Anybody working in the front line of health and social care
could give a first-hand account of the pernicious link between poor
housing and ill health. Yet more than 20 years after the
publication of the Black Report, Inequalities in Health,
which looked at the link between socio-economic factors and
health,1 those inequalities remain. National Energy
Action, the charity that campaigns for the eradication of fuel
poverty, estimates that up to six million households cannot afford
to heat their homes.
As a social worker, I have often felt frustrated in the face of
such a basic need. Having come here from a developing country, I
was shocked to find such conditions in Britain. Helping one family
move out of poor housing only passed on the problem to the next
occupant, and the grants system for home improvements seemed
unfathomable. There have been several recent initiatives to reduce
the damaging effects of poor living conditions, as well as to make
houses more energy efficient. The gains for the national economy
should be as great as those to personal household economies –
better health, less NHS expenditure, improved energy efficiency,
lower fuel bills, reduced energy demand and pollution.
One system that has helped in Staffordshire is Health Through
Warmth, a match-funded scheme run by utility company Npower and
partners, including National Energy Action, local health and
housing authorities, housing associations and social services.
Social workers, community nurses and support workers can refer
clients to a care and repair scheme run by Orbit Housing
Association, which arranges an energy survey of the property and
navigates through the grants available for any improvements.
Health Through Warmth is an example of the kind of involvement that
energy firms are having in combating fuel poverty since the
introduction of the government and energy regulator’s social action
plan. The scheme identifies funding for heating and insulation
measures from government grants. In cases where people are
ineligible for grants or the work is needed urgently, help can be
sought from Npower’s own crisis fund. People receiving help through
the scheme do not have to be Npower customers.
The scheme also provides training for front-line staff to recognise
common indicators of fuel poverty. We aren’t expected to provide
solutions, but just to pass on the referral so that an energy
adviser can suggest measures to improve the efficiency of people’s
heating or provide heating where none exists.
Some of the people helped by this scheme have presented us with
tough challenges. One woman called the duty social worker to report
that she had been quoted more than £800 for a replacement
boiler. Her pension would not cover that and, where we would
otherwise have been looking for grants or loans from the Social
Fund and charities (while she shivered at home), the problem was
sorted in a few days with a grant from the crisis fund that paid to
install a new boiler. Another example is a man with dementia living
alone who was at risk from turning on his gas fire but forgetting
to light it. A new fire was installed, which cut off the gas supply
if it was not lit within a few seconds. But aid can even be
provided with smaller measures such as draught proofing.
The scheme is not universally successful as the supply of
contractors can vary between areas. In some the response times are
quick, but in other places it is a struggle to find contractors.
There were a few initial teething problems with the training and
with the feedback mechanisms, but these were quickly dealt with,
and this spirit of openness and joint working has been a major
factor in the success of the operation.
It is good to see fuel poverty receiving more attention and there
is no shortage of initiatives. But busy social workers need a
reliable source of trusted expert help for specialised areas such
as grants and benefits. For us, this is the real value of the
Health Through Warmth scheme.
Mary duQuesnay is team manager in adult services,
Staffordshire social services department.
1 D Black (ed)
Inequalities in Health, Pelican, 1982 (originally DHSS,