Feature

Seize this window of opportunity

The persistence of widespread fuel poverty causes premature illness and death – but help is available, says Trish Brady

The Department of Health’s 1998 independent inquiry into health inequalities confirmed material deprivation as an important cause of ill health. One of its recommendations was for policies to improve insulation and heating systems in new and existing buildings, to reduce the prevalence of fuel poverty.

The accepted definition of fuel poverty – the need to spend 10 per cent or more of household income to keep warm – currently applies to an estimated 5.3 million households in England alone. A further 1.2 million households, classed as in severe fuel poverty, must spend over 20 per cent of income on fuel. Many of those suffering the worst fuel poverty are older adults. For households in severe fuel poverty, at least £1 of every £5 of income would need to be spent to ensure adequate warmth. Naturally, this is impossible on a low income, and the consequence is cold, damp living conditions, with all the hardship that implies. Additionally, fuel debt and disconnection, or rationing of energy for those on prepayment meters, often results from the struggle to keep the home warm.

Poor quality housing causes fuel poverty. Cold, damp homes have been linked to ill health and early deaths among some of the most vulnerable groups in society. The link between energy inefficient housing and ill health is now well documented. A number of conditions are exacerbated, including asthma and other respiratory diseases, cardiovascular disease and depression, and people living in cold, damp homes suffer more frequently from a range of common illnesses, such as colds and ‘flu, with older people and children particularly at risk.

Excess winter mortality in the UK is much higher than in other countries which experience colder winters, but which have more energy efficient housing. Typically 30,000 more people die in the winter in this country, a statistic that many, including Tony Blair, have declared to be unacceptable in the twenty-first century.

The overall cost to the NHS of treating cold-related illnesses is not known, but as early as 1992 it was estimated at £1bn annually.

The interdepartmental government review of fuel poverty, published by the Department of Environment, Transport and the Regions in 1999, makes a clear link between cold homes and poor health. This has resulted in the new government vehicle for addressing fuel poverty, the New Home Energy Efficiency Scheme (New HEES), being specifically targeted at those groups judged to be most at risk of the health problems associated with fuel poverty – older adults on low incomes, chronically sick and disabled people and families with young children.

The recognition by the current government of the problem of fuel poverty is a milestone, and its proposals to tackle the causes through New HEES is a significant step in the right direction. The new scheme will, for the first time, offer both a comprehensive package of insulation measures and heating and water heating improvements. In recognition of the particular vulnerability of older people, an enhanced scheme, New HEES Plus, will include partial central heating systems to people aged 60 or over on a means-tested benefit. This group will also have access to security measures (door and window locks and door viewers) through the scheme if they live in a high crime area. It is also intended that government assistance will tie in more effectively in future with other energy efficiency schemes, such as those operated by fuel companies under their standards of performance schemes, to offer low income and other vulnerable groups the most effective package of measures.

In addition to the specific eligibility criteria of New HEES, it is also intended that the scheme will be delivered primarily in private sector housing (private rented and owner occupied dwellings). The government has therefore placed a particular emphasis on establishing referral links with frontline staff in health, local authorities and the voluntary sector. This makes sense, since these are the people who see clients in their own homes, and can use referral to New HEES as an additional and potentially effective tool to address the housing and health problems that many will face. Unlike other forms of poverty, fuel poverty can be alleviated by the investment in capital improvements which schemes like New HEES offer, leaving fuel poor households not only warmer, healthier and more comfortable in their homes, but also potentially with more disposable income.

The potential to use New HEES and a range of other grant schemes to tackle fuel poverty in a strategic way is immense – and all opportunities to do so should be seized. We now have a raft of overlapping policy initiatives, including Health Action Zones, Health Improvement Programmes and Community Plans, and local networks set up to deliver them. These new frameworks could be used both to raise awareness of fuel poverty, and to develop practical plans for tackling the problem locally.

NEA develops policy and practice to tackle the heating and insulation problems of vulnerable households. For details on integrating fuel poverty into health strategies, contact Trish: 01912615677 or info@nea.org.uk. For information on New HEES and how to refer clients contact the scheme manager: 0800 952 0600.