Category Archives: Housing

Levels of rough sleeping have escalated rapidly in recently years, with reports of deaths on the street now increasingly common. The strong presence of homelessness-related commitments in all of the major UK political parties’ 2017 manifestos is welcome, but does little to dispel intense controversy over how best to intervene in this area.

At the most basic level, responses to rough sleeping can be distinguished by whether they explicitly seek to alter or ‘control’ the behaviour of homeless people (‘interventionist’ responses) or not (non-interventionist responses). Interventionist responses include the use of ‘force’, such as arresting people for begging, rough sleeping or associated activities, or excluding them from particular areas (using civil orders like ASBOs or Public Space Protection Orders). They also include ‘coercive’ approaches which seek compliance via a ‘threat of deprivation’, for instance, by making access to accommodation conditional on signing up to a support plan. ‘Persuasive’ techniques, such as ‘motivational interviewing’ are core to the more ‘assertive’ forms of street outreach now used in many major cities.

These interventionist approaches, and particularly ‘harder’ measures that employ force or coercion, are extremely controversial, often described as punitive or even as criminalisation. Some argue, however, that it is the non-interventionist stance of some soup kitchens, day centres, and traditional night shelters, generally run by faith-based organisations, that should be subject to moral censure, and that the ‘non-judgemental sanctuary’  that they offer can sustain damaging, even  life-threatening, patterns of behaviour among a highly vulnerable group of people.

These polarised and emotive debates pose a challenge to policy-makers and service providers, and risk obscuring the need for cool-headed reflection in determining the most ethical approach. In a recent paper, Suzanne Fitzpatrick, Sarah Johnsen and I propose a four-point framework (inspired by Ruth Grant, a political philosopher at Duke University) to cut through this contested moral territory.

First, does the intervention in question have a legitimate purpose? The idea that enforcement-based responses are pursued in defence of the aesthetic concerns and financial interests of wealthy gentrifiers has fuelled a great deal of the controversy that surrounds them. But in the UK at least, their adoption has also often been shown to be driven by the understandable concerns of ordinary local residents about health hazards like discarded needles or human waste in public spaces. The wellbeing of the homeless people targeted has also informed the Rough Sleepers Initiative of the 1990s as well as the more recent ‘No Second Night Out’ programme. Thus, despite widespread media hype, it is not the case that interventionist approaches necessarily reflect punitive intent on the part of politicians and policy-makers.

Second, does the intervention allow for a voluntary response on the part of those targeted, therefore respecting their autonomy and capacity for self-determination? Here, non-interventionist approaches may seem at first glance to have the ethical advantage over more controlling interventions. However, the waters are substantially muddied by clear evidence of the highly constrained capacity of some individuals sleeping rough, especially those suffering from severe addiction and/or mental ill health, to act autonomously – that is, in pursuit of their own settled and authentic preferences. In such circumstances, a refusal to countenance ‘paternalistic’ interventions which seek to safeguard, restore or establish some basic level of personal autonomy for a vulnerable adult appears to us (as to James Gregory in his paper Engineering Compassion) “more like a moral abnegation… than respectful distance”.

Third, what are the impacts of the intervention on the ‘character’ of those involved? There have been concerns, for instance, that commissioning practices that require faith-based organisations to engage in interventionist practices undermine their ethos of providing sanctuary and care unconditionally. Similar, homelessness organisations working with the police or UK Border Agency have been heavily criticised for ‘selling out’ and abandoning their core values. But we would argue that the material impact of homelessness interventions on their intended ‘beneficiaries’ should be given a much higher moral weighting than their impact on the character of the ‘benefactor’. An undue emphasis on the latter could be considered ethically dubious, even rather self-indulgent.

This takes us to our fourth, and most important, moral consideration: what are the actual outcomes of the intervention in question? In particular, is it effective in improving the wellbeing of rough sleepers and, crucially, is it more effective than alternative (less controlling) methods? For example, while there is evidence that ASBOs have led to positive benefits for some street homeless people, acting as a ‘crisis point’ prompting engagement with support services, the use of such strong enforcement measure can only be justified as proportional when used as a last resort. The full range of consequences of any intervention must also be considered, including unintended negative effects. This would include, for example, displacing rough sleepers into more dangerous or isolated areas of the city.

Equally, though, a key implication of this analysis is that the ‘tolerant’ approach taken by many soup runs, day centres and shelters ought to be subject to the same level of ethical scrutiny as interventionist responses. They should not be assumed to be morally unproblematic simply because terms like ‘unconditional acceptance’ sound innocuous. At a minimum, the possibility that tolerant approaches may inadvertently act to erode vulnerable people’s longer-term autonomy by sustaining them in street-based lifestyles must be taken seriously.

These four criteria are offered as a route through what continues to be an extremely polarised debate on how to best respond to escalating levels of rough sleeping. A priori arguments, emotional intuitions, the (good) intentions of staff and volunteers, or even the views of current users of a service, do not suffice to settle these controversies. Instead, we should pursue responses that have the most significant and lasting positive impacts on those at risk on the streets.

This was first published on the  British Politics and Policy blog

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Friday sees a Homelessness Reduction Bill before Parliament, sponsored by the MP Bob Blackman. It has the support of the Commons Select Committee and it expands the duties of local government and the categories of people eligible, calling for earlier interventions to prevent homelessness. What implications does this have for the difficult cases of complete homelessness and health?

Health breakdown is a consistent cause of homelessness and, when it affects the main income earner, it can take a whole family into homelessness. We know about the economic signals (unemployment or benefit cuts) and legal signals ( eviction or end of tenancy) leading to homelessness but what of the mental health, addiction, chronic conditions or multiple health needs of people which make it difficult or impossible for them to go back to the home they had, or has already made them homeless? Will health professionals be able to give 56 days’ notice that they believe an individual or family to be at risk?

How far will the proposed duty for local authorities to intervene go? And with health care being devolved to the new combined authority in Manchester with an elected Mayor, could this open up the possibility of integrated working with the homeless with severe health problems that has eluded previous reforms?

A useful summary has been provided by the Department of Communities and Local Government – always a good sign that the government might be behind this reform.

The Bill raises some interesting challenges. It puts a new duty on all public authorities, which clearly includes hospitals, to engage the local authority or housing authority if they anticipate homelessness at the end of a period of treatment, which most will already do. But it also opens questions about “unreasonable behaviour” and “refusal to co-operate” with new plans which can exclude people from help. A particular challenge with some of the most difficult patients with mental illness or addiction and behaviour problems. And, in any case, it is still a battle to be designated “ a priority” if you are single , not pregnant, or without a clear disability.

By the time the bill reaches its critical stages many of these issues will be centre stage at the 2017 Homeless Health Inclusion programme from the charity Pathway and the UCL institute. Now in its 5th year, this specialist conference has the added unique element that all the sessions are filmed or recorded for training and staff briefing and induction, making it one of the most valuable packages for professionals looking for solutions to tackle homelessness and the health issues that dominate these clients.

Will 2017 see a combination of new legislation, devolution and integration of local services and innovative pathways to tackle some of the most complex homeless and health issues which too often present in the same individuals? Perhaps a an early new year resolution is to make sure it does.

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We are becoming known as ‘generation rent’ and so, it is safe to say, getting on the property ladder isn’t easy. Therefore, when we finally do, we expect we will move on when we are ready, perhaps to upsize or change locations – house repossession is the last thing on our mind. That is until the day we find ourselves in debt – debt that spirals out of control so quickly that suddenly losing our home becomes a very, very real possibility.

House repossession comes about because you are in debt and debt doesn’t happen overnight. It will have been building up over time – meaning putting food on the table and paying bills has been an ongoing issue that has been causing you a significant amount of stress and worry before the repossession of your house even happens. But, having your home taken off you is the nail in the coffin – and one that comes with a whole new level of stress and worry. Is it any wonder that debt and house repossession are linked to mental health? Does it really come as a surprise to hear that people slip into depression when they are sinking further and further into debt, so much so that they could be out on the streets and they can’t see a way out of it.

A review by the British Medical Journal has uncovered a link between the 2008 recession (which followed the financial crisis) and mental health. This recession led to a rise in unemployment, homelessness and poverty – all important detriments of health.

An increase in house repossession from 2005, rising unemployment from 2008 and falling wages from 2009 as well as an average increase in household debt were all cited as causes behind a spike in ‘adverse health outcomes.’

However, there is good news and perhaps at least a dim light at the end of the tunnel because house repossession has actually been at an all time low. In fact, in 2014 the number of homes repossessed by lenders fell to their lowest levels since 2006. The Council of Mortgage Lenders (CML) says repossession fell by 26% to 21,000 with mortgage arrears also falling to an eight-year low. The improvement has been put down to the rising levels of employment and continuing low interest rates.

HML, a mortgage servicing firm, has predicted that 10,326 repossessions will take place this year. While these figures are promising no one should be lulled into a false sense of security, believing that the low interest rates we are currently experiencing will last forever.

Plus, there is, of course, still a chance this could happen to you and there is no comfort in the fact these numbers are lower if you are one of the many still facing repossessions.

But, you do have options… and there are things you can do to avoid it or, at the very least, postpone it. Start by talking to someone and getting advice on your specific situation from the experts, which could even result in you selling your home quickly to stop house repossession from happening to you and freeing up some money to help you get you back on your feet.

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North West Leicestershire is about to publish its Local Plan. An inch thick, this pedestrian document tells us that this Council will co-ordinate a wide range of other organisations to ensure infrastructure is provided at the right time and in the right place to absorb the impact of new housing developments and provide for the health needs of people moving into the area.

The best predictor of future behaviour is past behaviour.

At a recent Policy Development Group, a cross-party committee of elected Members pursued the fate of £1.3M of developer contributions for health that remained unspent, some of it at risk of being paid back.

Lacking a root cause analysis local GPs, NHS England and Council planners were involved in a blame game. The tangle of red tape, risked developers laughing at the public sector as they re-pocket money returned with interest.

Teasing this mess apart has allowed some funds to escape the log-jam and NHS England we are now spending some s106 money on Long Lane Surgery in Coalville and on a surgery in Measham. But I am not taken in by this snippet of good news. Nor do I trust in future solutions such as moving to a Community Infrastructure Levy. My GP informants still describe a legal system that makes easing this money out of the bureaucracy so difficult that most clinicians give up.

Remaining focused on funding GP premises, when so much else is pushing healthcare into the abyss, is almost certainly not enough. A Local Plan with vision would look beyond the immediate needs of service providers, such as GPs to the wider determinants of public health.

Loneliness is a killer. Thanks to the developer-centric demands of the National Planning Policy Framework, the Council’s plans for cultural facilities in Policy IF2 grudgingly allow their expansion if the community can prove an increase in demand.

After the closure of the iconic Snibston Discovery Museum perhaps I should not complain that the Plan appears to major instead on preventing existing community buildings from being demolished.

My colleagues in public health should be pleased to see that the Plan does have a detailed section on transport infrastructure. The Royal College of Physicians reports that there are 40000 deaths a year due to poor air quality mostly from exacerbations of asthma and COPD. We know that we have road junctions that repeatedly breach air quality guidelines including the Copt Oak and Broom Leys junctions.

According to the RAC North West Leicestershire along with neighbours South Derbyshire are in the top 10 Districts where working people are obliged to use their private car to go to work.

It is axiomatic that wealthier communities are healthier communities. Ensuring people in North West Leicestershire can access properly paid employment has to be a key public health strategy.

In supporting this Plan going forward for consultation, I am therefore particularly pleased to support Policy IF5 in which North West Leicestershire, in direct contrast to the County Council, commits itself to supporting the provision of public transport on the Leicester to Burton line.

Providing East-West connectivity and putting the former mining town Coalville of back on the railway map, as HS2 looks increasingly unaffordable, it would be good to get national support for this important public health intervention.

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What the London mayoral candidates have to say about housing policy:

CandidateZac GoldsmithSian BerrySadiq KhanCaroline PidgeonPeter Whittle
Total annual housebuilding target50,000 a year by 2020200,000 over a 4 year term50,000150,000 private units over 4 year term
Affordable housing target64,000 social and low cost rent, 400,000 low cost ownership• At least half of all new housing to be affordable
• Housing Associations to deliver 180,000 new homes over 10 years
50,000 council homes over 4 year term
Planning• Expert ‘flying planners’ team to support LA planning departments
• Standard viability assessments for affordable homes in developments
• Chief Architect for London
• London Plan to set aside more homes for Londoners on average salaries
• Reintroduce 50% affordable housing target for individual developments, require transparency on viability assessments
• Protect Zero Carbon definition
• Offer communities a Right to Regenerate – becoming partners in the planning
of opportunity areas and housing zones
• Develop planning rules to tackle ‘buy-to-leave’
• Improve planning and design to offer older Londoners more choice of suitable housing
• Greater transparency on viability assessments for affordable homes in developments
• Use powers more effectively to encourage home building, including benchmark that half of housing in new developments should be affordable for majority
of Londoners
Large development consents to be decided by local referendums
Development • Guarantee homes built on Mayoral land are only for Londoners – Homes built on TfL land reserved for those living in London for at least 3 years
• ‘London share’ retained in public sector land sold for development
• Company with a £0.5bln fund from council tax
to support smaller and community builders
• Free home insulation for homeowners
• Break up bigger development sites up into smaller plots
• Setting up ‘Homes for Londoners’ and building alliance of all with a stake in housebuilding
• Affordable homes to include social rent, new London Living Rent and part-buy- part-rent
• Attract institutional investors to finance homes for
long-term, secure rent
• City-hall owned developer to delivery 50,000 affordable homes
• Continue to levy Olympic Precept – leading to accessing finance of up to
£2 billion to build housing*
• Register of London’s brownfield sites
• Prioritise Londoners when developing on GLA land
Buyers • Londoners given first refusal on new-build homes built on TfL land
• ‘Mayor’s mortgage’ for
new-build property, 9 month agreement in principle window (instead of 6 months)
• Phase out shared ownership and replace with models such as mutual home ownership which will remain affordable in the longer term
• Campaign to reform leasehold law
• Londoners given ‘first dibs’ on all homes built on Mayoral land
• Seek to extend ‘first dibs’ to homes built on public land and to a proportion of homes built in all developments across
the Capital
Private Rented Sector• Three-year tenancies offered as standard
• Target high fees charged by estate agents to tenants
• Campaign for employers to offer ‘deposit loans’ for rental deposits to workers
• Create a ‘union for renters’
– which would be an advice and lobbying group
• Set up a register for landlords, which would allow tenants to rate and compare landlords
• Rogue landlords named and shamed in public database
• Set up not-for-profit lettings agency
• Increase renters’ rights on tenancy lengths and rents
• Promote landlord licensing and make the case for a London-wide scheme
• Promote 3-5 year tenancies
• All landlords to be registered
• Scrap agents’ lettings fees for tenants
Higher taxes for buy-to-let investors who leave property empty
Right to buy (Right to Buy comes under Central Government remit)Encouraging 2 for 1 replacement of properties sold• Lobby for end of Right to Buy
• Work with Councils and Housing Associations to mitigate impact of Housing and Planning Bill
Right-to-buy should come with a guarantee that a like- for-like replacement home for social rent will be built in local area• Scrap RtB for Social Tenants
• Introduce RtB for private tenants when landlords sell property
* Green beltProtect the GreenbeltProtect the GreenbeltProtect the GreenbeltProtect the GreenbeltProtect the Greenbelt
Estate regenerationRegeneration to replace run-down estates with
mansion blocks and terraces
– where a majority of local residents in favour
• No complete demolition unless absolutely necessary
• Regeneration to be led by residents who have right to independent ballot and support from Community Homes Unit
• Regeneration only with full resident support, demolition only where other options have been exhausted
• In-fill to boost housing numbers
HomelessnessExpand ‘No First Night Out’ which helps identify those at risk of homelessnessExpanding ‘No First Night Out’ scheme, with plans to end rough sleepingSet up ‘No Nights Sleeping Rough’ taskforce to oversee funding and implementation of Mayor’s priorities in this areaExpanding ‘No first night out’ schemeSet up a homelessness register at City Hall
Do you support:
Crossrail 2 YesYesYesYesNo
Bakerloo extension YesYesYesYes-
HS2 YesNoYesYes (but ensure impact on London is minimised)No
Heathrow extension
No
No (and close London City Airport)NoNoNo
EU membershipLeaveRemainRemainRemainLeave
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Yesterday the Government announced a temporary halt to changes on the Local Housing Allowance for supported housing. Yet fundamental problems remains – let me explain why.

Currently the Local Housing Allowance limits housing benefit for private rented tenancies at 30% of the local market rent. The Government is proposing to extend this to social housing from April 2018 for all new tenancies signed from April 2016. In addition Local Housing Allowance rates will be frozen from 2016 to 2020 irrespective of any market changes. The impact will be to reduce benefit payments for new social housing tenants and income for Housing Associations.

However there is a profound knock on for supported, sheltered and extra care housing. Costs in such housing are higher due to increased build, management and maintenance costs. There have already been substantial reductions in future income due to the 1% rent cut for the next four years and cuts in Supporting People funding.

There are two related impacts. The PlaceShapers Group estimate that the Local Housing Allowance changes will leave a £400 million gap for existing providers. Combined with other changes this may make supported housing unviable resulting in providers withdrawing from the market.

Secondly faced with uncertain and unviable income streams providers will decide to place on hold or cancel projects for vulnerable people. There is already evidence that this is happening.

In both cases valuable support for vulnerable people is at risk of being withdrawn with consequences both for their well-being and the impact on other services as that support is withdrawn.

The National Housing Federation has been campaigning against this change with some degree of success. There have already been concessions from the Government with the extension of Discretionary Housing Payment (already under pressure from the Bedroom Tax) to cover shortfall. They also agreed to hold a strategic review into specialist provision due to report this month. Yesterday’s announcement goes further in delaying the start date for a year whilst that review is taking place (although implementation date remains the same).

Although welcome this means that Housing Associations considering new build supported housing will still be faced with uncertainty about future income and with that uncertainty will be reluctant or unwilling to take such risk.

Hopefully this uncertainty will be ended soon with an agreement on future funding that will enable existing and proposed supported housing to prosper. Otherwise the future of supported housing looks bleak.

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