The need to keep stating the obvious

If the mainstream media is to be believed, our hospital systems are close to collapse as people flock into A&E and ambulances are back up outside hospitals with nowhere to unload their charges as vacant beds become as rare as hens teeth.

Against this backdrop it has emerged that the current death rate in England and Wales is running about one-third higher than its normal rate for this time of year, with people over 75 the worst affected. The death rate has risen by 3,700 people a week since early December. Of that more than 3,000 are over-75s.

The failure of the flu vaccine combined with the recent cold weather are identified as key contributors, but the impact of older people living in cold homes which they cannot afford to heat is often a neglected contributor.

Therefore it was a welcome intervention by Dr John Middleton of the Faculty of Public Health this week who, whilst noting that the current predominant flu strain (H3N2) particularly impacts on older people, stated that “The other major causes of winter excess deaths are housing conditions and heating – affordable warmth. What we’ve seen in terms of welfare cuts and the rising cost of heating homes could also be an important factor.”

I could not agree more. This is well documented phenomenon with a quantified evidence base, such as the BRE modelling of the cost to the NHS of poor housing. What we now need is a completely fresh approach to prevention of poor health through systematic, targeted housing improvement, integrated into health and social care systems. With the vast majority of substandard homes in the private sector, the national network of home improvement agencies, including pioneer Care & Repair services, could be at the forefront of such an initiative. Is it so much to ask?

Reflections by the CEO of Care & Repair England, Sue Adams, [February 2015]