Owl has tracked down the sources of the recent press comment on declining health and health inequality.This post places these on the record, with summaries below. (Serious read, not for the faint hearted).

In 2010 Sir Michael Marmot’s strategic review of health inequalities in England post- 2010 was published under the title “Fair Society, Healthy Lives” . In the review, recommendations were made in six domains:

• Give every child the best start in life 
• Enable all children, young people and adults to maximise their capabilities and have control of their lives
• Create fair employment and good work for all
• Ensure a healthy standard of living for all 
• Create and develop healthy and sustainable places and communities
• Strengthen the role and impact of ill health prevention

https://www.parliament.uk/documents/fair-society-healthy-lives-full-report.pdf

This February a “ten years on”  report has just been published which shows that, in England, health is getting worse for people living in more deprived districts and regions, health inequalities are increasing and, for the population as a whole, health is declining. The data that this report brings together also show that for almost of all the recommendations made in the original Marmot Review, the country has been moving in the wrong direction. 

HEALTH EQUITY IN ENGLAND: THE MARMOT REVIEW 10 YEARS ON

https://www.health.org.uk/sites/default/files/upload/publications/2020/Health%20Equity%20in%20England_The%20Marmot%20Review%2010%20Years%20On_full%20report.pdf

Report Conclusions and Summary of Recommendations

In 2008 the Commission on Social Determinants of Health, with Sir Michael Marmot as chair, published Closing the Gap in a Generation. The title was meant to reflect the fact that the Commission’s assembled evidence showed that, if acted on, the health gap – inequalities in health within and between countries – could indeed be closed within a single generation. The cover of the report read: “Social injustice is killing on a grand scale”. It was the Commission’s firm view that not acting on the evidence was deeply unjust to the billions of people whose health was made worse by social conditions they had no part in creating.

It was in this spirit that the Marmot Review team approached the task of assembling the evidence to show how the conclusions of the Commission on Social Determinants of Health could lead to recommendations for reducing health inequalities in England. Because we judged that social justice should be at the heart of policies to improve health, we gave the 2010 Marmot Review the title, Fair Society, Healthy Lives. Put fairness – social justice – at the heart of all policy-making and health would improve and health inequalities diminish.

This ’10 years on’ report shows that, in England, health is getting worse for people living in more deprived districts and regions, health inequalities are increasing and, for the population as a whole, health is declining. The data that this report brings together also show that for almost of all the recommendations made in the original Marmot Review, the country has been moving in the wrong direction. In particular, lives for people towards the bottom of the social hierarchy have been made more difficult. Some of these difficulties have been the direct result of government policies, some have resulted from failure to counter adverse trends such as increased economic inequalities or market failures. 

The purpose of this report is to show what can be done, in a spirit of social justice, to take action on the social determinants of health to reduce these avoidable health inequalities. It is not enough for the Government simply to declare that austerity is over. Actions are needed in the social determinants to improve the lives people are able to lead and hence achieve a greater degree of health equity and better health and wellbeing for all. While our approach emphasises the social determinants of health, there is much that the NHS can do to address the social needs of patients. Similarly, Public Health England should be taking a lead not only in action on traditional public health concerns but on the causes of inequalities that we have highlighted in this report.

But efforts to reduce health inequalities will require more than the NHS and Public Health England. Experience shows that action, across the whole of society, will require the commitment of the Prime Minister and the whole of government. The justification for whole-of-government action is that it is the route to reduction of health inequalities. There are two further reasons for the whole of government to act. First, as we said at the outset, health and health inequalities are good measures of how well society is doing: how well it is creating the conditions for people to lead lives they have reason to value. Second, there will be other benefits from the actions we recommend here. Investment in improving early child development, and reducing exposure to adverse child experiences, will reduce antisocial behaviour and crime in addition to its beneficial effects on mental and physical health. Improving education will lead to more capable citizens as well as a more qualified workforce. Creating healthy environments will be good for meeting climate change targets. Reduction of poverty is a good thing in itself, quite apart from its beneficial effect on reducing health inequalities. A more equal, cohesive society is simply a better, healthier place to live.

Although we have had much to say on the increasing levels of poverty in England – in some areas of England more than one child in two is growing up in poverty – the social gradient in health must remain in focus. The gradient has become steeper. Action must be taken not only to improve living conditions for the worst off, but also for those who are relatively disadvantaged. The aim of all policies should be to level up, for everyone to enjoy the good health and wellbeing of those at the top of the social hierarchy – hence our reiteration of proportionate universalism: universalist policies with effort proportionate to need. We extend this to include investment – over the last decade government allocations of funding have declined most in poorer areas and this must be reversed. Funding should be allocated in a proportionate way – those areas that have lost the most and are more deprived must receive renewed investment first and at higher levels. 

We repeat: we neither desire nor can envisage a society without social and economic inequalities. But the public thinks that inequalities have gone too far, and evidence from across the world suggests that the level of health inequality we see in England, is unnecessary. We welcome action from local and regional governments to tackle social determinants of health. More action of the type we have described here will be necessary. It is not, though, a matter of action by either central government or local government: we need both and we need leadership. If we leave this for another 10 years, we risk losing a generation. 

Our main recommendation is to the Prime Minister – to initiate an ambitious and world-leading health inequalities strategy and lead a Cabinet-level cross-departmental committee charged with its development and implementation. We suggest that the new strategy is highly visible to the public and that clear targets are set.

As we write the final words of this report, the world is demanding urgent action on climate change. It is of grave concern that such actions to mitigate climate change should not lead to wider socioeconomic inequalities. We need to bring the agendas of climate change and of social determinants of health and health equity together.

In effect, this report is calling for a reordering of national priorities. Making wellbeing rather than straightforward economic performance the central goal of policy will create a better society with better health and greater health equity. [Owl’s emphasis]

At last Conservative MPs get it, but what about the planners and EDDC DMC? The building of tens of thousands of homes on flood-prone land is worsening the damage to surrounding areas, Conservative MPs have said, as the head of the Environment Agency warned against new developments on floodplains.

Lisa O’Carroll  www.theguardian.com

Tory backbenchers called on Boris Johnson to review the government’s housing policy over concerns that new homes were either not flood-proof or were exacerbating issues in neighbouring communities.

John Redwood, the MP for Wokingham, said building on land most at risk of flooding was “a very foolish thing to do and it’s obviously making the problem considerably worse”.

He said the risk to residents had been “greatly increased” by building on floodplains in his Berkshire constituency, and added: “I think [the government] should certainly review their planning policy and I think they should take the Environment Agency’s advice more seriously on appeal and regard it as a very important factor.”

Two severe flood warnings remained in place on Tuesday night, in Hereford and Ironbridge where homes were evacuated as the River Severn was expected to reach near-record levels. Residents were also evacuated in the town of Snaith, east Yorkshire, after the River Aire burst its banks.

There were 250 flood warnings and alerts in place across England, from Devon to Cumbria, with a further 10 in Wales following one of the wettest Februarys in 254 years of records.

The government has come under pressure over its aims to build 300,000 homes a year by the mid-2020s to help ease a chronic shortage across the UK. Local authorities say they are struggling to meet these demands because of a shortage of available land, leading to one in 10 of new homes in England being built on high-risk flood sites since 2013.

The Guardian revealed on Sunday that more than 11,000 homes were planned in areas the government considers a high flood risk in the seven English regions swamped by Storms Ciara and Dennis.

The government says its planning policy is clear that housing should be located in the areas least at risk of flooding and, when development in a risk area is absolutely necessary, “sufficient measures should be taken to make sure homes are safe, resilient and protected from flooding”.

However, a series of experts, MPs and local authorities have said that these new developments often increase the flood risk to surrounding areas because water that would be otherwise absorbed by the land instead runs off more quickly into rivers that then burst their banks.

The Tory MP Laurence Robertson said two huge housing developments were under construction in his Tewkesbury constituency, comprising 2,500 homes, and that one of them was currently under water.

“All of that [new housing] is just going to make [the flooding] so much worse,” he said. “I don’t think there’s been any adequate demonstration that they can contain the water in the new buildingwork. I’ve got other examples in my constituency where houses have been built, particularly on slightly elevated land, which throw the water downhill. They suffer [in surrounding areas] and that’s what I fear.”

Kieran Mullan, the newly elected Conservative MP for Crewe and Nantwich, said housebuilding on floodplains was “asking for trouble and I would need a lot of convincing to find that is ever justified”. He said a recently built housing estate had caused a road in his constituency to flood and that residents’ concerns about the dangers had been ignored. “It is no surprise concreting over fields can make localised water drainage worse,” he said.

Ahead of a speech in London on Tuesday, the head of the Environment Agency, Sir James Bevan, said properties should not be built on the floodplain “as far as possible” and that some developments should never have been approved.

Speaking on BBC Radio 4’s Today programme, Bevan also raised the possibility that some vulnerable communities on the coast and in river valleys may have to move to avoid repeated flooding.

He said those communities should not be “forced out” but that there needed to be a conversation about how they can be protected in the long term.

In a speech at the World Water-Tech Innovation summit in central London, Bevan said it was unrealistic to ban all housebuilding on floodplains given England’s geography.

However, he added: “The clue is in the name: floodplain. So we can and should insist that development only happens there if there is no real alternative, that any such development doesn’t increase other people’s flood risk … and that properties built on the floodplain are flood resilient, for example with the garages on the ground floor and the people higher up.”

Labour has called for an immediate end to building on land considered to be at high risk of flooding, which equates to 10% of land in England. Analysis by the Guardian found that more than 84,000 homes had been built in these high-risk flood zones between 2013 and 2018, with the annual total having doubled in that time.

The government also came under fire from the National Farmers’ Union, which blamed a “third world” approach to water management for the devastation.

The NFU president, Minette Batters, said the government had done “nothing” in the last eight years to act on its 2012 manifesto involving more reservoirs and a national plan to transport water elsewhere to the country to meet needs.

“Years of neglect has created an urgent problem,” she said, adding that farmers’ efforts with wood dams or the introduction of beavers to naturally manage water flow were part of the solution.

As Caroline Lucas calls for councils to be given powers to regulate Airbnb, Owl intends running a couple of posts on the subject. It is one many may regard as controversial but in Owl’s eyes looks to have the potential to wreak havoc, particularly in small communities. Although East Devon is not yet as badly affected as North Devon or the South Hams, Owl believes Airbnb has almost wiped out the traditional b&b . The crucial difference between the two is that the b&b owner lives on site and is a permanent member of the local community.

Helen Pidd  www.theguardian.com

Local councils in England must be given powers to regulate Airbnb and other short-term letting sites in order to alleviate the “intolerable” pressure they put on the availability of local housing, the Green party MP, Caroline Lucas, has said.

Her intervention followed a Guardian investigation that found one Airbnb listing for every four residential properties in some hotspots across Britain. Airbnb has disputed the finding.

Meanwhile, an organisation representing landlords has warned that imminent tax changes will drive an increasing number of landlords towards Airbnb and its rivals, depriving renters of long-term, stable tenancies.

Last month Lucas asked the government to make it easier for councils to impose a 90-day cap on homes let out on Airbnb and other online platforms. Airbnb says the vast majority of properties on the platform are already rented for less than 90 days a year.

She wants the UK government to follow Scotland’s lead. In January Holyrood announced new measures giving local authorities in Scotland powers to regulate short-term lets. This includes a licensing scheme with health and safety stipulations, which would also allow councils to address the concerns of local residents. A tax on short-term lets is also being considered.

“Brighton and Hove city council should be given the powers to regulate this industry, which is having such a serious impact on an already overstretched private rental sector and on more highly regulated hotels and B&Bs, which are being undercut. There needs to be a level playing field,” said Lucas.

“The pressure put on the availability of local housing by Airbnb in some areas of UK is intolerable. Local councils must be given powers to regulate this, so local housing needs are not squeezed out,” she tweeted on Friday.

Airbnb said the Guardian’s data was flawed and that some listings were for hotel rooms, single rooms in homes, and unusual properties such as caravans, meaning their rental did not affect housing stock.

Patrick Robinson, the company’s director of public policy, said: “Airbnb is a good partner to cities and we were the first platform to limit how often hosts in London can share their homes. We are also working with cities across the UK on proposals for a host registration system that we will proactively put to the government later this year to help ensure that rules work for everyone.”

But some critics of the company in hotspot areas say the saturation of their neighbourhoods is changing their way of life. Chris Hayes, a 55-year-old train driver who lives in the North Laine area of Brighton, said his life was being made a misery because five of the 29 cottages in his row were being advertised on Airbnb and similar sites.

“Residents have no way of stopping noise without confrontation. The owners are unknown or uncontactable, the ‘hosts’ do not have contact numbers for out-of-office hours, the council does not have noise abatement officers at night, the police treat it as very low priority,” he said, complaining of being woken by parties and the sound of suitcases being trundled along the alleyway in the middle of the night.

He added: “Airbnbs should be a planning change of use from residential. You need a change of use to convert a home to an office, hotel or shop. Why not to Airbnb?”

In 2018, up to 2,000 homes were being used as short-term holiday lets in Brighton, according to the council – a figure that is likely to have increased since. Between May 2019 and January 2020, the number of active UK listings on the website increased by 14% to 257,000.

The Residential Landlords Association (RLA) warned on Friday that renters were finding it harder to access long-term homes to rent because taxation changes are driving landlords to move into the holiday lettings market.

Last month, research from ARLA Propertymark found that nearly half a million UK properties could be left unavailable for longer-term rent as more landlords exit the market in favour of short-term lettings. Many landlords blame the government for restricting mortgage interest relief to the basic rate of income tax, claiming they will be significantly worse off or even unable to make a profit on their lettings.

The change does not apply to short-term lets, encouraging more landlords to move into that market, according to the RLA. Anyone buying a second home or buy-to-let property has also been hit with a 3% stamp duty surcharge since April 2016 under changes introduced by George Osborne as chancellor.

David Smith, the RLA’s policy director, said: “Government policy is actively encouraging the growth of holiday homes at the expense of long-term homes to rent, which many families need. This is completely counterproductive, making renting more expensive and undermining efforts to help tenants save for a house of their own.

“The chancellor must use his budget to give tenants a better deal by supporting good landlords to provide the homes to rent that they want to live in.”

Owl has received a communication from a clearly anguished “Friend of Shandford”. Here is a resume:

Abbeyfield gets lots of lovely press coverage even while doing the dirty (causing extreme distress) to residents, family, friends and most of all its 35 staff. As a ‘Friend of Shandford’ I have watched Abbeyfield and its antics, and all I can say is that no wonder they are in financial difficulties because they appear so incompetent. The excuses for closure have rained down on us all. 

We believe we can refute all of them for it seems that the C.Q.C is not good enough for the likes of Abbeyfield who now quote standards that don’t appear to exist. Then they even apparently challenged the fire survey completed in September 2019 in which Shandford came out with a glowing report on which NO, yes NO, black marks were issued.

No expenditure needed in the foreseeable future.  No more fire doors, evacuation procedure fully implemented and acceptable.

Yes, the new group of business people did consider the situation, but with Abbeyfield saying that over a £1million needed to be spent on infrastructure, almost certainly untrue, and then being told the new committee would have to be held liable for any losses, there was always going to be only one answer from them. 

There is probably never going to be a huge profit percentage here but with good management and no fees of £2,000 a week being handed over to Abbeyfield management  for which they have never appeared on site. 

 Why, when Abbeyfield have finally admitted it cannot benefit financially from the sale of Shandford, is it running headlong at great pace to remove the residents entirely, even to the employment of a new  (presumably very well paid, very short-term) ‘Project Manager’ ? 

 Many questionable actions appear to have been taken – Owl 

Owl recalls, when much younger, being given presentations by the special EDDC team of planners designing this new green town of Cranbrook. It included a wonderful town centre with all the latest mod cons. It wasn’t to be. All that money and effort wasted. Developers, we were told, knew best and should be allowed to design and build to their own vision. Look what has happened! 

Daniel Clark eastdevonnews.co.uk 

A special meeting over the future of Cranbrook will see a consortium of developers put forward their vision for its town centre. 

East Devon District Council’s (EDDC) Strategic Planning Committee this week agreed to the move to see if members can support the concept behind any proposals.

It was recently announced that plans for a new Morrisons supermarket and significant extra retail, commercial and residential spaces had been put forward by the Cranbrook Consortium.

The Cranberry Farm pub is so far the only building in the ‘town centre’ that has been constructed.

Proposals the consortium are putting forward may not conform to what was originally envisaged for the town centre and would be smaller than initially suggested, councillors were told.

Ed Freeman, service lead for planning strategy and development, said the authority therefore wished to produce its own ‘masterplan’ for the town centre.

This would be in the form of a Supplementary Planning Document (SPD) which could take up to six months to complete.

Councillor Kevin Blakey, portfolio holder for economy, urged the committee not to go down this route as it runs the risk of leaving the town centre empty for many years.

He added: “The Cranbrook Delivery Board has been in discussions with the Cranbrook Consortium with the object of coordinating delivery of the town centre.

“It has led to a plan which was prepared by the consortium and includes a major brand supermarket and commercial and public space, which is in excess of what is required by the Section 106 agreements and will deliver some of those well before the trigger points that they are legally due.

“The balance of the deal comes from release of extra land for housing development, but the belief is that the town centre does not need to be as big as initially envisaged and otherwise parts of it could be left undeveloped.

“We are on the brink of a deal but it is time limited. The anchor tenant [Morrisons] has six sites they are looking at, but only three will go forward, so they have the option to walk away from anything that is too difficult or lengthy.

“If the discussions collapse, they will move on and a viable town centre for Cranbrook will stall.

“The consortium wish to present full proposals for the committee to consider at the earliest possible date.

“Don’t go down the route of an SPD as it will result in a delay for sure, and runs the risk of leaving the centre of Cranbrook empty for many years to come.”

Cllr Sam Hawkins added: “If we keep taking our time, Cranbrook town centre will be the greenest in the country, because it will just be a field.”

Councillors unanimously agreed that a special meeting of the Strategic Planning Committee needed to be held as soon as possible.

This will enable the consortium’s proposals for the town centre to be assessed and members can decide whether they are strategically right for the town.

A formal planning application would still need to be submitted and approved for any ideas which are backed.

EDDC can still go down the route of preparing a SPD outlining how it would like to see the town centre developed.