Letter to the Prime Minister

The Rt Hon Boris Johnson MP
Prime Minister
10 Downing Street
London
W1A 2AA

29 June 2020

Dear Prime Minister

Many of us represent organisations or are individuals who are at the forefront of the current Covid-19 crisis. We believe urgent action is needed to improve health outcomes and support the most vulnerable people who are at most risk of needless death and cold related morbidity this winter. We are therefore writing to call on you to follow through with your welcome proposals in your manifesto and Queens Speech to invest in warmer and healthier homes¹.

You know from your own experience the critical importance of beating this virus and of a living environment which gives people that are ill the best possible chance of recovery. Whilst the current crisis has so far taken place in the warmer months, millions of people across the country will be dreading this coming winter. The health implications of cold temperatures on respiratory conditions² and on frail and elderly households are well known. These impacts are also intergenerational³, with children twice as likely to suffer from asthma or bronchitis if they inhabit cold and damp housing⁴.

During the colder months many people will continue to stay at home for longer periods. Alongside the psychological stress and social isolation caused by the virus, too many will have to choose between heating their home adequately and falling into debt or rationing their energy use and living in cold damp homes that are dangerous to their health and can shorten their lives. This can lead to a vicious cycle of hospital admission, discharge and readmission. Even before the current crisis, the economic burden of this ‘carousel of morbidity’ cost the NHS between £1.4 and £2.0 billion every year⁵. A second Covid-19 wave during a cold spell this winter could be catastrophic for individuals, families and overwhelm our health and social care services.

A key preventable factor is the UK’s building stock which remains notoriously inefficient and hard to heat. Millions face this winter in properties which are dangerous or unfit for colder seasons. Poor housing leads to sharp rises in energy use.⁶ A recent independent analysis suggests that, if a second lockdown was re-imposed during winter months, families in cold, leaky homes would face heating bills elevated on average to £124 per month, compared with £76 per month for those in well-insulated homes – a difference of £49 (£48.7) per month⁷.

Despite welcome proposals in your manifesto and Queens Speech to help improve this situation, recent Government statistics highlight energy efficiency delivery has dropped dramatically since 2012⁸ and one in ten households in England live in fuel poverty, meaning they live below the poverty line but also have much higher bills due to poor levels of energy efficiency⁹ . As lockdown begins to ease and you consider our economic recovery plan, you can address those preventable factors that aggravate respiratory illnesses and create or exacerbate other serious health conditions. By kick-starting a nationwide home and public sector energy efficiency retrofitting programme – starting with fuel poor households and social housing – you can directly save lives.

Such a programme will put people back to work¹⁰ , address regional variances in economic deprivation and provide a major stimulus to the economy¹¹ . These actions would also help to provide active referrals to many existing health and housing schemes¹² , reduce poor air quality which also damages respiratory health and reduce carbon emissions to make a direct contribution to meeting the UK Government’s goal of becoming net zero.

The recurrent crisis of early death and ill health caused by cold homes will not abate by itself. We call upon you to take actions that will prevent such a crisis, stimulate the economy and build back better.

The Conservative manifesto and Queens Speech committed to investing an £9.2 billion in the energy efficiency of homes, schools and hospitals; £3.8 billion over ten years for a Social Housing Decarbonisation Fund, £2.5 billion over five years to 2025 for Home Upgrade Grants for support deep renovation for low income households living in highly inefficient homes and £2.9 billion over five years to 2025 for a Public Sector Decarbonisation Scheme. This amounts to an additional investment, over and above current policies, of £2.9 billion over the next two years.
Public Health England (PHE), 2015. The National Institute for Health and Care Excellence (NICE) have also produced related guidelines on reducing the risk of the impact of cold homes which has been supported by many independent health institutions.
Age-specific mortality rate per 100,000 people, Number of deaths registered each month in England and Wales, including deaths involving the coronavirus (COVID-19), by age, sex and region, ONS.
Friends of the Earth and Marmot, 2011
BRE (2015) The cost of poor housing to the NHS. [Online]. Available from: https://www.bre.co.uk/filelibrary/pdf/87741-Cost-of-Poor-Housing-Briefing-Paper-v3.pdf [Accessed: 21 June 2019].
Emissions from homes and public buildings rose sharply by 2.5m tonnes or 4% in 2018 as a result of the Siberian weather system ‘the Beast from the East” equivalent of a small country’s like Albania’s annual emissions.
Lockdown in Leaky Homes, The Energy and Climate Intelligence Unit, 22 May 2020.
Business, Energy and Industrial Strategy Committee Energy efficiency: building towards net zero Twenty-First Report of Session 2017–19 Report, together with formal minutes relating to the report Ordered by the House of Commons to be printed 9 July 2019, page 23.
Annual fuel poverty statistics report for 2020 (with 2018 data), Department for Business, Energy & Industrial Strategy, 30 April 2020
According to Bank of England forecasts, unemployment is likely to increase by an additional 1.79m people by the end of 2020.
Rebuilding for resilience, Energy efficiency’s offer for a net zero compatible stimulus and recovery, Energy Efficiency Infrastructure Group (EEIG), June 2020
NEA has catalogued health and housing schemes which deliver energy efficiency improvements through LA’s and the health sector which have had success in addressing and/or stabilising related health conditions, see: https://www.nea.org.uk/wp-content/uploads/2019/10/Catalogue-of-Health-Related-Fuel-Poverty-Schemes-2019.pdf.

SIGNED BY

Health professionals

Professor Maggie Rae, President, Faculty of Public Health
Dr Jessica Allen, Deputy Director, UCL Institute of Health Equity Medact
Ivan Browne, Director Public Health at Leicester City Council
Dr Caroline Dimond, Director of Public Health, Torbay Council
Rachel Wigglesworth, Director of Public Health Cornwall Council
John Middleton, Honorary Professor of Public Health, Wolverhampton
Rob Howard, Consultant in Public Health and Head of School: Health Education East Midlands – Public Health
Sarah Muckle, Director of Public Health, City of Bradford Metropolitan District Council
Teresa Roche, Director of Public Health, Rotherham Metropolitan Borough Council
Dr Rupert Suckling, Director of Public Health, Doncaster
Professor Dominic Harrison, Director of Public Health and Wellbeing, Blackburn with Darwen Borough Council
Dean Wallace, Director of Public Health, Derbyshire County Council
Ruth Harrell, Director of Public Health, Plymouth
Rachel Flowers, Director of Public Health, Croydon
Miriam Davidson, Director of Public Health, Darlington Borough Council
Catherine Mbemba, Lewisham’s Director of Public Health
Kate Blackburn, interim Director of Public Health for Wiltshire Council
Julia Burrows, Director of Public Health, Barnsley Metropolitan Borough Council
James Szymankiewicz, GP
Chris Newman, GP, London
Jonathan Groome, Anaesthetist, London
Rosa Roberts, Psychiatry CT, Bristol
Rita Issa, GP registrar, London
Tracy Lyons, Pharmacist, Bournemouth
Peter Labib, Surgical registrar, Plymouth
Mangala Patil Mead, Occupational Medicine, consultant St Albans
Finola ONeill, GP
Deirdre Watters, GP, Liverpool
Kirsten Shukla, Psychiatrist
Susan Myint, GP, Ealing
João Martins, GP registrar, Oxford
Hannah Short, GP, Newmarket
Shireen Kassam, Consultant Haematologist, London
Issabella Beale, GP, Dorset
Olivia Davies, Registrar in Geriatrics, Poole
Nadia Audhali, GP Rebecca Hall, GP, Frome
Stefan McKenzie, Psychiatry Trainee, Sheffield
Helena Clements, Consultant Paediatrician, Nottinghamshire
Andrew Boyd, GP, London
Juliette Brown, Consultant Psychiatrist, London
Eliot Waterhouse, Emergency Medicine Trainee, Sheffield
Elmer van der Hoek, GP Locum, Colchester/ London
Jonathan Fluxman, GP (ret)
Eleanor Cooke, Psychiatry trainee
Robert Johnstone, Clinical Scientist, London
Dominic Nee, Neurology registrar, Brighton
Miranda Cole, Medical registrar, Bristol
Lynne Jones, Consultant child and adolescent psychiatrist, Cornwall
Asmamaw Sisay Yigeremu, GP
Cordelia Howitt, Consultant histopathologist, Stoke on Trent
Harriet Roberts, GP Registrar, Exeter
Thomas Downs, Foundation Doctor, Bangor
Anne Hayden, GP (Ret)
Hattie Nicholas, Clinical Education Fellow, Bristol
Jasmine Schulkind, Junior Doctor (F4 locum stroke medicine)
Alistair Wardrope, Neurology trainee, Sheffield
Sophie Williams, Oncology trainee, Sheffield
Jonathan Monk-Cunliffe, Junior Doctor, Bristol
Dilys Noble ,GP ret, Sheffield
Sian Ashby, GP ,Glasgow
Claire Gaughan, GP
Francine Martin, GP, Glasgow
Gordon Black, GP
David Stewart, GP ,Glasgow
Neil Calderwood, Junior doctor
Sarah Briggs, Oncology Registrar, Oxford
Simon Kaye, GP Cumbria
Ruth Arnold, GP, Poole
Margaret Jackson, GP, Yorkshire
Naomi Adelson, GP, Birmingham

Elected officials

Peter Taylor, Elected Mayor of Watford
Cllr Denise Jeffery, Leader of Wakefield Council and Chair of Cabinet
Cllr Jonathan Slater, Lewisham Council Cabinet Member for the Community Sector
Cllr Paulette Lappin, Sefton Council
Cllr Mulherin, Leeds City Council
Cllr Jeanie Bell, Cabinet Member for Community Safety, St Helens Borough Council

Housing and energy sector

Adam Scorer, Chief Executive, National Energy Action (NEA)
Tracy Harrison, Chief Executive, Northern Housing Consortium
Sue Adams, CEO, Care and Repair England
Jim Watson, Professor of Energy Policy Research Director, UCL Institute of Sustainable Resources
Jacky Peacock OBE, Director, Advice for Renters
Angela Gascoigne, CEO, SHAL
Andrew Harrison, Broad Oak Properties Ltd
Raymond Osborne, MD, Osborne EnergyAndrew Scotter, Borthwick Heating Insulation UK LTD
Gearóid Lane, Agility ECO
Martin O’Brien, Association of Local Energy Officers, London
Hardial Bhogal, CEO, Area Eco
Graham Edwards, Chief Operating Officer, Wales & West Utilities
Gill Wyatt, Exeter Community Energy
Georgina Sommerville, Director, Green Rose CIC
Duncan McCombie, Group CEO – YES Energy Services CIC
Erik Coates, Energy Services Director, Pacifica Group
Matt Neal, National Energy Foundation
Jim Lynch, Commercial Director, Northern Gas Heating Limited
Frazer Scott, Chief Executive Officer, Energy Action Scotland
Dr Tim Jones, Chief Executive, Community Energy Plus
Guy Pulham, CEO, UK & Ireland Fuel Distributors Association
Rachel Jones, Chief Executive, Act on Energy and Chair of West Midlands Association of Local Energy Officers
Ian Henderson, Managing Director, Boiler Plan UK
Dr. Simone Lowthe-Thomas, Severn Wye Energy Agency
Jonathan Cosson, Director, Cyfarwyddwr, Warm Wales Cymru Gynnes CBC
Matthew Cole, Chair of Trustees, Fuel Bank Foundation
Emily Thompson, Director of Climate Change & Fuel Poverty, Groundwork in the North
Simon Kilshaw, Green Doctor Manager, Groundwork North, East & West Yorkshire
Stuart Dawks, CEO, PECT
Sue Painting, Chair of The Footprint Trust Paul Stapleton, Managing Director, NIE Networks Tom Bell, Head of Social Strategy,
Northern Gas Networks Anton Humphrey, Retrofit Works
Mark Randall, Managing Director, Aran Services
Fiona Price, Melin Homes
Phil Hurley, Managing Director, NIBE Energy
Dr Mark Fishpool, Director, Middlesbrough Environment City

Local Citizen Advice organisations

Carol Shreeve CEO, Citizens Advice Mid-North Yorkshire
Lesley Powell, CEO, Citizens Advice Denbighshire
David Harper, CEO, Citizens Advice Reading
AbI Conway, CEO, Citizens Advice Northumberland
Helen Goldsack CEO, Purbeck Citizens Advice
Stuart Dexter, CEO, Citizens Advice County Durham
Liz de Villiers, CEO, Citizens Advice Tunbridge Wells & District
Angela Newey, CEO Citizens Advice in North & West Kent
Caroline Jones, CEO, Citizens Advice Calderdale
Janie Moor, CEO, Citizens Advice South Hams