Mind the Health Gap is a year-long project between Greater Govanhill and The Ferret, a Scotland-wide investigations media co-op. Working together with community members in Govanhill, we will report on responses that address the health inequalities that exist on a local level. In the first of the series, Karin Goodwin met with energy advisors from South Seeds.

By Karin Goodwin | Photos by Eoin Carey

It’s 11am and before starting his long restaurant shift, Ioan has a couple of hours to play with his three-year-old son, whose current loves are his toy cars and spiderman.

Since Ianis was just a couple of months old he has had asthma to an extent that has seen him hospitalised. Ioan knew what was wrong right away. “It happened to me too when I was a child,” he explains.

He and his wife struggled to get medical professionals to take them seriously. They resorted to returning to their home country of Romania and paying for a private doctor, whose diagnosis was finally accepted back in Glasgow.

Meanwhile they did what they could to keep the symptoms at bay. “One important thing was to make sure the house is not damp because that makes things much worse,” Ioan says.

But the 22-year-old father – who had previously lived in a flat with a prepaid meter – hadn’t understood that because he was not providing his energy company with readings, his bills were under-estimated. Earlier this year, it emerged the family owed £2,200 – an impossible sum to pay on their household income.

Friends put him in touch with South Seeds – a Govanhill community organisation which provides an energy advice service, where advisor Agnes Berner sourced grants to cut the debt in half and helped him set up an affordable payment plan. “It was such a big relief,” he says.

Rising energy bills have been the story of 2022. The monthly increases in both gas and electricity prices in April 2022 alone were by far the largest ever recorded since 1988, and have shot up again in recent months. Meanwhile the profits of many energy companies are eye-watering. Last month Shell announced third quarter profits of over eight billion pounds.

Estimates on how stark the impact will be vary, but some claim they will push up to two-thirds of UK households into fuel poverty by January 2023. That’s despite the help of the UK Government’s Energy Price Guarantee – which means unit prices will be capped until April 2023 – and an additional £400 through the energy bills support scheme.

What’s less widely reported, is the devastating impact that cold homes will have on the health of communities up and down Scotland.

According to a report by the Institute of Health Equity, homes that are cold due to increasing fuel poverty are about to turbo-charge health inequalities. That means people who can’t afford gas and electricity are statistically more likely to suffer from health conditions – or even die younger – than those who can.

Living in a cold home – more likely to be damp and mouldy – can cause and worsen respiratory conditions, cardiovascular diseases, poor mental health, dementia, hypothermia and problems with childhood development, they explain.

Luckily in a neighbourhood like Govanhill there are support agencies determined to cushion people wherever possible.

South Seeds, with its bright and welcoming green shop front at the top of Victoria Road, can’t offer the structural changes they say are so urgently needed.

But it is fighting back regardless. What it can offer – including providing empowering energy advice, sourcing financial support and advocating for people when things go wrong – is help keeping people warm, or getting them reconnected.

There are Scotland-wide phone based advice services, but this type of face-to-face service is certainly not available everywhere. And it’s getting results.

Over the last year, their clients have benefited to the tune of £118,441 in emergency vouchers, supplier refunds, good will payments and hardship funding with a further £16,050 provided in the form of warm home discounts.

They’ve conducted 2,056 appointments in the time period, helping people across G42 and G41 postcodes.

This year looks set to be even busier.

“We’re now seeing people whose fuel bills are as high as their benefits,” says Poppy Ives, who works alongside Agnes in the bustling office.

Already this morning the team have been busy applying for fuel vouchers – some provided by charities and others by energy companies themselves – for people who simply can’t afford to top-up. Some of these appointments have been squeezed into an already bulging diary. There’s a month-long wait for non-urgent cases.

Next on the team’s schedule is a home visit to a family with a prepayment meter that’s constantly out of credit.

In Govanhill homes, 27 percent of residents have prepayment meters, according to the most recently available data. The Scottish average is just 16 percent but that rises as high as 69 percent in some deprived neighbourhoods. The most affluent have none.

Poppy is increasingly aware of warrants being granted to fit prepayment meters where people have run up debts. Comparison website Uswitch claims 60,000 new meters were installed across the UK in the six months to March.

But meters also cost customers more. By September, Citizens Advice UK had seen 18,000 people unable to top-up their prepayment metres. This family is far from alone.

Once inside their tenement flat, Agnes takes a look at the meter and finds that from a £5 top-up, £1.60 went to paying back the emergency credit and £1.90 to a previous debt.

It leaves just over £1 of credit after the standing charge is deducted.

Poppy explains: “They owe £500 and so every week money from the top-up goes towards the debt.” She can apply for hardship money on their behalf to ensure they can stay on supply, she says, offering another appointment.

Before we go, a woman living there shows me a bag of medicines she takes – antibiotics, painkillers and anti-inflammatories. She mimes a shiver and runs her hand over the cold radiator. “This is not good,” she says.

Concerns about heating and health come up repeatedly amongst South Seeds clients. James has osteoarthritis in his knees and hips, angina and such severe depression he’s tried to take his own life twice. He’s back on medication now and doing much better.

The worry about fuel bills is not helping. “It’s really bad for my mental health because to save myself getting really cold I end up going to my bed at 4 or 5pm,” he explains.

South Seeds have helped him apply for a warmer homes discount. “They took all my details and they’ve told me I’d been awarded £320 by the energy company. So with that money I’d be able to start turning those on for at least a couple of hours.” It’s a simple fix but life-changing for him.

Nearby lives Bob Nelson, a wheelchair user whose electricity use is high. He has arthritis and has suffered multiple heart attacks, mini-strokes and survived cancer three times.

His energy bills are paid by Fuel Direct – in which a payment goes directly from his benefits to the provider – but had not increased for years leading to debt of £1,200.

Poppy finally managed to track down Fuel Direct customer service and agreed a rate that should make Robert’s situation easier to manage. Meanwhile he’s been forced to use food banks just to get by.

South Seeds know they are making a difference by “meeting people where they are” and “offering a personalised service”, explains manager, Lucy Gillie. This even extends to walking clients to other recommended services to help them find extra support.

“I think there is an efficiency achieved with a face-to-face service which internet and phone services fail to deliver,” she adds. “Staff are less likely to make assumptions or judgements when people present their energy problems face-to-face. And clients value their problems being solved, so they listen carefully to the energy efficiency advice given.”

But there is also frustration that the energy companies are not more proactive – and that Ofgem is not more able to hold their feet to the fire. “It’s often very difficult to get an energy company call handler to even open a complaint,” Agnes says.

In July, Ofgem, the energy regulator, demanded improvements from five energy suppliers on issues such as debt, staff training, and direct debit increases. Poppy has seen improvement in those areas: “It shows that Ofgem’s actions can be effective. But unfortunately, it seems like they are struggling to fully assess all the complex problems customers experience when communicating with their energy suppliers.”

An Ofgem spokesperson said its “priority is to protect consumers” and claimed suppliers must be “proactively making contact to identify if a customer is in payment difficulty, assessing repayments on a customer’s ability to pay and ensuring debt management activities are done in a fair and reasonable way”.

“We closely monitor compliance of this and we have taken robust enforcement action as a result of the failings we have found,” they added.

But that’s far from the only issue, according to the South Seeds team, who want to see other structural changes including funding the retrofit of homes, investing in public spaces and making sure people are properly paid.

The Institute of Health Equity report also flags that long-term change is needed. More immediate recommendations include local health providers better recognising the impact of cold homes and working with agencies like South Seeds.

Report co-author Tammy Boyle acknowledges the scale of the challenge can be difficult to comprehend. “I truly think we are moving into uncharted territory,” she says. “We can’t quantify the impact on health inequality but it will have a huge impact.”

But she believes there are steps we can take: “Every year there are millions of pounds in unclaimed benefits so we need to make sure people apply for everything they are due.” She says that local councils should also allocate emergency repair budgeting to warmer homes programmes, fixing boilers, broken windows and holes in the walls, and that health services should work more closely with third sector partners.

Back at Ioan’s house, playtime with his son is over. But his problems with gas and electricity bills are not. He was paying £40 a week a few months ago – now that’s at £80, just under half of the £170 he earns in the restaurant. He’s looking for another job. ”That’s really hard too,” he says.

South Seeds is applying for a hardship grant, which they hope will help the family through the winter. But as prices continue to rise, the future still feels uncertain.

This project was funded by the European Journalism Centre, through the Solutions Journalism Accelerator. This fund is supported by the Bill & Melinda Gates Foundation.