David Ormandy, Richard Moore and Stephen Battersby argue that the proposed house health and safety rating system should be seen as a welcome aid to the profession, and not as a threat

This article, on the health and safety rating system, is in response to "If it ain't broke, don't fix it", written by Norman Parkinson and Robyn Fairman in the Environmental Health Journal (EHJ, October, page 330). It aims to promote constructive debate and, as we submit that most of the assumptions on which the authors based their arguments in that article are incorrect, to avoid the propagation of misconceptions by providing some corrections, clarifications and comments.

It is hard to see what prompted the authors to write their article at this late stage and why the issues discussed were not raised during the consultation period - particularly as one of the authors was interviewed during the research which informed that process?(1) It seems that Mr Parkinson and Ms Fairman have tried to air-brush away seven years of debate, consultation and information on the current standard and options for reform.

development of the fitness standard
The brief review of the current standard given by Mr Parkinson and Ms Fairman is misleading. This standard is based on principles first proposed in 1919, eventually introduced into general legislation in 1954 and consolidated in the 1957 Housing Act.(2,3,4) Minor amendments were made in 1969 which were incorporated in the 1985 Housing Act as s604.5 Based on sanitary principles, the standard may have been appropriate in 1919, but it was not relevant to the housing conditions, tenure patterns and social expectations of the 1980s. It did not even meet the recommendations of the Mitchell Report of 1946 as it failed to include requirements for hot water, personal washing facilities, artificial lighting or heating.(6)

review of the current standard
It was not until 1990 that the standard appeared in its current form.(7) Even when first introduced, it was criticised as inadequate by local authorities, professional and special interest bodies and by individuals. Following the demand for change, no fewer than two private members' Fitness Standard Amendment Bills, both sponsored by the CIEH were introduced into parliament during the mid-1990s. The previous government responded by initiating a review of both the standard and the associated enforcement regime.

Two arms of the review confirmed much of the criticisms.(8) Several matters were not covered, leaving local authorities powerless to deal with the most serious threats to health and safety in housing. Mr Parkinson and Ms Fairman suggest that this can be overcome by relatively minor changes to the legislation and guidance (something Mr Parkinson has been proposing since 1985).(9) However, this demonstrates a lack of appreciation for the practicalities and the legal and political environment in which local authorities exist. Any standard which imposes duties on authorities to intervene and enforce compliance must be reasonable, realistic and capable of application. Adding in the additional requirements would more than double the number of dwellings failing the standard, necessitating additional trained personnel and financial resources. This option was considered and, after reviewing the results of the consultation process, discounted.(10)

Another criticism of the current standard is that it fails to differentiate between the marginally unfit and the grossly dangerous. Mr Parkinson and Ms Fairman do not see this as a valid point, but state that if it is an issue it could be overcome by qualitative risk assessment based on professional judgement. This fails to recognise two problems. A flaw with any minimum standard which draws a pass/fail line is that it tends to become a maximum; it sets down just what is to be met to avoid intervention. This is the case with the fitness standard. There is no in-built incentive to progressively improve conditions.

Used in isolation, qualitative risk assessment based on professional judgement is, superficially, a good idea. It is something which has been adopted by many authorities attempting to cope with the numbers of unfit dwellings requiring intervention and with the numbers of grant applications. Unfortunately, these approaches are arbitrary and lack consistency between individuals and authorities. What would overcome both these problems is an orthodox system which enables professionals to grade the conditions.

it is broke
In short, there is compelling evidence that the current standard, both in its content and approach, is broken. After a major review, which canvassed opinion and sought suggestions, the concept of a rating approach to the assessment of housing conditions was proposed. The response to the consultation paper showed overwhelming support (93 per cent of respondents) for this proposal. The Government is fixing the current standard and, to its credit, it is fixing it not by further tinkering with an outmoded 19th century based sanitary standard, but by introducing a new system capable of meeting the needs of housing intervention in the 21st century.

the HHSRS
The Housing Health and Safety Rating System (HHSRS) is not a standard, it is an approach to the assessment of housing. It has been devised to use informed professional judgement to grade conditions in a consistent way which will provide a sound and understandable basis for decisions.

We believe that Mr Parkinson and Ms Fairman are mistaken in thinking that the current standard is broader that the HHSRS. While comfort, convenience, efficiency and privacy are important to occupiers and factors for any target standard for improvement, these are not covered adequately by the current standard. (Interestingly, at least two of these are issues that, in 1992, Mr Parkinson thought needed to be added to the current standard).(11) The system is not based solely on hazards, but starts with the collection of information on any building-related faults whether inherent or a result of deterioration. Once the whole of the dwelling has been surveyed, any hazards resulting from the identified faults are assessed.

Although Mr Parkinson and Ms Fairman note that the DoE has recognised that removing personal judgement from the assessment of housing conditions is unattainable, they then go on to allege, with no supporting evidence, that the DETR intended to make the standard more "objective", but failed.(12) They are right that professional and technical judgement is needed throughout the process, this has been the fundamental core of the whole system since its conception. Neither the DETR nor the developers intended otherwise.

The authors also perpetuate the misconception that the system relies on computers and that it measures and prioritises the risks presented in housing. As well as devising a workable rating system, both a paper-based and computer-based survey procedure was developed. In both survey procedures it is professional judgements which are recorded. This recognises that, as now, if a judgement is to be challenged then it is the professional who will be required to substantiate it, not the notebook, or the form, or the computer. It is a system which, using professional judgement, allows conditions to be compared against various benchmarks, including the ideal.

Using the computer survey programme has benefits. Like a schedule, it encourages the recording of information in a consistent and standardised format. It also provides information which can be called up on site, including summaries of the guidance on each individual hazard.

rating hazards and the forumla
To rate hazards two factors are assessed. First, the likelihood of an occurrence (an event or period of exposure), and second, the most likely and the other possible health outcomes or harm which may result. This is analogous to breaking down into logical and explainable steps the judgement of whether conditions are prejudicial to health or make a dwelling not reasonably suitable for occupation.

Mr Parkinson and Ms Fairman allege that there is a dearth of evidence to support the system and again this is misleading. For example, the BRE have published reports reviewing the extensive research on effects of building conditions on health and safety and are continually updating these; the DTI annually publish information on the health effects of home accidents; and the DETR publish the findings from the English House Conditions Surveys.(13,14,15) There is also work on Classes of Harm which provides a means of categorising the possible health outcomes.(16)

Based on this and other available information, it was possible to create a formula to generate a single score for each hazard. This formula was devised specifically for housing hazards by the Healthy Building Centre at BRE and designed to produce a result which can be related to an equivalent annual risk of death. (It is not, as mistakenly assumed by the authors, based on work by the HSE.)

While the DETR is providing sufficient evidence-based guidance for authorities to increasingly achieve consistent ratings during the roll out of the system, further evidence and guidance to inform professional judgements will be provided prior to legislation. One of the merits of the HHSRS is that it provides a clear focus for further research on the relationship between housing conditions and health and safety risks.

the system and the standard
As stated above, the HHSRS is a system, or an approach. To create a standard a threshold has to be drawn which triggers a power, a duty or a liability. Such a threshold is built into the current fitness standard - a dwelling is unfit if it fails one or more requirement and by that failure is not reasonably suitable for occupation.

As the aim has been to replace the current outdated and inadequate standard with one which is progressive and comprehensive, a threshold has to be set. Such a threshold could be used to prompt the next stage in any enforcement or grant regime. Other thresholds could also be set, suggesting targets to be achieved on renovation or enforcement.

As a hazard score generated can be compared with an equivalent annual risk of death, information was sought on what has been found to be perceived as acceptable and unacceptable. Although this is a complex area, there is guidance which suggests that hazard scores of 1,000 or more could be said to be unacceptable, and those of 100 or less acceptable. Whether these two thresholds will be adopted is yet to be decided, a decision which is likely to be influenced by the responses to further consultation.

There have been suggestions that the system and any threshold will be used to lower standards. However, in that any threshold on the rating scale is a meaningful measure, representing a specific level of risk, it will be more difficult for either central or local government to lower standards unacceptably than with the current legislation. With the latter, subject to being challenged in the courts, it is quite possible for EHOs to hide behind the curtain of professional judgement to validate their policy or resource requirements.

The HHSRS is built on evidence of the potential harm that can be caused by housing conditions. The underlying principle is that a dwelling should provide a safe and healthy environment for its occupants. As this is a basic tenet of environmental health and as it relies on expert judgements, it should be welcomed by EHOs and not seen as a threat.

References
1. See LRI (1998) Controlling Minimum Standards in Existing Housing.
2. Ministry of Health (1919) Manual on Unfit Houses and Unhealthy Areas.
3. Housing Repairs and Rents Act 1954, s9.
4. At s4.
5. Housing Act 1969, s71.
6. Ministry of Health (1946) Report of the Standards of Fitness for Human Habitation Sub-Committee of the Central Housing Advisory Committee.
7. By the Local Government and Housing Act 1989, Sched 9, para 83.
8. DoE (1993) Monitoring the New Housing Fitness Standard, and CRC (1995a) Building regulation and health and CRC (1995b) Building regulation and safety.
9. Parkinson (1985) "Still not a fit standard", Housing Review, Vol 34, No.6, pp 190-191; and Parkinson (1897) "Towards a new standard of fitness", Housing Review, Vol 36, No.1, pp 25-28.
10. See Controlling Minimum Standards in Existing Housing op cit.
11. During the interview as part of LRI (1998) op cit.
12. DoE (1993) op cit.
13. CRC (1995a) and (1995b) op cit.
14. See Dti (1998) Annual Report on the Home Accident Surveillance System.
15. DoE (1998) English House Condition Survey 1996.
(16) CRC (forthcoming) "A risk assessment procedure for health and safety in buildings."