Time was when utilities and healthcare were distinct sectors. Now the lines between the two are less clear, as elements of social policy – including people’s health and wellbeing – are increasingly becoming the responsibility of utilities.
“There is a move from government to put responsibility for some aspects of social policy on utilities, with funding coming from consumers rather than through taxation,” says Jonathan Stearn of Consumer Focus, who is responsible for policies on disadvantaged consumers. Recent examples of such policies include social tariffs, which are to be designed and administered by water companies (see feature, page 22) and the new Energy Company Obligation, the latest version of energy supplier-delivered fuel poverty and energy efficiency relief (see features, pages 18 and 20).
Meanwhile, changes to healthcare provision mean health is facing some of the challenges utilities have dealt with for years. The 2012 Health and Social Care Act makes GPs responsible for healthcare budgets and commissioning services. Funding issues in healthcare will increasingly force doctors to look at commissioning the most cost-effective services, such as those offered by private providers, and to ensure services operate more efficiently – much as utilities have to do.
There is also a growing recognition that utilities play an essential role in supporting people’s health and wellbeing. In 2010, the Marmot Review report Fair Society, Healthy Lives highlighted the damage to health caused by living in cold conditions. Respiratory illnesses, an increased incidence of older people injuring themselves through falls, and depression are all associated with living in a cold home, the report found.
Health and wellbeing boards, which come into force next year, could also result in the health sector having closer links with utility companies. These boards will be a forum for key leaders from the health and care system to work together to improve the wellbeing of the local population and reduce health inequalities.
Mervyn Kohler, special adviser at Age UK, says: “Health and wellbeing boards will be seeking to work with others who can help them to tackle fuel poverty. We hope they will actively engage with energy companies to do this.”
Energy companies already have a range of schemes in place to help those in particular need. “The industry is spending around £275 million this year to help two million households, and it spent over £250 million last year,” says Christine McGourty, director of communications at Energy UK.
From 2009 to 2010, British Gas was involved in a pilot scheme, in partnership with local authorities and a Primary Care Trust in Greater Manchester, to target individuals who were potentially vulnerable to fuel poverty. During a GP consultation, those patients were flagged up on their practitioners’ computers. This prompted doctors to ask patients if they needed help or support to keep their homes warm, and if they consented, a referral was made to their energy supplier, explains Angela Mawle, chief executive of the former UK Public Health Association, who led the scheme.
Mawle says the Health Housing and Fuel Poverty Forum is now leading negotiations with one of the big six energy suppliers to create a unique partnership with local authority and NHS Commissioning Groups, which will extend and expand this GP referral system in the North West.
The water sector also embraces initiatives designed to support the health of its customers, because “first and foremost we are a public health industry”, says Rob Wesley, policy adviser for Water UK. Ten years ago Water UK established the Water for Health Alliance. Working closely with government health authorities to influence policy, this initiative has highlighted the benefits of staying hydrated, specifically within the healthcare sector, through working with hospitals and care homes.
Stearn believes there is enormous potential for healthcare organisations and utilities to work more closely together for the benefit of everyone. “Creating links between health services and utilities would be immensely beneficial to those in vulnerable positions,” he says. For example, GPs could raise awareness among patients about how living in a cold home can affect their health, and the importance of seeking support from their energy supplier if they are living under such conditions. But he cautions: “But we need to be aware of the limited time GPs have to spend with patients.”
While forging closer links between the two sectors has its benefits, there are also potential problems. Some fear utilities are increasingly being relied upon to decide social policy. “It is not appropriate for utilities to make decisions on social policy – this is the government’s role,” says Stearn.
Kohler is concerned that to meet their social obligations, energy companies will be forced to pass costs on to the consumer – including those most vulnerable to fuel poverty and least able to pay.
While Wesley says the water sector is “happy to meet its social obligations”, he believes it needs a “helping hand” from government to tackle debt levels. He says the 2010 Flood and Water Management Act was supposed to help the sector deal with bad debt, but that as yet “nothing has happened to address this, and the situation is getting worse”.
Exactly how utilities and healthcare will work more closely together in the future is unclear. According to Kohler: “It’s a work in progress. We have yet to see how health and wellbeing boards intend to discharge their new responsibilities, and how in practical terms the Green Deal – the main instrument to tackle fuel poverty – will be allied to these boards.”
But he believes the possibilities of what could be achieved for consumers are immense: “There is tremendous scope for greater co-operation and collaboration between the two sectors. For the present it’s all ‘hopes and opportunities’ but we hope – and are working hard – to ensure these aspirations will begin to bear fruit for the benefit of communities.”
Kathy Oxtoby is a freelance journalist
This article first appeared in Utility Week’s print edition of 25 May 2012.
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