Northern Ireland Housing Executive Review of Housing and Health - Towards a Shared Agenda.

Consultation response from The Institute of Public Health in Ireland, September 2007.  The Housing Executive's original consultation document can be accessed here.

The Institute of Public Health in Ireland welcomes the opportunity to comment on the Northern Ireland Housing Executive (NIHE), Review of Housing and Health – Towards a Shared Agenda policy.   The Institute aims to improve health in Ireland, North and South by working to combat health inequalities and influence public policies in favour of health.

The Institute recognises the potential health impacts linked with housing and welcome the proactive approach NIHE is adopting. By identifying the wider determinants of health, the NIHE acknowledges that as a statutory organization they have a major role to play in contributing to improved health for Northern Ireland.   There are many causal pathways linking housing to health and due to the nature of social housing, a number of vulnerable groups, for example those on a low income or the Travelling Community are subject to NIHE policies. 
 
Overall the policy outlines a number of key recommendations.  The Institute advise that the Implementation Plan which will incorporate the recommendations should outline targets which can be measurable, for example, under Objective 1 which identifies the reduction of fuel poverty.  We recommend that key targets are outlined to show what action the NIHE has set in accordance to measure a reduction in fuel poverty. 

This response has been prepared in accordance to the six corporate objectives outlined in the strategy:

Objective 1 Achieving the Decent Homes Standard

Consultation Question: Objective 1 
1. Do you agree with the recommendations relating to achieving the Decent Homes Standards? Yes 

2. Do you believe these recommendations go far enough? 
Yes 

3. Further comments
As the statutory organisation responsible for social housing, NIHE already demonstrates a high level of commitment towards partnership working to improve the health of the population.  The Institute recommends that NIHE continue to input into Investing for Health partnerships, Neighbourhood Renewal etc.

Pilot projects such as water temperature in homes have provided valuable learning experiences and demonstrated a contribution to health.  Future pilot programmes should be measured for specific health impacts e.g. renewable energy schemes.

Objective 2 Promoting Independent Living

Consultation Question: Objective 2 
1. Do you agree with the recommendations relating to Promoting Independent Living? 
Yes 

2. Do you believe these recommendations go far enough? 
Yes 

3. Further comments
The recommendations outline information relating to various projects but it is not always clear what projects will be initiated in the future.  For example, no future plans have been outlined in relation to future provision for the Traveller Community.  A community identified as suffering a number of health inequalities e.g. high mortality rates, poor education, poor accommodation provision etc. needs a targeted action plan by the NIHE to address these health inequalities.

NIHE are to be congratulated on their proactive engagement with other partners to deliver effective programmes of work and in their acknowledgement of a multi-sectoral approach to ‘Promote Independent Living’.

Eleven client groups have been identified, all of which may be identified as vulnerable due to their physical, mental or social situations.   NIHE has to ensure that alongside physical adaptations to buildings, the social considerations are also taken into account for example, victims of domestic violence often require family accommodation which is safe to provide assurance for protection from further harm.

Objective 3 Foster urban and rural regeneration

Consultation Question: Objective 3 
1. Do you agree with the recommendations relating to Foster urban and rural regeneration?
Yes 

2. Do you believe these recommendations go far enough? 
Yes 

3. Further comments
NIHE have embraced Health Impact Assessment in Northern Ireland.  This has been demonstrated through commitment to provide resources to two case studies, the redevelopment of Dove Gardens, Derry and the Lower Shankill Regeneration, Belfast.  The Institute advocates that the NIHE continue to apply HIA to all renewal and regeneration initiatives and make HIA a requirement for all future policies.

Recognising that one in seven people in Northern Ireland live in deprived areas, it is essential that the needs of vulnerable groups including those on low income are considered in relation to any proposal development which may affect them. NIHE has a key role to play in addressing health inequalities which are evidence across Northern Ireland and ensuring adequate and safe housing in a supportive community will contribute to addressing this issue.

A number of programmes have been established to address health issues which exist in both urban and rural areas.  The Institute advocate that programmes are continually reviewed to ensure they are effective delivery mechanisms to help address the physical, social and mental health impacts which exist.

Children and young people have been identified as a vulnerable group.  The Institute recommends that the provision of adequate open spaces and play areas are provided in all regeneration schemes to provide opportunities for physical activity, social interaction and engagement.

Objective 4 Promoting affordable living

Consultation Question: Objective 4 
1. Do you agree with the recommendations relating to Promoting affordable living?
Yes 

2. Do you believe these recommendations go far enough? 
Yes 

3. Further comments

Affordable housing is a major issue in Northern Ireland and a number of health impacts associated with this have been identified.   NIHE should recommend/ outline how future provision for affordable social housing is to be identified to help address the current shortfall in provision. The House Sales Scheme has provided a great opportunity to those on a low income to purchase their own home and the Institute welcomes the proposed review of this scheme to ensure it is relevant to local need.  The NIHE must ensure that social housing requirements are addressed in future years to address the rising numbers presenting for social housing and also the rising homeless figures.  There are a number of health impacts associated with temporary accommodation including mental stress and anxiety as well as social impacts.  Adequate social housing provision is required to create stable communities according to local need.

Objective 5 Building a stronger community

Consultation Question: Objective 5 
1. Do you agree with the recommendations relating to Building a stronger community?
Yes 

2. Do you believe these recommendations go far enough? 
Yes 

3. Further comments
NIHE are currently represented on a number of local and regional partnerships that work to address potential health impacts of deprived communities.  The Institute acknowledges the resources that NIHE dedicate to this objective and advocate that this continues to ensure there is a cross-sectoral approach to local and regional issues.   There is a need to ensure that this proactive approach is not diluted in the changes due to take place as part of the Review of Public Administration so that the experience gained at a community and partnership level which has been developed over a number of years is not lost

Objective 6 Deliver better public services

Consultation Question: Objective 6 
1. Do you agree with the recommendations relating to delivering better public services? 
Yes 

2. Do you believe these recommendations go far enough? 
Yes 

3. Further comments
The Institute welcomes the approach outlined for developing the commitment to promote health within NIHE.

The Institute of Public Health in Ireland welcomes the recommendations in the strategy.  Specific targets for measurement performance should be set for each objective area to ensure performance can be measured and monitored.

Contact details: 
Dr Jane Wilde, CBE, Chief Executive, jane.wilde@publichealth.ie
or
Claire Higgins, Public Health Development Officer, Claire.higgins@publichealth.ie
The Institute of Public Health in Ireland, Forestview, Purdy’s Lane, Belfast, BT8 7ZX
Tel: 028 90 648494
Website: www.publichealth.ie

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