Decent homes, good work, and access to advice

Three ways the 2025 spending review can directly address health inequalities

Joel Llewellyn, Policy and Evaluation Manager and Catherine Rennie, Communications and Public Affairs Manager discuss the Trust’s recent response to the Treasury’s spending review.

In December, HM Treasury launched Phase 2 of the Spending Review, which will deliver the government’s Plan for Change. We were invited to submit feedback on government spending priorities and suggest policy ideas to inform policy decisions and resource allocation.

As a health equity charity working with local communities experiencing the greatest marginalisation and disadvantage to address health inequalities, our response focused on priorities falling under the government’s health mission, to prevent illness and early death, and to halve the gap in healthy life expectancy. This is crucial to the Department of Health and Social Care (DHSC) strategic goals.

We presented 12 mission-aligned recommendations alongside strong cases for investment. In this blog, we focus on three areas that are crucial to addressing health inequalities: Decent homes, good work, and access to advice

Our submission was rooted in data, experiences and testimonies of our nationwide network of grassroots community organisations we support, drawing on our Community Manifesto for Health Justice. These expert organisations are anchored in neighbourhoods and with communities facing the sharpest levels of disadvantage.

Decent Homes

Tackling poor housing conditions is critical to the government’s missions on health, the environment and economic growth. Urgent investment is needed to prevent avoidable deaths, reduce NHS strain, and contribute towards the Government’s goal to improve healthy life expectancy and reduce the gap in health between the country’s richest and poorest. Unequal access to secure and good quality homes in the rented sector means that, for many people, poor housing conditions are currently unavoidable and a direct cause of short and long-term health issues.

Improving housing conditions would save the Government significant investment over the long term. Highly regarded studies have suggested that poor housing is estimated to cost the NHS an estimated £1.4bn per year. A 2023 study found that improving the quality of homes could add 105,000 healthy life years per year, generate £5.9 billion in health and wellbeing benefits per year, and save the NHS £858 million annually through prevention.

We welcome the Renters’ Rights Bill and, if properly resourced, believe it has the potential to significantly improve the health of renters. Crucial to its success is the enforcement of the decent homes standards that are due to be applied to the private rented sector for the first time.

Local councils are key to enforcement, and they need the resources to enforce properly including resources to do proactive inspections of rented properties. Central government must ensure that landlords are meeting legal obligations through well-resourced enforcement locally, and that there is national coordination to ensure that there is consistency across the country.

People’s Health Trust calls on HM Treasury to invest in MHCLG and local government budgets to ensure that they can deliver on their commitment to improve housing conditions in the private rented sector. We recommend that local authorities receive ring-fenced funding for enforcement of standards based upon the number of private rented sector dwellings registered within their boundaries, in order to reflect their relative enforcement burdens and be able to maintain standards for private renters.

As members of the Safe Homes Now campaign, we also call for a cross-government housing and health strategy to tackle poor quality housing across all tenures, and a commitment to halve the number of non-decent homes over the next decade.

Good work

The grassroots organisations we work with have been clear that one of their primary concerns for people living in disadvantaged neighbourhoods is the lack of opportunities to find good work. These barriers are especially steep for young people with no or few qualifications at 16 or 18, and those not in any form of education, employment or training.

As the Chancellor said in her Spring Statement this week, one in eight young people are now not in employment, education or training, almost 1 million young people. And 677,564 young people aged 18 to 24 are not achieving Level 2 qualifications such as GSCE’s 4 or above, or NVQ level 2. This has profound implications for their careers, their earning potential and ultimately their health. Young people now have the poorest mental health of any age group in the UK, with one in three people aged 18-24 reporting symptoms of common mental disorders.

People’s Health Trust welcomes Government’s development of Skills England and renewed focus on getting apprenticeships right and making sure they both work for people and align with national and more local industrial priorities. The £240 million investment to tackle the root causes of unemployment and inactivity, announced in the Get Britain Working white paper, centres the role of ill health in economic inactivity as well as needs-based and place-based solutions, and is an approach we also strongly support.

We welcome the Individual Placement Support (IPS) pilots NHS England have invested in to support people with Severe Mental Illness to find employment. We have recently launched a partnership with the National Institute for Health Research’s School for Public Health Research (NIHR-SPHR), a world-leading research school funded by NHS England. We have launched a new fund – Good Work for Young People’s Mental Health – to test the IPS approach for young people with mild to moderate acute mental health problems and who are not in education, employment or training.

Access to advice

Having access to timely, free and independent advice when it is most needed is critical, and getting support can reduce anxiety and longer-term stress and improve health. For people experiencing marginalisation, discrimination, and disadvantage who are disproportionately impacted by the cost of living crisis, the need for advice services on matters such as housing, finance, debt or asylum is even greater. Yet too many people who need advice services the most are unable to access them because they are too overwhelmed by the pressures and inequalities they face in their day to day lives.

Research from the Access to Justice Foundation shows that for every £1 invested in free specialist legal advice, the government saves £2.71, potentially saving the Treasury up to £4 billion annually by avoiding expensive interventions such as court proceedings or emergency housing services.

In October 2024, we began funding five projects in the Midlands and Southern England through our Advice for Health programme, focussed supporting people experiencing marginalisation and disadvantage to feel less overwhelmed and to access advice, and to work with advice services to tailor their offer and outreach to better serve this group of people.

People’s Health Trust calls on Treasury to ensure that the advice sector is resourced and incentivised to ensure access for people who need to access advice services but are too overwhelmed to do so. We also agree with Advice UK’s recommendation to develop a cross-departmental advice sector strategy, modelled on the Welsh Government’s Information and Advice Action Plan, to integrate social welfare advice across health, housing, justice and social care sectors, ensuring accessible advice throughout the UK

We await the government’s Spending Review in June, and will summarise the implications of the announcements in a further blog once details are announced. Follow us on LinkedIn or BlueSky for the latest updates across our Health Justice Fund priorities and policy work.