Ade Williams is the lead pharmacist at Bedminster Pharmacy, Pharmacist of the Year 2018, and the Royal Pharmaceutical Society’s Patient Champion.
Photo: Schnobby creative commons
My patient Brian worked out a routine for seeking warmth by staying in public buildings, including my pharmacy: ”Wear a smile and try to be inconspicuous. Most people just leave you alone, they figure you aren’t trouble. Holding a newspaper helps.”
Brian isn’t homeless and despite receiving state help, finding warmth is what occupies his day. I have observed his routine for several years, dismissing his building-hopping as harmless eccentricity – I now know better. Brian is cold, especially at home.
A household is in ‘fuel poverty’ if paying for its energy costs would push it below the poverty line in terms of remaining income. Brian is one of Bristol’s estimated 20,700 households classed as fuel poor. Bristol has the highest fuel poverty in the South West, with 10.8% of homes suffering.
Brian drives a mobility scooter and suffers from chronic respiratory problems; he needs multiple inhalers. He wears many layers that visibly weigh down his thin frame, yet this is essential getup for him.
The Bristol Joint Strategic Needs Assessment (JSNA) identified these as Bristol’s fuel poverty risk factors: poor health, housing with poor energy efficiency, and low income. Some of the areas at greatest risk include Hartcliffe and Withywood, Lawrence Hill, Filwood, Ashley, Southmead and Easton.
Older people are more at risk of being fuel poor; they’re more likely to live alone in larger houses and likely to spend more time at home. They are not always computer literate and less likely to take advantage of cheaper energy tariffs available online through comparison sites. This is the case for Brian.
It is estimated that one in three fuel poor households include somebody with a disability or long-term health condition. Unemployment among disabled people increases their likelihood of spending more time at home. This potentially leaves individuals trapped in a cold house for long periods.
Since 2012, an Energy Performance Certificate (EPC) is issued whenever a property is built, sold or rented in the UK. It is used primarily by would-be buyers or renters to see how much their energy-related CO2 emissions and costs are likely to be.
It was hoped the EPC would also be a tool for landlords to improve the efficiency, running costs, and therefore the overall comfort of their property for tenants. But there was no incentive for them to do so.
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Housing in Bristol is notoriously costly to buy or rent. Of about 200,000 dwellings in Bristol, 29% are privately rented – above the national average. Tenants on benefits or even medium incomes are increasingly unable to afford the rising costs of rents in the city, and this is a driving factor behind fuel poverty.
The government’s Clean Growth Strategy sets the ambition for all fuel poor homes to be upgraded to an EPC rating of C by 2030. According to the latest EPC ratings, 63% of private rented dwellings in Bristol are rated below C, 4,500 of which are rated F or G. (For more data, see other page).
Thankfully, from 1 April 2020, new legislation will mean landlords of private rented properties in England and Wales need to ensure their properties reach at least an EPC rating of E for all tenants.
This legislation matters because, as well as causing suffering, there is mounting evidence that cold homes actually kill. Up to 30% of excess winter deaths can be considered attributable to cold homes, according to the World Health Organisation.
I ask William Cotterill, Energy Advisor at the Centre for Sustainable Energy (CSE), what Brian needs to survive this winter. CSE is a Bristol-based charity that works with various organisations, including energy providers, to support those living in fuel poverty.
William tells me that sadly Brian’s story is not uncommon. Most people experiencing fuel poverty do not realise it, but present to food banks, health services or community and faith groups with problems that could be symptomatic of fuel poverty, such as inability to pay for food and transport costs, debt, excessive damp and mould, and physical and mental health problems.
CSE also contacts and encourages Bristol council tenants to get more modern heating systems. Through their interventions, around 25% of these tenants have agreed to have their heating system replaced. Demand is high and most local fuel poverty services are at capacity.
There are some encouraging signs regarding the regulation of energy efficiency in privately rented property. Bristol’s work profiling local ‘cold home hazards’, has been mentioned as an excellent example for other councils, and a citywide ‘cold homes strategy’ is imminent.
Kate Thomas, the lead on a CSE project to help landlords in Bristol understand their legal obligations, welcomes the changes. “The new regulations are a good opportunity to improve these properties, to make them more livable and save lives.”
Brian shows me his tar stained hands from smoking, a habit I have discussed with him before. ”I sometimes smoke to keep warm indoors, but I can’t tell you that, can I?”
Tackling cold homes would not only save lives but can help the planet, by heating homes efficiently and reducing CO2 emissions. Now more than ever, it’s time to address both of these issues. We need more funding, better housing regulations and joined-up working across agencies to help those in need.
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