Healthy dialogue

Housing and health policies have a long history, dating back to the first Public Health Act in 1848. Introduced to combat insanitary urban living conditions, the act established precursors of local authorities and recognised the link between poor housing and ill health.

More recently, the housing sector has been seeking to re-establish that link, and has often been frustrated at the lack of traction achieved with health colleagues. This is often blamed on the different language used by health – but is this a valid reason? Do doctors complain they can’t understand what their local housing association is talking about?

Perhaps there’s something about the housing sector itself that makes it difficult for it to engage successfully with health. How does a universal service, free of charge and available to all, begin to comprehend a service predicated on tenure or even whether you have a home at all?

On a more practical level, if a housing officer suspects that a tenant has a health problem they can advise them to see their local GP, or even visit accident and emergency. If a district nurse identifies a heating problem, for example, where would she go for help? It can be unclear where the entry point, the front door, to housing is.

As a tenure-neutral practical support service, I think home improvement agencies (HIAs) are well suited to being that front door; either providing services directly or referring on to others. There would need to be consensus both locally and nationally, but unless housing services collaborate based on people rather than property then health is likely to remain ambivalent at best.

However, it should be recognised that the involvement of housing associations in delivering HIA services has diminished markedly in the past 10 years, falling from 80% of the sector in 2004 to just 30% today.

Paul Smith, director, Foundations