Fuel Poverty Conference 2011
Monday 7th February 2011 -9.30am
Opening & Welcome
Welcome: David McCarthy, Chairman, Energy Action
Chair: Brendan Halligan, Chairman, SEAI
Speakers: Duncan Stewart, Award Winning Architect & TV Presenter Prof. Owen Lewis, CEO, SEAI Bríd Horan, Executive Director, Electric Ireland & Shared Services, ESB
In the last year community action groups have been urged to support projects that facilitate the creation of sustainable employment opportunities in their areas. This is in fact what Energy Action has been doing for the past 21 years” said David McCarthy, Chairman of Energy Action. Energy Action, he pointed out, continues to mentor several community groups to encourage the establishment of projects to deliver a quality service to the most vulnerable in their area and in so doing, creating community employment. Over the past 21 years, Energy Actions two main objectives have been continuously achieved namely addressing fuel poverty and creating local employment.
David McCarthy hoped that the conference would facilitate dialogue between policy makers and provide a stimulating form for those working in the area to share information and ideas and to network with peers.
Brendan Halligan began his address by commending the work of Charlie Roarty and his colleagues, and also held the work that has been done by Energy Action as a great example to the public sector. The conference he suggested was unusual in the sense that its policy context is absolutely and utterly clear. It is an area where the connection between social and economic policy is blindingly obvious. On the one hand it is combatting poverty and on the other hand it is addressing social justice, while also stimulating energy efficiency and making a serious contribution to economic growth. It’s not complex – this is a win-win situation. What it requires according to Mr. Halligan is intelligence and scale of ambition.
“Revenue raised from the Carbon Tax should be used to tackle fuel poverty”, Duncan Stewart said when he opened the Energy Action Conference in Dublin Castle today. “This would have the added benefit of reducing our dependence on imported fuel and generating badly needed jobs.
Mr Stewart said that fossil fuel imports were costing 4,000 jobs to the economy and that 95 per cent of households were dependent on it for heating purposes. “While the Carbon Tax is in all our long term interests it is important to ring fence some of the revenue to ensure it is used to help those in fuel poverty.
“Otherwise there is a danger that it can operate, unintentionally, as a regressive tax, penalising those who can least afford to pay.” The number of households experiencing fuel poverty has risen significantly since 2009, when there were 340,000 receiving fuel allowances. It is estimated the figure rose to 375,000 last year. “The problem was exacerbated this winter by: The severe winter weather with sub zero temperatures for protracted periods
The effects of the recession and rising unemployment on people’s ability to pay fuel bills rapidly rising fuel prices over the past 3 months.
“Energy Action has pioneered the development of Community Based Organisations to solve the problem of fuel poverty on the ground. It has shown in a very practical way that this is the best approach because community based organisations are the best placed to identify the fuel poor.
“They are trusted to deliver a personal service because people know the motivation is social rather than profit driven and the emphasis is on delivering sustainable solutions to people’s problems. They also create jobs in communities ravaged by unemployment.”
Prof. Owen Lewis
Prof. Lewis recognised the excellent work carried out by Energy Action and highlighted the fact that the original Energy Action CBO model has played a crucial role in the establishment and mentoring of emerging CBO’s throughout the country. In a former academic role, Owen Lewis and Peter Clinch carried out a study that Energy Action sponsored and it was published as “The Cost of Heating Ireland” and it involved drawing up a 10 year plan for upgrading all of the residential building stock and a fairly elaborate cost analysis illustrating that the value of that work clearly exceeded the cost of undertaking the work.
In recent years energy poverty has become much more prominent within the overall policy context. It’s apparent in the National Action Plan for Social Inclusion, the Government’s Green & White Papers on Energy and the National Energy Efficiency Action Plan and if we look at the scale of the financial commitment the Government has made to address this issue we can see that even in these difficult financial times the issue is still being addressed. In 2008 5,300 houses had been upgraded in terms of energy efficiency with the expenditure of €6,000,000 entirely through CBOs. In 2009 16,000 were upgraded with a budget of €12,500,000. Some private contractors were introduced to support the work of CBOs and achieve national coverage. In 2010 the figures were just under 25,000 with a budget of €30,000,000.
There are three things that contribute to fuel poverty. They are household income, the price of fuel and the efficiency of the dwelling. Household income is addressed through measures like the fuel allowance, the household benefits package etc. With regard to the price of energy SEAI have been able to demonstrate that the price of electricity has become more competitive in Ireland and is now at the European average. The Warmer Homes Scheme particularly addresses the issue of the efficiency of the dwelling. 28 CBOs are involved in delivering that service in addition to 20 private contractors. SEAI’s role is not only in delivering tax payers money as capital support but also as designing a technical specification. It is important that high standards are held.
Fuel poverty is a not a new problem but we now have a golden opportunity to eradicate it, Brid Horan, Executive Director of ESB Services and Electric Ireland told the Energy Action conference in Dublin Castle today.
“Fuel affordability is not just an issue in recessions, boom times can often generate high energy costs, and prices, that the most vulnerable in our society can often ill afford”, she said. “Fuel poverty is a complex issue with many dimensions and the ESB understands the importance of working with other stake holders and agencies to eradicate it.
“ESB is proud of its long association with Energy Action and fully supports its pioneering work in the area. The provision of affordable energy is an important social and economic priority. By helping people improve the energy efficiency of their homes and heat their homes adequately we improve their health and personal wellbeing, we help them deal with their financial problems, we reduce our dependence on fossil fuel imports and we help generate jobs.
“Our staff members are very aware of the social as well as the economic issues involved because we deal with them every day. By working with community based organisations such as Energy Action we can improve the delivery of our own services to customers. We also work with the help agencies and our customers who have difficulty paying for their energy needs. We encourage customers to work with us by contacting us early to address ant difficulties they are having.
“On the employment front the ESB itself has engaged in employment initiatives such as ensuring that we continue to produce craft workers and technicians to the highest standard through our apprenticeship and graduate programmes. We took special measures to ensure that apprentices in disciplines where we could, for example, are involved can complete their training.
“We also upgraded 3,000 homes in the last two years as a direct contribution to improving energy efficiency and addressing fuel affordability.” “It is part of our overall strategy of supporting economic recovery and ensuring that when it comes, as it undoubtedly will, we are fully prepared to take advantage of it. In this regard we are promoting many initiatives such as e-cars and Novus Modus fund, which is investing in innovation and development, but we do not forget that the road to recovery, like so much else, begins in the home”.
Monday 7th February 2011 -10.00am
What is Fuel Poverty and Who Suffers From it?
Chair: Charles Roarty, General Manager, Energy Action
Speaker: Dr.Brenda Boardman, Emeritus Fellow, Environmental Change Institute, University of Oxford Dr.
It is extremely hard to identify the fuel poor, Brenda Boardman, Emeritus Fellow of the Environmental Change Institute, University of Oxford, told the Energy Action conference in Dublin Castle today. She also expressed concern about the effects liberalising the energy markets had, especially on the elderly. “People who don’t switch to lower tariffs tend to be the elderly.
They end up subsidising those who do switch by continuing to pay the higher tariffs”, she said. The elderly also tended to be the people who “don’t self-refer” themselves to agencies that can help them and who fail to take up benefits they are entitled to.
At the same time she said that after many years she had come to the conclusion that free insulation schemes should no longer be supported. It was the better off who tended to benefit most from such initiatives and we also need to look at releasing equity to help pay for insulation measures.
Monitoring fuel poverty was extremely difficult. In the UK the 30 per cent of households with the lowest incomes spent 6.1 per cent of it on fuel, or £12.73p a week; while the other 70 per cent of households spent 3.4 per cent or £19.24p a week on average on energy.
At present low income pensioner couples were spending an average of £6.65p a week on fuel, but to heat their homes adequately they would need to spend £16.15p. With an efficient heating system the cost would drop to £10.35p and with a well-insulated dwelling, the cost would fall to £5.65p.
However not all pensioners are poor. Although pensioners received 49 per cent of fuel allowance payments only 24 per cent of pensioners were living in fuel poverty. Other low income groups were also affected. The use of a word such as ‘vulnerable’ when dealing with the problem was “a misleading descriptor”, she added. In 2008 71 per cent of English households contained someone who was elderly, young, disabled or had a long term illness. Not all of them were poor.
More accurate monitoring of fuel poverty was needed to ensure resources were deployed where they were most needed. That was why community based organisations such as Energy Action were so important.
Monday 7th February 2011 -11.00am
Addressing Fuel Poverty – The UK/NI Experience
Speakers: Norman Kerr, Director, Energy Action Scotland Richard Rodgers, Managing Director, Eaga International Nigel Brady, Director, Northern Irish Energy Agency Bill Sheldrick, CEO, Alembic Research
In 2001, when power was returned to the Scottish Government, Energy Action Scotland lobbied the Scottish Government to ensure that energy efficiency and fuel poverty were included in the housing bill. The Scottish Government, like the UK Government now have a duty to eradicate fuel poverty “as far as is reasonably practicable by 2016”.
When they began to measure fuel poverty in Scotland they looked at the housing conditions survey of 1996. This survey is now a rolling survey. In 1996 736,000 people (one third of the population) were living in fuel poverty. Today there are still close to one third of the Scottish population living in fuel poverty (2009 Fuel Poverty Survey).
Trends in terms of fuel poverty – between 1996 and 2002 we saw the deregulation of the energy market which saw an influx of new energy suppliers who were all competing for customers. That bottomed out in 2002 when fuel prices hit rock bottom. Since 2002, the 13 fuel companies that existed have now consolidated into 6 and their prices have continued to rise year on year since then. The industry regulator in the UK has now begun to look at companies and how they make profit.
Fuel poverty continues to rise. Norman Kerr believes that in order to address fuel poverty we need to be able to identify the fuel poor and he pointed to how the Scottish Housing Conditions Survey is used to identify where the fuel poor actually live. A lot of rural areas have high concentrations of people living in fuel poverty, and these areas are located off the mains gas line. As a result, people in these areas have to resort to other forms of fuel such as oil and LPG which are unregulated. The issues that have been suffered by those who use oil to heat their homes has been significant and the Office of Fair Trading in the UK are now looking into whether there is a cartel operating in Scotland to control the price of oil.
In Scotland it is known who the fuel poor are and what is needed to be done to reach them but the question still remains, what is actually being done to address fuel poverty in Scotland? The Scottish Government had a Central Heating Programme in place which is now the energy assistance package. The programme focused on providing central heating systems to anyone over 60 who didn’t have a central heating system in place. This seemed fair until you looked at fact that there were people over 60 who had well-paid jobs but didn’t have a heating system in place were applying and receiving the system. Those people were not fuel poor and would never be fuel poor. There are now a myriad of programmes in place. The problem with that is that it makes it more difficult for people to decipher whether they are entitled to avail of any of the programmes. This issue has started to be addressed and has been rebranded the Home Energy Scotland programme which provides a range of assistance options. In Scotland it is known who the fuel poor are and where they live but there are still challenges in addressing fuel poverty in terms of the quality of the housing stock, the national minimum wage, benefit levels and also the regulation of the energy industry, gas and electricity that are controlled in Westminster. It is part of Energy Action Scotland’s job to continue to work with Westminster and the Scottish Government on these issues.
Norman Kerr pointed to the fact that we are unfortunately seeing the increased privatisation of the fuel poor in Scotland. The Government are taking a backward step in this regard. £350 million has been withdrawn from the Government’s Warm Home Scheme and it’s been pushed towards the energy companies and the energy companies through CERT and CESP are now funded by the consumer as it is added on to the electricity bill.
There is consistency in the way that people see fuel poverty. It is the three legged stool; energy efficiency, fuel prices and income. Fuel poverty is a large issue and a growing issue as fuel prices continue to increase. We must start by improving energy efficiency. Unless we improve energy efficiency, fuel poverty will never be eradicated said Richard Rodgers of Eaga. He also highlighted the incredibly poor thermal efficiency of the Irish housing stock.
In England the Warm Home Front has been put in place and 2.2 million homes have been aided in the past 10 years to improve their SAP ratings. Roughly a quarter of a million homes have received a benefit entitlement check. In Wales, 124,000 have benefited from benefit entitlement checks. All of these schemes will end in 2012 and they will be replaced. The question is whether these schemes have helped to reduce the numbers living in fuel poverty? In the UK and NI people are entitled to the winter fuel payment irrespective of whether they need it or not. Richard Rodgers placed great emphasis on the fact that their needs to be retargeting of the way scarce resources are spent. He said that we need to take a long term approach using the money spent on winter fuel payments to pay for retrofitting schemes rather than paying it out to individuals.
The creation of Green jobs through the CBO model in Ireland is much more developed than in the UK. The future in the UK is that there will be green jobs, local intervention and local economic stimulus through proposals that will come into play towards the end of 2012. All of this is focused on carbon reduction targets. It is irrelevant whether one believes in global warming or not as the fossil fuels that we use to heat our homes are finite resources that will not last forever. In the future we need to start looking towards renewables as a way of addressing fuel poverty as they reduce price uncertainty. Renewable technologies are generally not cost effective. There has been a lot of comment about the feed in tariffs in England and Wales and in reality this is a solution for the south of England and followed by a solution that is due to come into operation in June called the renewable heat incentive. The reality with all these incentives is that the consumer pays for it. It is in effect a stealth tax.
The problem with the feed in tariff was who could afford the £15,000 to have solar PV panels installed on their roof? The private consumer may have had disposable income but what of the fuel poor? Eaga are encouraging long term partnerships between companies like themselves, not for profit groups and government departments in order to make a difference. Eaga are tackling the local authority market for solar PV. They have raised £300 million through the market to put 30,000 solar panels on local authority social housing. It then provides those tenants with free electricity for the year. It is the feed in tariff that funds the payment of the debt. Eaga have brought an innovative approach to the feed in tariff that was available. In conclusion Rodgers pointed to the fact that without the interventions of the past two decades many more households in Ireland & UK would be in fuel poverty today. Although Ireland has lagged behind in terms of progress that has been made in the UK in addressing fuel poverty Rodgers emphasised the fundamental opportunity presented by the proposed National Retrofit Plan to address fuel poverty and the opportunity it would provide Ireland to present itself as an international leader in addressing the issue while at the same time stimulating the local economy and creating jobs.
Founded over 100 years ago, the Bryson Charitable Group has been actively involved in addressing fuel poverty. Bryson Energy (which comes under the umbrella of Bryson Charitable Group), formerly the Northern Ireland Energy Agency is the groups business unit that operates a range of initiatives that address fuel poverty. Bryson Energy works in three main areas. It provides energy advice, it administers grants on behalf of a range of organisations and it is now carrying out a range of improvement measures such as heating and insulation in some 5,000 homes across Northern Ireland. Bryson’s approach as a social enterprise sees a range of sub-contractors delivering the measures, ensuring local employment through local jobs in local areas said Nigel Brady.
Northern Ireland continues to have the highest levels of fuel poor households. Fuel poverty has risen from 34% in 2006 to 44% of all households in Northern Ireland in 2009. The main reason for this increase can be attributed to increasing fuel prices. The target in the 2004 strategy was to eradicate fuel poverty by 2010 but obviously this has not been met. The Government’s efforts to alleviate fuel poverty rather than eradicating it can perhaps be explained by the challenges we are faced with ahead. Average domestic expenditure on fuel for home use in all other regions of the UK in 2006 was seen to have fallen. In the North of Ireland the average amount spent on fuel was 4.9% of annual income. It is the intention of the Northern Irish Government that a severity index will be devised so that those living in the most severe fuel poverty will be targeted first.
The Department of Social Development is the lead department responsible for addressing fuel poverty in Northern Ireland and in 2010 they launched the Warmer Healthier Home which is a consultation paper on the new fuel strategy for Northern Ireland. It recognises that while responsibility for addressing fuel poverty is spread across government departments a partnership approach is vital. The Department of Social Development’s energy actions will not alone eradicate fuel poverty and the six other government departments each have an increasing role to play. The establishment of the interdepartmental group on fuel poverty is responsible for the effective coordination of policies and actions while the fuel poverty advisory group reports on the effectiveness of the current policies. The fuel poverty fund delivers energy efficient improvements to fuel poor households who do not qualify for government schemes and the Fuel Poverty Task Force was established in response to increasing energy costs. This resulted in a household fuel payment of £150 to 167,000 households across Northern Ireland.
The recognition of the links between ill health and fuel poverty has been well illustrated by the Investing for Health Partnerships. It is the Warm Home Scheme, the Department for Social Developments main tool in tackling energy efficiency in the owner occupied and private rented sector. The Warmer Home Scheme was first launched in 2001 and then relaunched in 2009. The key objective is achieving an average energy efficiency gain of at least 15% in 9,000 fuel poor households a year. A fully controlled heating system and insulation are provided to the householder at no extra cost. The Warm Home Scheme is for householders who receive some benefits from the state but are living in their own home or a private rented dwelling. In addition to the energy efficiency measures, energy advice is also provided. The programme is currently exceeding its targets.
As part of the Warm Home Scheme household benefit checks are also carried out. The issue of household income is what sets Northern Ireland apart from other parts of the UK. Householders in Northern Ireland spent almost twice as much on energy that householders in London and almost 60% more than the UK average. This is as a result of the climate in Northern Ireland, high reliance on oil (unregulated fuel), lower household income and higher levels of benefit dependency.
Northern Ireland Energy Agency undertook a study in conjunction with Prof.Christine Liddell into unclaimed benefits and found that, households living in fuel poverty had on average £42.93 in unclaimed benefits every week. If those people did collect the benefits it would bring an extra £3.6 million in to the economy annually. This is not happening due to a lack of awareness of entitlement and the concern of the effect it may have on other benefits that they are claiming. Brady believes that there is a clear need for a benefit advice service.
Nigel Brady concluded by outlining the general anticipation that the new Fuel Poverty Strategy for Northern Ireland will include a revised definition of fuel poverty for better targeting the removal of energy inefficiency in homes through the increased installation of better heating systems, boiler replacement and insulation. The strategy, he emphasised, will have to deal with maximising income through benefit uptake initiatives. It will recognise Green New Deal to create jobs. It will assist with fuel budgeting through a Northern Irish wide Energy Budgeting scheme. Behavioural advice, Brady said, will need to be acknowledged as having a role to play in increasing energy efficiency going forward. Social tariffs, equity release, smart meters must all be explored if we are to reach energy affordability. We must invest in large and small scale renewables to secure energy supply into the future.
“We will eradicate fuel poverty by using local initiatives, using local people, going door to door, going street by street, targeting, and doing all the work” says Bill Sheldrick, Director of Alembic Research. Community Based Organisations play a critical role in solving the issue of fuel poverty as they provide advocacy services as well as a comprehensive insulation service and they ensure that jobs are retained in the local community.
In Scotland the Community Energy Saving Programme was designed to promote a 'whole house' approach and to be delivered through the development of community based partnerships involving local authorities. However, Sheldrick argues that this has not worked as there are hardly any community based projects left. By privatising the response to fuel poverty you see private contractors coming in to the market, who are constantly trying to cut costs and therefore end up decreasing the amount of jobs in the community. This in turn leads to the death of that community. Managing agents have never remained satisfied with being managing agents and they inevitably diversify to control a larger share of the market.
Sheldrick argued that local community based organisations can play a crucial role in addressing fuel poverty but in order to do so they must be provided with support, finance and protection. In Scotland community based organisations have been completely stripped down as a result of ___and the time has now come to build them up again, but empowering the local community is not cheap.
Sheldrick warned that in Ireland we should be working to protect CBO’s in their delivery of a service to the fuel poor.
Monday 7th February 2011 -2.15pm
Fuel Poverty – Current Policy & Practice
Chair:Niall Ó Donnchú
Speakers:Stjohn O’Connor, Principal Officer, Department of Communications, Energy & Natural Resources Brian Motherway, Chief Operations Officer SEAI Adrian Kelly, Residential Markets Manager, ESB Electric Ireland
Addressing Fuel Poverty is very complex as many departments are dealing with different aspects of the issue. Dr. O’Connor questioned whether the extent of the energy poverty people in which people are living should be estimated using subjective or objective methods. He argued that whilst the expenditure share method is an arbitrary and, in many cases, unsatisfactory measure, it does give an indication of the level of household resources taken up in obtaining home heating and transport. He also pointed to the fact that it helps to give an indication of potential vulnerability, especially in the event of an energy price rise. Dr. O’Connor suggested that we need to use different metrics such the EU model of twice the median.
Existing government policy on fuel poverty focuses on retrofitting, income supports and consumer protection. Dr.O’Connor believes that we need to consider what the balance is between investing in retrofitting and providing fuel allowance/benefits? The problem he argued is not going to be solved through income support alone and as a result we need to see more retrofitting. Thermal efficiency is key. By understanding the housing stock we can decide what measures need to be taken. Since 2001 61,413 homes have been thermally upgraded and Dr.O’Connor anticipates that we will soon have social housing that is far more efficient than the private sector.
The State should be spending money where it is needed, rather than providing grants to everyone. Dr.O’Connor suggested that we need to move more towards an area based approach in order to tackle fuel poverty but he disagreed with Dr. Boardman about eligibility and the ability to target those living in fuel poverty.
SEAI plays a co-ordinator role. They are helping to build a sustainable market. There is more confidence in the market at the moment as there is high public awareness about energy efficiency. SEAI are concentrating as a priority on a simple intervention programme.
SEAI support the provision of energy efficiency measures through a number of programmes including the Home Energy Saving Scheme and the Warmer Homes Scheme. The Warmer Homes Scheme which targets vulnerable fuel poor households is a runs on self-referral basis. SEAI have advertised this service but there are still people who don’t know about the WHS and this needs to be addressed. Brian Motherway believes that CBOs are the backbone of what SEAI do as they have a relationship with the vulnerable in the community and they play an important part in informing people about the WHS scheme. Since 2007 private contractors have also been employed to deliver the WHS, augmenting the network of CBOs.
Quality of service and financial probity are both essential in SEAI’s work and quality is ensured by constant inspection.
Since the deregulation of the energy market in 2007 we have seen the wholesale markets north and south of the border become one. Keeping prices low is one of the biggest factors from a Utility perspective to help address fuel affordability and retail harmonization it is hoped will result in greater competition and thus lower prices. The ESB has embraced the competition agenda and Adrian Kelly highlighted the fact that the ESB continues to help customers to manage their bills through early contact via phone call, text and letters. The ESB have a code of practice in place for dealing with customers and they provide direct support to fuel poor. 160,000 payment arrangements entered into with customers during 2010 (i.e. c700 plans per day) The ESB also have close working relationships in place with SVP volunteers, MABS staff and HSE Community Welfare Officers. The ESB also believe that an early large scale rollout of Pay As You Use meters will assist customers manage their usage and bills as well as the significant choice of payment channels available e.g. Equaliser, Household Budget Scheme.
Prof. Christine Liddell
Current consensus from research on tackling fuel poverty is that it has a large impact on the mental health of adults and children, it affects the physical health of children, infants and teenagers and it can also affect the physical health of adults overtime says Prof. Christine Liddell from the University of Ulster.
Prof. Liddell has suggested that “excess winter mortality” may underestimate the number of deaths caused by fuel poverty as it only looks at the three months of winter and it does not take spring and autumn into account which are also very cold in Northern Ireland. In the colder regions of the UK and Ireland annual excess winter death statistics may underestimate the impacts of cold weather on human health by about 25%.
New research undertaken at Queens University Belfast has drawn a link between fuel poverty and the development of neonates. The study found that the heaviest babies are conceived in May and the lightest babies are conceived in October. According to the study, the babies conceived in October spent a whole winter in the womb and therefore we exposed to colder conditions in utero. Research has also been undertaken in Glasgow which has shown that the blood pressure of a group of volunteers living in a well-insulated block of flats over a year long period was higher than the blood pressure of a group of volunteers living in another block of flats that were poorly insulated.
Cost benefit analysis of tackling fuel poverty shows that 42c of every €1 spent on tackling fuel poverty is returned in savings on health expenditure on all householders.
Prof. Liddell closed her presentation by emphasising that we must be targeting those within known cold sensitive health risks.
In 2005 the UKPHA launched the ‘Health Housing and Poverty Forum’ (HHPF) with the aim of maximising the contribution that the health housing and energy sectors make to the delivery of energy improvements to vulnerable households. The work of the HHPF is viewed as essential in helping to improve health outcomes and to simplify the labyrinthine systems of referral. In order to avoid the labyrinth the UKPHA identified the need to establish a central clearing house system in order to help those living in fuel poverty access the necessary supports. The Central Clearing House Model was developed through intensive facilitated national workshops involving grassroots expertise from the health housing and energy sectors. Although health professionals see the impacts of fuel poverty it is not their job to fix their homes. As a result of the cooperation between different sectors, the Central Clearing House Model ensures that both the root of the problem and its symptoms are addressed.
The Central Clearing House system was piloted in Greater Manchester area as part of their fuel poverty initiative based on the AWARM system. AWARM is a single point of contact for both the referrer and for the client. AWARM provides tailored training for priority staff such as community nurses, GPs etc. Ssenior management were informed of this training to ensure buy-in /support within the various organizations at the top level in order to reflect the level of priority the issue should have. The programme uses secure methods of communication which is important when sharing patient/client data. All cases are efficiently managed ensuring the immediate allocation of ‘referral’ to the various delivery agencies which ensures prompt delivery of solutions. AWARM is not just a signposting service – there is a level of customer support that’s fairly unique to AWARM – it can take up to a year to ensure that a client has received all the services to which they are entitled. AWARM ensures the most vulnerable do not drop through the net. AWARM provides this service for the 10 local authorities in the Greater Manchester area and it is totally flexible to the services, grants and eligibility criteria within each authority.
A GP referral system was also been piloted. GPs are trusted in the community and it was therefore an effective way of finding people who were in need of help in dealing with fuel poverty. When the GP identify someone as living in fuel poverty they feed the info into a simple system on their screen and this is forwarded to the central clearing house. This has not yet been rolled out all over Britain but Mawle believes that it needs to be made part of GP’s routine procedure.
The main problem identified with the AWARM pilot is that it is not accessing those most in need. There is a lot of data available, both from the health sector and local authorities but it is not being used effectively. Mawle believes that “the development of processes of data share and referral both individually (at the patient-GP interface) and at population level (through data-overlay mapping between local authorities and [currently] PCTs which enables evidence based targeting at a Unitary (or equivalent population size) wide level” needs to be developed in order to effectively address the issue of fuel poverty. It is all about bringing people together to show the commonality of purpose.
Dr. Helen McAvoy
The dynamic of fuel poverty is changing all the time. For example; severe weather events, increasing/decreasing salaries, decrease in social welfare benefits, rising price of oil etc. The impact fuel poverty has on population health is also changing rapidly itself (increasing life expectancy, increase in rate of chronic illnesses, increased management of cardio vascular diseases, changes in vaccination etc.) making this a complex and dynamic area.
Despite the advances that have been made over recent years in terms of public health there are still large health inequalities in Ireland. In the World Health Organisation Commission on Social Determinants in Health report they referred to vital social goods and interestingly as well as food they included energy in this. Helen believes that we should be looking at the role of fuel poverty in creating health inequalities. Health needs to be in the definition of fuel poverty. It’s vital that in any programme and in any strategy to tackle fuel poverty that health forms the definition.
Targeting means knowing who is in fuel poverty and also knowing the relative risks of ill health as a result of being in fuel poverty. I think public health has a role to play in developing population attributable risks. This get the health sector more involved in engaging in addressing fuel poverty.
Fuel poverty affects younger people as well as the elderly. We still haven’t engaged with the issue of fuel poverty in the way that we’re dealing with infectious disease control. If we are going to develop a model to see how fuel poverty effects health we need to take into account the benefits of the offset of the impacts of climate change and the Institute of Public Health is doing some work on that area.
At the individual level we need to learn how household temperature effects body temperature, blood pressure and state of mind. Over 11% of our over 65’s live in houses with no central heating and the older one gets the more vulnerable they are to the cold. The damp & mould associated with cold also has a detrimental effect on peoples respiratory systems. The rate of damp & mould in households living in fuel poverty is four times that of those not living in fuel poverty.
Helen highlighted a number of “policy asks” that she felt were critically important in addressing fuel poverty from a population health perspective. They included Health and well-being at the centre of legislation and policy related to fuel poverty/ affordable energy, meaningful set of fuel poverty indicators that are monitored and reported, leadership and co-ordination driven by a strategic interdepartmental approach not just in the development of policy but also in its implementation. Helen also emphasised the need for Increased and sustained capital investment in improving housing condition and energy efficiency of dwellings within the National Energy Retrofitting Programme and within the implementation of the Energy Affordability Strategy.