Healthy housing
Ryan Jennings hears South Eastern Trust Chief Executive Hugh McCaughey’s explanation of the role of housing in keeping the population healthy.
Housing, Hugh McCaughey says, is one of the major health determinants. Simply increasing the standard of housing – and therefore decreasing deprivation – would contribute to both a longer life expectancy and lower rates of poor health.
“If you look back over the last century or centuries, the big gains in public health have been made through sanitation and housing,” he suggests. Research by the World Health Organisation would also suggest that health is directly correlated with deprivation.
Glasgow, for example, has come to represent the great inequality. Areas which are only a mile apart could have life expectancy differences as wide as 20 years. There are other factors of course which play a part in society’s health, such as education and employment. McCaughey’s view, though, is that neither have as great an impact as housing.
Nowhere is that more evident than in the older population, which he expects to increase by 18,000 in the next decade in his own South Eastern area. Clarifying that increase, he says: “In Northern Ireland we are parachuting in the population of Ballynahinch of over 65s every year for the next 10 years.”
An older population will certainly lead to more demand for services and therefore McCaughey believes that the focus should be on getting “up-stream” i.e. focussing on the things that make a difference to people’s health and
demands on social care, rather than the current rehabilitation model.
“If you ask the question, ‘how many people would like to finish their days in a residential home?’ I don’t think you will get many hands up,” he suggests. That, he says, is the traditional model but it has become unsustainable.
Currently, residential care can cost the patient up to £20,000 per year, leading to the sale of their assets (most likely a house) to pay for it. The retirement village concept, he believes, should be explored more on this side of the Atlantic.
McCaughey believes that the time has come for technology to play its part: “You now have sensors to see if [older residents have] got out of bed, to see if the toilet has been flushed, if the fridge has been opened,” he says.
That means either a ‘response centre’ or a relative can be alerted if there has been no movement for some time.
Government policy would also have a part to play in any move towards that concept. Tax breaks for those wishing to maintain their independence, he says, could be a start. However the concept should not be alien to us all: “Some people already have a second home in Spain or Turkey and actually what they’re doing is paying a certain amount per year or per month to maintain it.
“Is that model not fit for a retirement village so you’re actually buying that support and buying into your
independence and buying into maintaining your asset?”
McCaughey acknowledges that traditionally retirees don’t buy a property in a village but does not think that will be impossible to change: “We’re very much a society that likes to buy buildings as an asset. So why would you not buy that if there’s going to be one in three more elderly people in the next couple of years who are also going to want that thing; it’s going to be re-saleable.”
In the long term he suggests that supported housing, with less public capital and more private buy-in, could go some way to easing the pressure on the Health Service. In an age when the health budget is being squeezed already, openly saying that housing could make a difference could lead to calls for increasing the housing budget directly out of the health department’s pocket.
He’s heard that before: “Equally I could also say there are other facets [such as] education and employment. You could argue, as the DFP and First Minister do, that if we create more employment that will contribute to health. The same can be said for the Sports Council.” In short, there needs to be a response across the board.
Currently sick people are only picked up when they get to the doctor but technology, McCaughey believes, is where the revolution will be. And that revolution will happen in the home.
