causes asthma symptoms to worsen, which results in hospitalisation, or exacerbates symptoms of arthritis and reduces the ability of sufferers to perform everyday tasks proficiently, thereby increasing the risk of falls and accidents.

Moreover, when an individual’s physical health deteriorates, their mental health is often affected. It stands to reason that if someone lives in a property that makes them physically ill, which fails to meet their family’s needs and which makes life more difficult on a daily basis, they are likely to feel depressed and anxious, and their self-worth is liable to plummet. When physical and mental health is affected in this way, because homes are unsuitable, that has an impact on someone’s wellbeing and their ability to participate in work, education, and social and other activities, and consequently impacts on public services such as social care and, of course, the NHS.

In Coventry, our local authority recognises the human costs for the individual of poor housing, as well as the economic costs for public services such as the NHS. That is why its new draft housing strategy places significant emphasis on improving the condition of the city’s existing housing stock.

The strategy prioritises integration of the housing and public health departments to deliver affordable warmth projects, tackle fuel poverty and improve residents’ overall health. It also aims to tackle rogue landlords who leave their tenants at risk as a result of poor maintenance, poor standards and poor management of homes, and it explores the option of introducing discretionary licensing schemes to improve standards. Moreover, it seeks to maximise the existing housing stock in the city and bring empty homes back into viable use.