171.The rapid development of the coastline by the Victorians and Edwardians was characterised by the creation of attractive public spaces, distinctive architecture and thoughtfully designed promenades, piers and entertainment facilities. This was, in part, fuelled by a belief that seaside living promoted good health and a sense of wellbeing. The reality for many seaside towns now is very different, as many have been left with significant areas of poor-quality housing stock, often the result of converted former tourist accommodation and dilapidated public spaces. This, and other social and economic issues affecting coastal communities, mean that seaside towns have some of the worst health outcomes in the country.
172.This chapter will look at the physical environment and wellbeing in seaside towns. It will examine issues around housing and examine some of the factors behind the poor health outcomes reported by many coastal areas. It will also consider how well coastal areas are supported to tackle the threat from coastal erosion and flooding.
173.Issues relating to housing emerged as one of the most prominent concerns voiced by coastal towns. We recognise that many of the issues reported are not unique to seaside towns. There were, however, a number of factors identified which have led coastal towns to suffer disproportionately from high levels of poor-quality housing, and from the associated challenges this poses for those communities.
174.A key theme to emerge was the impact of a proliferation of Houses in Multiple Occupation (HMOs) that many areas told us underpinned and exacerbated a number of the social and economic challenges that they faced.
175.Since April 2006, all HMOs had been required to be licensed by their local authority and to meet minimum physical standards, with the onus being on the landlord to apply for a license. The definition of a mandatory licensable HMO has remained unchanged since the provisions came into force. However, after 1 October 2018, the scope of mandatory licensable HMOs was extended, and smaller HMOs were brought within the scheme. Under the Licensing of Houses in Multiple Occupation (Prescribed Description) (England) Order 2018, HMOs are defined as being occupied by five or more persons, from two or more separate households.
176.Well managed multi-occupancy houses can play an important role in local housing provision. In many areas across the country, however, HMOs are associated with poor quality housing and poor tenant management. High concentrations of HMOs have also been related to increased anti-social behaviour, poor social cohesion and increased pressure on local services. These issues have prompted successive governments to introduce measures to regulate HMO properties, including through mandatory licensing, which requires HMOs to be licensed and to meet nationally prescribed standards on room size before they can be let to tenants.
177.Although the challenges associated with poorly-managed HMO properties are not unique to seaside towns, we have concluded that these issues are particularly persistent in coastal areas, and it is clear that coastal towns suffer disproportionately from high levels of poor-quality housing. What makes the issue particularly marked for seaside towns is that HMOs often occupy a high percentage of the local housing stock, and are, as recognised by MHCLG “prevalent in many coastal towns.” This trend is linked to the decline in tourism, which left many seaside towns with a legacy of redundant tourist accommodation, including former hotels and bed and breakfast properties. Many of these properties were then converted to cater for the private rental market, leading to a “dramatic growth” in the number of HMOs in seaside towns. Seaside towns are, therefore, often labouring under the dual impact of a declining local economy, and the economic and social issues relating to poor quality housing.
178.Problems caused by the prevalence of HMO properties, we were told, were amongst the most urgent challenges for coastal areas. The evidence suggested that the oversupply of poor-quality HMOs was contributing to some of the most significant and persistent socio-economic disadvantages that seaside towns faced. Blackpool Council, for example, listed “the disproportionate number of poor-quality Houses in Multiple Occupation, converted from failed holiday accommodation” as one of its core challenges, a challenge which it also emphasised “had not changed since the 2006-07 House of Commons Select Committee inquiry into coastal towns.”
179.The evidence on HMOs centred around the following concerns: that HMOs are associated with population transience; that HMOs can impact adversely on the quality of local housing stock and on local housing market values; and that local authorities lack the powers and resources to tackle the problems related to this type of housing effectively.
180.The abundance of low-quality housing stock in many coastal towns was linked to two key problems for seaside towns. First, that there is a link between HMOs and a transient and vulnerable population, which can place additional pressure on local services, and can impact negatively on community stability and cohesion. Second, that concentrations of sub-standard housing stock, that is often dilapidated, unsafe or even abandoned, acts as a blight on the locality, making these areas unattractive for redevelopment and frustrates efforts to complete wholesale regeneration in coastal towns.
181.Professor Darren Smith from the University of Loughborough confirmed that population transience was a recognised feature of coastal areas, telling us that: “What you tend to see is an increasing number of populations moving into seaside towns temporarily. They are not putting down roots or establishing or forging attachment, belonging or buy-in to the areas.” A number of coastal communities reported high levels of population transience within their localities. Dorset County Council told us that:
“Seaside communities such as Weymouth, Portland and Boscombe have very high levels of Transient Renters living in low cost housing. In Weymouth there are three times the proportion of transient renters than in the County as a whole.”
182.Similarly, Blackpool Council provided data on the levels of transience in their area and demonstrated the impact it can have on composition of the community:
“Analysis of Blackpool Housing Benefit data from 2013/14 showed that there were 4,845 successful claims from new households who had last lived outside of the borough, compared with a total resident population of 64,000 households, and a clear majority of the 8000 residents ONS estimate to come to Blackpool each year. Of these new claimants, 2/3rds moved to addresses in inner Blackpool. An analysis of these claimants’ household characteristics shows that 44% were single males, 18% were single females, and 17% were one parent families, skewing the demographics of the community and leading to households with fewer community ties or local connections.”
183.A key concern amongst the areas reporting high levels of transience was that these populations often contained a proportion of vulnerable individuals, with a range of physical and mental health concerns. Scarborough Borough Council suggested that local services were struggling to meet the needs of the population inhabiting HMO accommodation stating that:
“One of the major impacts is on local services in both the public and voluntary / community sector who are left to address the problems caused. Services across both sectors, with limited resources and budget cuts over recent years, have been stretched and struggle to address the problems in meaningful ways. One example is the reduction in Supporting People budgets and cuts to Adult and Social Care, which means that the wider support for tackling complex and challenging problems (mental health issues, drug and alcohol issues) is substantially affected.”
184.Scarborough Borough Council suggested that the prevalence and impact of population transience, in and out of coastal areas, has not been well recognised, meaning that there was insufficient support available for coastal communities to manage the effects on individual communities. The Council asserted that: “Our issues and problems are on a similar scale to those of highly deprived inner-city areas. As a result, the level of support required to address such problems needs to be on a similar scale to that provided in such areas.”
185.It was suggested that the movement into seaside towns of vulnerable people was often the result of neighbouring local authorities moving people out of their areas, towards cheaper housing along the coast. Ramsgate Coastal Community Team, for example, stated that population transience in the area was “largely the result of London boroughs relocating applicants for social housing away from support networks.” The Coastal Communities Alliance outlined the impact that this practice has and suggested that local authorities lacked the resources to manage the pressures that population transience may cause:
“Compounding the effects of coastal deprivation is the local authority funding formula that does not cover the costs generated by transient populations, looked-after children, mental health issues, homelessness, housing benefit dependence and worklessness. Overstretched service budgets can undermine efforts and the resources available for community engagement, developing attractions, stimulating business growth and engaging in the costly uncertainty of inward investment promotion.”
186.We found that, too often, population transience involving the movement of vulnerable adults and children, was referred to in terms of the problems it caused, rather than with reference to how individuals might be better supported and enabled to fulfil their potential. Any action taken to address the impact of population transience on seaside towns must include ensuring that vulnerable adults and children receive the right support to meet their needs. It is important that support networks in their previous locale are, at least to some extent, maintained.
187.A sustained, long-term effort is required to address the impact of transience on coastal areas. We recommend that the Department for Work and Pensions works with MHCLG to assess the scale and impact of population transience in and out of coastal areas, and examine the extent to which this is a result of non-coastal local authorities placing vulnerable adults and children into these areas. Such an assessment should be cross-referenced with the Government’s updated research into the challenges facing coastal communities, including the disproportionately high levels of people claiming sickness and disability benefits in coastal towns, referred to in paragraph 48.
189.Another key theme to emerge was that high concentrations of HMOs were acting as a barrier to regeneration efforts in seaside towns. A number of areas highlighted that their local housing stock was dominated by HMOs that have been poorly converted, in many cases without planning/building regulations approval, resulting in a proliferation of sub-standard, poorly designed accommodation. As the Tourism Alliance noted: “Poor quality accommodation coupled with poor local economy is leading, in some destinations, to acute social deprivation. This in turn impacts on consumer perceptions and the desirability to visit.”
190.The National Housing Federation suggested that poor quality housing in the private rented sector could also, in some areas, provide a barrier to regeneration, particularly where there is a desire to take a place-based approach to regeneration:
“In communities where the private rented sector is large and low quality it is extremely difficult for the local authority, or anyone else, to undertake place-based regeneration.”
191.Catherine Ryder, Head of Policy at the National Housing Federation, provided further detail on this point:
“Local authorities make a lot of investment in places, but, unless you address some of the desperate need for regeneration in the homes themselves, regeneration will take you only so far. When ownership is complex, and you have empty homes and are not sure who owns them, it is difficult to take a holistic approach to regeneration of a place. That can in some instances form a real barrier to properly lifting places up and addressing all the regeneration requirements, including housing.”
192.Ian Higgins of the Chartered Institute for Environmental Health suggested that private landlords should play a greater role in improving the quality of their properties, stating that:
“It is time that the private rented sector took those obligations a little more seriously and started to divert some of the profits that they make from renting properties out to housing benefit tenants back into improving the quality of those properties . . . “
193.However, it was also highlighted that, while there were enforcement actions that local authorities could take to ensure minimum standards were met in the private rented sector, there existed very few incentives for private landlords to reinvest their income into making improvements to their properties. John Stewart, Policy Manager at the Residential Landlords Association, referred to the incentives that used to exist for minimum energy efficiency standards:
“There used to be the landlord’s energy saving allowance, or LESA, which was a tax incentive for landlords to invest energy-saving works in properties. It was removed three years ago, and we now have the minimum energy efficiency standards for the private rented sector, whereby you have to have an EPC rating of E legally to let.”
“…energy efficiency improvements to private rented properties are considered exactly that—improvements. Any tax relief on those improvements cannot be secured until the property is sold, and they are set against capital gains. So, there is really very little incentive for landlords to invest up front in energy efficiency. It is now all about the stick.”
194.It was suggested to us that there was also limited financial support available for housing regeneration in areas that required extensive redevelopment. The Local Government Association Coastal Special Interest Group emphasised that:
“One-off large grants, such as those available through Homes England or via the Housing Infrastructure Fund, do not provide the funding required over the medium to long-long term to make real, sustainable change. In addition, large scale grants will lean towards the delivery of maximum new houses at the lowest costs. This places regeneration projects at an immediate disadvantage due the associated cost of demolition, remediation and place making.”
195.Catherine Ryder highlighted a similar point and suggested that grants that were currently available to support new housing could be channelled into redeveloping existing sites. Ms Ryder argued that:
“There is currently no funding or support for stepping into an area, buying up places and regenerating them. All public investment at the moment is channelled towards new supply, and there is a massive role for new supply in regenerating coastal communities and having an offer for people on lower incomes. That is hugely important. If investment or public support was available for people to step into those areas and give them the confidence to do that—you are talking about how much it costs to buy up homes in those areas—or to regenerate homes that they already own, it would be a huge step forward for many areas.”
“If the Government put their weight behind this and offered some flexibilities in the affordable homes programme, for example, and what it can be used for, it would open up a lot of opportunities in some of those areas.”
196.Another issue that was underlined, in relation to HMOs, was that where there were concentrations of privately rented HMO properties, and local property owners had converted buildings into as many small flats as possible for rent to maximise their returns, there was often a high proportion of residents in recipient of housing benefits. The Local Government Association Coastal Special Interest Group observed that:
“Old terraced properties, in many cases former B&Bs, have been converted into HMOs which often offer low quality accommodation. A high percentage of occupants are private tenants, with many partly or fully dependent on housing benefit to pay rent and related housing costs. There is a high demand for this form of property, incentivising its ongoing creation by private land landlords.”
197.In some areas, this was leading to a situation whereby recipients of housing benefit make up the majority of the private rented sector. In Blackpool, for example, it was estimated that “over 80% of private tenants in inner Blackpool receive housing-related benefits.” Thanet District Council reported similar figures of 75% of private sector tenants in Cliftonville being in receipt of housing support.
198.This trend was reported by a number of seaside towns and we were told that this could impact directly on the local housing market. Ian Higgins explained that:
“Because there is such a high demand for these properties—for cheap accommodation that people can afford to rent—with properties converted to houses in multiple occupation, in many areas housing benefit effectively drives the housing market. It is the principal driver for the market in that area.”
199.The effect of housing benefit driving local market rates has caused two related problems for local authorities. First, it has the effect of driving up the commercial value of HMO properties, even if those properties were of a very poor standard. As Blackpool Council explained: “The rents received by the landlords are not linked to the quality of the accommodation, nor to its real market value”. The Council stated that this problem was compounded by the way in which housing benefit rates were calculated:
“With little alternative market for these flats, rents reflect the Housing Benefit levels set and paid by Government through the Local Housing Allowance regulations. These are set based on rents in a much wider area, which includes more affluent resorts like Lytham St Annes.”
200.Second, where housing benefit rates acted to distort local market rates by disproportionately raising the commercial market value of HMO properties, this could impact on the willingness or ability of other investors to redevelop poor quality housing stock. We were told that local investors were at risk of losing money from converting these types of properties. As Blackpool Council explained: “the artificially high rental yields make it expensive for public and private investors to buy up buildings for redevelopment into more positive uses.”
201.A number of local authorities made us aware that they were endeavouring to tackle the problems associated with high proportions of HMOs in their areas through the use of the existing powers available to them, for example, through selective licensing, or by applying specific planning policies. Frustrations, however, were repeatedly expressed over the limitations of those powers, which failed to provide local authorities with enough armoury to tackle comprehensively the negative effects of poor-quality HMOs.
202.The Ministry for Housing, Communities and Local Government (MHCLG) outlined the powers that were currently available to local authorities to tackle both the proliferation of HMOs, and poor housing conditions. It stated that:
203.Some areas reported that they had made successful interventions on problem HMOs through some of the measures listed above. For example, Portsmouth City Council stated that: “Controls have been introduced through the planning framework to limit the concentration of HMOs in areas, and there is strong working with landlords to ensure that properties are managed in a responsible way.” Brighton and Hove City Council reported that: “Licensing of larger HMOs through national mandatory licensing have brought about improvements in both the management and quality of HMO accommodation.” A number of areas, including Thanet District Council and Great Yarmouth Borough Council also reported that they had implemented selective licensing schemes (where all landlords in a designated areas must apply for a licence if they want to rent out a property) which had helped to tackle problem housing in their areas.
204.Other areas, however, reported that the existing powers aimed at helping to manage problem HMOs were either difficult to implement with any real success, or were ineffective within the context of a coastal area. Much of the criticism of these local authority powers centred on how well local authorities were able to use enforcement powers to tackle poor housing standards.
205.We were told that local authorities often felt limited in their ability to intervene to improve the quality of local housing stock, particularly in concentrations of poorly managed HMOs. Ian Higgins from the Chartered Institute for Environmental Health, speaking about enforcement powers, asserted that:
“In some cases, the primary legislation is really unhelpful; it is very poorly drafted, leading to interpretations and tribunals, which have been unhelpful to the enforcement process. That has served to deter many local authorities from undertaking enforcement action, because of the complexity of the legislation—the fact that it is poorly drafted in many instances—and it is very resource hungry. Some of the decisions have effectively doubled the amount of time that officers need to spend in the construction of quite straightforward notices to remedy defects in poor housing.
So, it is resource hungry, and local authorities have been consistently deprived of resources over the last decade. In many cases, they struggle to do an effective job in areas where the private rented sector is increasing dramatically, and the pressures on those areas are enormous.”
206.Insufficient resources and financial constraints within local authorities were cited as a significant challenge for enabling effective enforcement action on housing standards. John Stewart told us that:
“There is also the issue that the stock within the private rented sector has generally doubled over the past 10 or 15 years, while the resources that have gone into enforcement, particularly for environmental health, have halved. There is a real mismatch, to start with.”
The Chartered Institute of Environmental Health argued that local authorities needed dedicated financial resources in place to allow them to use existing enforcement tools against poor standard accommodation.
207.It was argued that, taken together, the powers available to local authorities fell short of what was required to help support effective action against poorly managed HMOs. One common complaint was that the powers were ‘piecemeal’ and difficult to enforce, particularly in the context of coastal communities. Blackpool Council asserted that local authorities were working with:
“… a series of well-intentioned but fundamentally weak policy instruments implemented without sufficient regard to the unique coastal context. One example is additional and selective licensing, which has helped address the very worst housing issues without tackling the system which produces them. Equally, government’s use of individual funding pots acts against sustained change and progress by producing short-termism, the inability to sequence regeneration activity to extract most value for money, and provides further constraints through restrictive funding criteria.”
208.Similarly, Scarborough Borough Council told us that:
“Government policy towards the private rented sector has fought shy of introducing an effective regulation model for the sector and having some form of independent regulator. Whilst there is a myriad of regulatory requirements affecting landlords of private rented properties they tend to be piecemeal and without any central focus and there is a reliance on local authorities with limited resources for enforcement.”
209.Issues related to housing are central to the disadvantages faced by seaside towns. Coastal local authorities reported a concerning imbalance within their local housing markets: there are perverse incentives on private landlords to populate the local housing stock; but also, a complete lack of incentives for either private landlords to make improvements to their properties, or for local investors to intervene and undertake housing redevelopment.
210.Local authorities told us that existing powers were not sufficient to help them tackle poor quality housing, much less to enable them to initiate the wider interventions needed for sustainable regeneration. This results in a situation whereby sub-standard housing dominates the local housing stock, and the related social and economic issues become deeply entrenched, exacerbating disadvantage and intensifying deprivation in seaside towns.
211.We were, however, offered possible solutions for how problem housing could be tackled in coastal areas. Creating a distinct package of bespoke measures was one of the most persuasive suggestions we heard. Blackpool Council, for instance, identified the following priorities:
A note by Baroness Wyld
We were provided with accounts of innovative schemes that some local authorities have introduced to help tackle housing issues in their areas. On our visit to Blackpool, we visited a number of housing developments created by the Blackpool Housing Company. The Company, which is wholly owned by Blackpool Council, has been acquiring, converting or refurbishing homes for market rent in inner Blackpool since 2016. The Company is wholly commercial, borrowing through the Council and requiring a lower return than private investors. We were shown around a property which the Company had renovated; a former hotel which has been converted into a set of two-bedroom flats. We were told that in two years, the Blackpool Housing Company has delivered 200 homes.
Source: Blackpool Visit Note, Appendix 5
212.Blackpool Council and Business in the Community both advocated the creation of a Housing Action Zone in Blackpool. The aim of this proposed initiative was to pilot a holistic approach to tackling poor quality housing, combining a range of policy, legislative and financial initiatives. The key asks of the ‘Housing Zone’ proposal were to:
213.The proliferation of sub-standard housing and poorly managed HMOs in seaside towns underpins many of the social and economic problems that struggling coastal areas suffer. The paucity of tools and resources to tackle poor quality housing is severely limiting the ability of local coastal authorities to make meaningful progress towards regeneration.
214.We consider the following areas as requiring the most urgent attention:
215.We are convinced that any approach to improving housing in deprived coastal areas must be delivered as a comprehensive package of measures, so as to enable local authorities to focus intensively on addressing the issues in the physical and social environment.
216.Perverse financial incentives to offer poor accommodation, financial pressures on inspection and enforcement regimes, and the sheer scale of the problems associated with housing, mean that many coastal areas are making only very limited headway relative to the size of the problems they are experiencing.
217.We recommend that the Government determines whether local authorities require additional powers to address the problems arising in areas with especially large numbers of HMOs. This determination should include the introduction of measures that enable local authorities to safeguard resources necessary for the enforcement of housing standards.
218.We recommend that the Government implements changes to the system for the calculation of local housing allowance rates in areas with high densities of HMOs, to ensure it more accurately reflect local market rents.
220.We recommend the introduction of stronger incentives for private landlords to improve the quality and design of their properties. This might include tax relief for making improvements to properties.
221.We recommend that the Government pilots the introduction of Housing Action Zones, which might comprise of the proposed recommendations outlined above, and be delivered as a comprehensive package of measures to support housing regeneration in coastal areas.
222.As part of the pattern of decline experienced by many seaside towns, significant inequalities have emerged between coastal areas and the rest of the country. As previously noted, these include disadvantages associated with employment, education and skills and housing. Many areas, however, also reported serious concerns around the health and wellbeing of their local populations.
223.A number of reports have highlighted the significant health inequalities suffered by populations in seaside towns. Most recently, the Social Market Foundation reported that of the 20 local authorities in England and Wales with the highest proportion of individuals in poor health, 10 were in coastal communities.
224.Many areas cited poor health outcomes as a feature of their local population and, although the evidence we received on health was not extensive, a number of key themes emerged, including: the prevalence of drug and alcohol addiction within coastal communities; the impact of the demographic makeup of many coastal areas—specifically that coastal populations often included a higher proportion of older people, and a transient population of vulnerable people; difficulties in recruiting and retaining medical staff; and limited access to health services, particularly to A&E departments.
225.Coastal areas have been associated with high rates of harmful behaviours, attributed to factors such as physical isolation, low levels of employment, and constrained socio-cultural opportunities. This has been widely recognised by a series of national studies on the health inequalities found in seaside towns. Public Health England’s statistics show that Blackpool has the highest alcohol-specific mortality rate for men in Britain, and the second highest for women. It is also worst in England for deaths from liver disease. In Brighton and Hove, rates of alcohol-related harm are higher than the national average.
226.In 2018, a report by the Office for National Statistics found that some of England and Wales’s seaside resort areas were among the towns with the highest rates of death from misuse of heroin/morphine—six of the 10 local authority districts with the highest rates were coastal resorts. Blackpool has been the location of the highest death rate since 2012, with 14.0 heroin and/or morphine misuse deaths per 100,000 people in 2016. This compared with the national average of 1.9 in England and 2.3 in Wales and is almost twice as high as the area with the next highest rate of heroin and/or morphine misuse deaths, Burnley (just over 30 miles inland from Blackpool), which has a rate of 7.6 per 100,000.The other seaside locations to feature in the 10 areas with the highest rate of heroin or morphine misuse deaths are Bournemouth, Portsmouth, Hastings, Thanet and Swansea.
227.Many areas highlighted the levels of drug and alcohol abuse amongst their local populations. Scarborough Borough Council told us that: “The Public Health Outcomes Framework shows the number of deaths from drug misuse in Scarborough is significantly higher than England, with a rate about 2.5 times the England rate in the three-year period 2015-17.” Worse than average outcomes from drug abuse were also reported by Blackpool Council, Brighton and Hove City Council and Barrow-in-Furness.
228.Karen Tyrell, Executive Director of External Affairs at Addaction, offered an explanation for the high levels of drug use in seaside towns:
“From our point of view, there are lots of drivers of people ending up in seaside towns and why more vulnerable people end up there. Certainly, when I talk to staff about why Blackpool and various other towns around the country are the way they are, I hear that a range of things attracts people, including the attraction of seasonal work. Quite a lot of people have a sense of nostalgia; it is about where they were happiest in their earlier life, and wanting to get back to that time.
“There is an issue about bigger cities exporting people as well, and I have certainly heard of that in places such as Margate. But lots of people choose to go to seaside towns, and often they are quite vulnerable people.”
229.Recent studies have also highlighted the prevalence of poor mental health in coastal communities. A study in 2017, which analysed NHS prescription data, found that doctors in deprived coastal towns in the north and east of England were prescribing almost twice as many antidepressants as those in the rest of the country. Blackpool, Sunderland and East Lindsey, in Skegness, were the leading three areas for the most prescriptions out of England’s 326 districts.
230.North Yorkshire County Council elaborated:
“Common mental health disorders, such as anxiety and depression, appear more prevalent in Scarborough compared with England. The national General Practice Patient Survey in 2016/17 found that 16.1% of adults in Scarborough reported they were moderately, severely or extremely anxious or depressed, compared with 13.7% in England. Applying this rate to the adult population in Scarborough suggests there are about 14,300 adults aged 18+ with anxiety or depression. If Scarborough had the England rate, there would be about 2,100 fewer adults with anxiety and depression. The rate of self-reported anxiety and depression has increased in Scarborough from 13.5% in 2014/15. The England rate also increased, but more slowly, from 12.4% to 13.7% in the same period.”
231.Some demographic factors, common to seaside towns, were identified as playing a significant role in persistent levels of poor health reported in coastal communities. Coastal communities tend to have an older age profile than other communities across the UK. In a sample of 274 coastal communities in England and Wales, 20% of the population were aged 65 years or over (compared with 16% nationally).
232.Professor Rhiannon Corcoran of the University of Liverpool also emphasised that:
“Coastal towns tend to be characterised by an aging population of long-term residents or incoming retirees and a transient younger, marginalised group. These populations are themselves polarised but both are vulnerable.” Professor Corcoran went on to suggest that seaside towns often suffer with a distinct mix of social and economic issues which contribute to the “profound health and wellbeing challenges” experienced in coastal towns, including “ aging, social drift and transience, insecure, low paid seasonal employment, skills gaps, poor quality and out-dated private rented accommodation, lack of community cohesion, resources and inadequate stewarding of the public realm.”
233.Coastal communities, therefore, often comprise populations with complex health needs which places their health and social care services under additional pressures. We heard evidence to suggest that coastal health services do not always have the resources to meet these challenges
234.Some areas suggested that funding formulae for local health services failed to take into consideration the diverse set of challenges faced by health professionals in coastal areas. The global sum allocation formula (Carr-Hill Formula) has been used as the basis of core funding for General Medical Services practices since the introduction of the current contract in 2004. Through the formula, payments are weighted for factors that influence relative patient need and costs, including population characteristics such as age and rurality. We heard, however, that the adjustments to the GP funding formula were not always sufficient to support the complexities found within the context of a coastal community. Sam Crowe, Acting Director of Public Health at Public Health Dorset, speaking about the GP funding formula, suggested that:
“That national funding formula comes up time and again in conversation with those practices, because they are practising in quite stretched circumstances. Although there is an allocation that reflects the area of deprivation score, it does not adequately resource the level of complexity that they see with some of those people, in the way they live. Even with a very simple public health intervention such as childhood immunisation, or adults taking part in screening programmes, the way in which practices traditionally communicate—by writing a letter—may not be the best way to do so with some of those people. In the homes they live in, the letters may go astray; the tenancies are often unstable, and there is quite a high turnover in some of those properties.”
235.Thanet District Council told us that it suffered due to a low number of GPs per head of population, which it linked to the funding formula for GPs:
“The other obvious issue with many coastal towns including Thanet is the low number of G.P.s per head of population, perpetuating the inverse care law. Generally, General Practice will be dealing with a multiple morbid population earlier in their life course who will continue to require care for a further 20 or so years beyond first seeking G.P support, this sort of demand is not recognised in the funding formula for G.Ps; hence low numbers compared with the demand.”
236.Other areas pointed to the inadequacy of funding formulae for local authorities. The Health and Social Care Act 2012 conferred a number of statutory duties relating to public health on local authorities. Since 1 April 2013, local authorities have been responsible for improving the health of their local population and for public health services including services aimed at reducing drug and alcohol misuse. Lincolnshire County Council told us that coastal public services often faced significant pressures:
“Compounding the effects of resort deprivation is the local authority funding formula that does not cover the costs generated by transient populations, looked-after children, mental health issues, homelessness, housing benefit dependence and worklessness. Overstretched service budgets can undermine efforts and the resources available for community engagement, developing attractions, stimulating business growth and engaging in the costly uncertainty of inward investment promotion.”
237.MHCLG stated that a: “…critical principle for action is to match service to need i.e. to ensure that areas with the highest health needs receive proportionately higher levels of health care. This organising principle will help treatment reach those who need it most and simply match the demand and supply of health care services.” The NHS Long-Term Plan, which was published in January 2019, commits to targeting a higher share of funding towards geographies with high health inequalities through the amount that Clinical Commissioning groups receive, stating that:
“For the five-year CCG allocations that underpin this Long Term Plan, NHS England will introduce from April 2019 more accurate assessment of need for community health and mental health services, as well as ensuring the allocations formulae are more responsive to the greatest health inequalities and unmet need in areas such as Blackpool.”
“…NHS England will also commission the Advisory Committee on Resource Allocation to conduct and publish a review of the inequalities adjustment to the funding formulae.”
A note by Baroness Wyld
On the Committee’s visit to Fleetwood, the Committee heard that the area has some of the lowest life expectancy in Wyre borough. All five wards in Fleetwood are significantly above national averages in terms of the prevalence of chronic disease, such as diabetes and coronary heart disease. There are also significant levels of drug and alcohol abuse, and poor mental health and social isolation amongst the local population. There are high numbers of children in care and a high proportion in care due to abuse or neglect.
I was deeply impressed by the leadership demonstrated by a local GP, who has instigated a number of programmes aimed at improving the health of the local population. Many local residents were suffering either residual health problems from the industries they used to work in, or problems such as mental health related issues caused by the loss of the fishing industry in the area. Three local GP practices have come together to approach the area’s problems. The key to all of this is, as far as possible, enabling people to improve their own health—to do things for themselves, rather than to be “done to”. The practices have helped to develop Healthier Fleetwood, which was described to us as a “residents-led, social movement”. The group have so far set up a community choir and a table tennis club, which has helped residents’ health, in terms of providing a source of physical activity and fostering a sense of community.
It’s clear that initiatives such as this can and should be replicated in other areas facing similar issues, and that energetic leadership is half the battle.
238.Compounding many of the health issues facing seaside towns were difficulties with recruiting and retaining medical staff. Many coastal areas reported that they were struggling to recruit and retain the people they required to staff local health services. Skegness Town Council told us that it was “difficult to attract skilled persons, professionals and doctors to the area. Local GP surgeries, the local urgent care centre and nearest hospital have all reported this as an issue.” Similarly, North Yorkshire County Council stated that:
“Scarborough district experiences difficulties in recruiting and retaining GPs and specialist medical staff in primary and secondary care. There are also challenges recruiting to social care posts. These are national issues, however, it is particularly challenging in more isolated, rural and coastal towns.”
239.Dr Sam Crowe, Acting Director of Public Health at Public Health Dorset, suggested that there were examples where areas had introduced changes to the model of primary care to help attract and retain health staff. Dr Crowe asserted that: “There are solutions: a lot of the practices are moving away from the so-called partnership model and are looking at employing salaried GPs, and some of those roles are very different from before, enabling GPs to do a couple of clinical sessions in a practice in a deprived area, and perhaps mix that with some academic work, or even some sessions at a hospital. That seems to be what some of the younger GPs are interested in.”
240.Access to health services was also highlighted by many areas, due to challenges around transport connectivity and geographical isolation. Karen Tyrell of Addaction stated that: “Being able to take services to where people are in the community is really important. We are beginning to see a bit of a trend with people struggling to get to services—to A&E, for example. It might be three bus rides to get to the nearest one.”
241.Coastal areas face a range of challenges around the health and wellbeing of their populations. There are a common set of health challenges that are prevalent in these areas, including high rates of drug and alcohol abuse, poor mental health, and additional pressures on local services from both an ageing population, and from the high levels of population transience.
242.It is vital that the Government recognises that there is frequently an additional cost of delivering health services in coastal areas, due to higher proportions of older people, the impact of population transience, the prevalence of poor mental health and geographical isolation. Again, seaside towns are disadvantaged; Government policy, where it pertains to decisions on priorities for investment, with particular regard to national funding formulae, must recognise this.
A note by Lord McNally
In recent decades Fleetwood has suffered a succession of setbacks which would have tested the fortitude of the most resilient of communities. A town which was once one of Britain’s “big three” fishing ports along with Hull and Grimsby lost its deep-sea fishing role after the “Cod Wars” of the 1970s. It had already lost its passenger rail link thanks to the “Beeching Axe” which fell in 1970 and the freight rail link ended in 1999 following the closure of the large ICI plant in nearby Thornton. During the same period Fleetwood lost its ferry services to the Isle of Man and Ireland – the final service to Northern Ireland ceasing in 2010. These series of body blows were accompanied by the radical change in UK holiday patterns and choices which have impacted on so many of our seaside towns.
Yet, the fishing industry for which it was once famous bred a strength in the local community which is helping to provide the basis of community action in the face of adversity. The Fleetwood Trust epitomises that resilience. Originally the brainchild of local clergy and faith groups, it now brings together business leaders, faith, voluntary and charity groups with the aim of buying and restoring the partially closed Fleetwood Hospital into a community hub for health care provisions and as a base for a range of local groups addressing the needs of the local community. The Trust has now bought the hospital. Extensive consultations with the people of Fleetwood are now underway to ensure that what is provided meets with their needs and aspirations. The project has been chosen as one the “Seven for Seventy” high impact community projects selected for support by the Prince’s Foundation to mark the seventieth birthday of Prince Charles. So, winds are now set fair for creating a new, vibrant community-led facility which will be both a hub and inspiration for Fleetwood’s successful re-birth as a twenty-first century success story.
244.Another common challenge for seaside towns was managing the threat of coastal erosion and flooding. There are specific challenges and significant resource requirements in relation to the infrastructure needed to manage coastal erosion, flood events and the impact of environmental change (e.g. rising sea levels). This placed a considerable burden on coastal local authorities and was yet more evidence of the disadvantages felt in coastal areas, that are not present inland. We did, however, also hear a good deal of evidence which highlighted the positive impact that coastal protection schemes could have on the local visitor economy and on wider regeneration.
245.The key themes that emerged around coastal erosion and flooding were: the challenges posed by the threat of coastal erosion and flooding; the adequacy of the support that is available for coastal defences; and the opportunities to use coastal defence schemes to deliver wider benefits to the local economy.
246.Coastal erosion causes considerable damage to the physical environment and infrastructure in seaside towns. The Local Government Association Coastal Special Interest Group outlined the impact nationally of coastal erosion and emphasised that efforts to tackle the issues would need to increase in the future. It stated that:
“Approximately 44% of the England and Wales coast is defended to prevent or reduce flood risk and coastal erosion. Coastal erosion is relentlessly occurring on 30% of England’s coastline. The rise in sea level relative to the land will be greater than the global average in southern and eastern England because the land is gradually sinking. For many parts of the coast, the increase in mean sea level during the 20th century is up to 20cm (Intergovernmental Panel on Climate Change 5th Report 2013), [which] will have doubled the risk of flooding (Environment Agency 2011). It is anticipated that the number and frequency of intense storms and tidal surges is likely to increase significantly. It is projected that spending on coastal defences will need to double by 2080 (DEFRA) the use of managed realignment and other forms of soft coastal defence measures are likely to increase.”
247.In addition, some areas outlined the damage coastal erosion was inflicting on their local environment. East Riding of Yorkshire Council stated that coastal erosion:
“…occurs at a rate of approx. 4m a year along unprotected stretches with current estimates for 237 residential properties to be lost to erosion by 2105, with 24 of these being lost by 2025; a significant number of valuable agricultural operations and over 500 holiday chalets, statics and touring caravans are projected be lost by 2105; some sections of the highway network are under threat, with the coast road strategic north south link, the B1242, coming within 70 metres of the eroding cliff edge in places”.
248.As well as the physical damage caused by coastal erosion, a number of areas told us that having land vulnerable to flooding could also be an impediment to making improvements to local infrastructure and to efforts focused towards regeneration. The Coastal Communities Alliance outlined the unique difficulties coastal areas have in securing investment for much-needed housing developments, due to the disadvantages these areas faced from being at risk from coastal flooding:
“There is a need for housing in coastal areas to support economic growth, but some Seaside communities / coastal towns face the particular challenge of flood risk in areas of low land values. Development in areas affected by flood risk must incorporate the necessary flood defences, such as raising the build platform. This increases the cost of developing, lowering residual values and rendering schemes which have low land values and low sale prices unviable.”
249.East Lindsey District Council asked that these challenges, unique to seaside communities, be better recognised at the national level. The Council argued that:
“Future legislation should facilitate the delivery of a mixed portfolio of housing developments, while concurrently recognising the constraints placed upon coastal districts (in terms of flood risk) by supporting innovation in housing design which mitigates local environmental considerations.”
250.The majority of the funding for flood and coastal erosion management is channelled through grants from the Department for Environment, Food and Rural Affairs (DEFRA) to the Environment Agency. In May 2011, DEFRA introduced a new policy, “Flood and Coastal Erosion Resilience Partnership Funding”, better known as “Partnership Funding”. This approach required the project costs to reduce flood and coastal erosion risks to be shared between national and local funding sources. Funding levels for each scheme related directly to the number of households protected, the damages being prevented, plus the other benefits that a scheme would deliver. Catherine Wright, Director of Digital and Skills (Flood and Coastal Risk Management) at the Environment Agency, told us that:
“The determination on flood risk investment is made through the spending reviews. The last settlement, in 2015, for the first time covered a six-year period, to 2021. That programme, which is for all types of flooding, is for £2.6 billion, and will better protect 300,000 properties around England. What is important about the decisions that sit behind that is that the government approach to funding is that we try to optimise investment to get best value for money, because we are competing for public money alongside other vital services for the UK. The priority in the programme was to focus first on the homes at greatest risk of flooding. The programme was put together on that basis, but it also takes account of deprivation.”
251.Ms Wright explained that the biggest benefits from the current £2.6 billion programme were realised through the damage it helped to prevent. She stated that:
“The £2.6 billion programme delivers benefits of about £22 billion in damages avoided; a £5 billion benefit to transport infrastructure commerce; a £1.5 billion benefit to agriculture because of the knock-on reduction in damage that those flood defence improvements can have on agricultural land; and a benefit of about £600 million in environmental outcomes. That is based on the rules we have. The NAO made an assessment of the value for money of flood investment back in 2014. That was the last time it made an assessment of the flood risk programme. Its assessment was that for every £1 we invest in flood risk, we get back a benefit of about £9.50 in avoided damages.”
252.Some areas, though, were critical of the way in which funding was calculated for projects to reduce flood and coastal erosion risk, suggesting that it resulted in restrictive and inadequate levels of support. Cornwall Council told us:
“Cornwall’s recent experience of severe weather and potential for more in future, highlights the need for an improved methodology to assess and forecast its economic impact. For example, Looe has a longstanding reputation for regular and severe flooding. However vital prevention work has not progressed due to the cost-benefit calculations used by the Environment Agency. This is despite wide acknowledgement of the need to intervene. A more comprehensive methodology should incorporate the wider impact of climate change in specific locations. Looe risks losing its function and identity as a visitor attraction, which would have a disproportionate impact on the whole of South East Cornwall. An improved methodology would enable preventative investments, reducing reactive expenditure to repair damage.”
253.It was noted that the current approach gave a high degree of priority to protecting residential dwellings, but more limited emphasis on the protection of businesses, agriculture and infrastructure assets. Felixstowe Forward explained that:
“Due to current policy, the majority of funding for Flood & Coastal Risk Management (FCERM) allocated by Defra is focussed on reducing the risk of residential property, with additional weighting for deprived communities. Some of the potential cost of damage to commercial assets and losses to the economy can be taken into account, but receive a modest weighting. But many of the wider economic benefits cannot be factored-in to the cost benefit analysis or economic benefit assessment for coastal infrastructure projects. In addition, the costs of coastal resilience schemes tend to be significantly higher due to the scale and type of infrastructure needed to defend against the sea.”
Felixstowe Forward concluded that: “coastal resorts with large numbers of business premises and low density of residential properties in the tidal flood plain/erosion zone land are placed at a disadvantage”.
254.There was some acknowledgement of the concerns relating to the funding formula for coastal defence by the Environment Agency. Catherine Wright noted that “a lot of stakeholders have told us that they think the funding formula could change, and there is an opportunity to do that next year in the spending review”. She added that:
“There is a case for thinking about the local economy, particularly investment in social infrastructure, such as schools, hospitals and highways, to make sure that we maximise the sustainability of those investments for the future when it comes to climate change”.
255.We recommend that DEFRA reviews and revises the approach taken to coastal flood risk investment decisions in order to give greater account to the protection of non-residential properties and assets, including business and public infrastructure.
256.The financial and environmental burdens resulting from coastal erosion and flooding clearly give cause for concern. We were, however, told of examples which demonstrated how the innovative design of coastal defence structures had the potential to impact positively on seaside regeneration.
257.Thanet District Council stated that when developing coastal defence structures: “enhancements that bring added value to the community should be sought and encouraged.” Thanet demonstrated that it had successfully applied this principle when developing its own coastal defence scheme, which we saw during our visit to Margate. The Council outlined the details of the project:
“In 2011 a £6m grant funded coastal defence scheme transformed the seafront area and provided a large brand new area of public realm with strong pedestrian connectivity and easy access to the foreshore whilst increasing the standard of flood defence to the indicative standard for the next 50 years.”
258.The Environment Agency provided several examples of coastal defence projects that had also contributed to local regeneration. One example was the Runswick Bay Coastal Defence Scheme, led by Scarborough Borough Council and funded by the Environment Agency and the Runswick Bay Sea Defence Trust, a group of homeowners and local residents who have contributed to the funding of the scheme to help secure the future of their community. The Environment Agency outlined the details of the scheme:
“The £1.5m Runswick Bay Coastal Defence Scheme is an essential project designed to address seawall degradation, toe erosion and the implications for the stability of the slopes behind the deteriorating defences. Failure or loss of even part of the existing defence structures could have serious and relatively rapid implications. There are 96 residential and 17 non-residential properties which are considered to be at risk from coastal erosion. Wave overtopping at Runswick Bay Village is also a problem.
…This scheme offers protection to the holiday homes and also provides a safe area for visitors to rockpool/go crabbing/use the beach thus helping support the local economy.”
259.It was suggested that additional support was necessary to help local authorities commission coastal defence projects that sought to deliver wider economic benefits. Lincolnshire County Council suggested that “capital infrastructure funding should be increased to top up statutory Environment Agency funds for coastal defence”. This, it argued, would support a move towards “designing and implementing new physical structures which can support diversified economic activity”.
260.There was broad agreement that any approach to coastal defence strategy should, in addition to assessing the standard social, economic and environmental impacts of any proposals, consider options that enhanced the built environment and the local visitor economy. From the examples we were provided with, and those we were able to visit, we are seized of this approach.
A note by Lord Bassam of Brighton
During our visit to Skegness, issues with the funding formula currently used to prioritise investment in coastal flood defences were highlighted. In particular, it was noted that the current approach largely prioritised the protection of residential dwellings, with more limited emphasis placed on the protection of businesses, agriculture and infrastructure assets.
We were told that around 30% of the District was identified as being at significant risk of flooding. Along the coast of East Lindsey, flood defences were managed through a mixture of hard defences, flood banks and a beach nourishment project. This project started in the early 1990s and serviced 20km of open coastline, costing around £6–7 million a year.
This work has had a positive effect on the appearance of the beach and had helped to keep residents safe. Council representatives raised concerns around the levels of funding available for future flood defence schemes, suggesting that this was creating uncertainty for future commercial investment; it was suggested that existing funding models did not always reflect realities on the ground.
The Council highlighted that having a large area of the district vulnerable to flooding had affected their ability to bring forward new build housing in East Lindsey. There was a desire to link flooding funding with projects that would support growth, and to make investment in coastal defences deliver more for the district in terms of its tourist offer.
Source: Skegness Visit Note, Appendix 5
160 Written evidence from Blackpool Council ()
161 (Professor Darren Smith)
162 Written evidence from Dorset County Council ()
163 Written evidence from Blackpool Council ()
164 Written evidence from Scarborough Borough Council ()
165 Written evidence from Scarborough Borough Council ()
166 Written evidence from Ramsgate Coastal Community Team ()
167 Written evidence from the Tourism Alliance ()
168 Written evidence from the National Housing Federation ()
169 (Catherine Ryder, Head of Policy, National Housing Federation)
170 (Ian Higgins)
171 (John Stewart)
172 Written evidence from the Local Government Association Coastal Special Interest Group ()
173 (Catherine Ryder)
174 Written evidence from the Local Government Association Coastal Special Interest Group ()
175 Written evidence from Blackpool Council ()
176 Written evidence from Thanet District Council ()
177 (Ian Higgins)
178 Written evidence from MHCLG ()
179 Written evidence from Portsmouth City Council ()
180 Written evidence from Brighton and Hove City Council ()
181 Written evidence from Thanet District Council ()
182 Written evidence from Great Yarmouth Borough Council ()
183 (Ian Higgins)
184 (John Stewart, Residential Landlords Association)
185 (Ian Higgins)
186 Written evidence from Blackpool Council ()
187 Written evidence from Scarborough Borough Council ()
188 Written evidence from Blackpool Council ()
189 Written evidence from Blackpool Council ()
190 Government Office for Science, Future of the Sea: Health and Wellbeing of Coastal Communities (August 2017) p 7:
191 Lancashire County Council, ‘Alcohol’: [accessed 4 February 2019]
192 Government Office for Science, Future of the Sea: Health and Wellbeing of Coastal Communities (August 2017) p 7: [accessed 25 March 2019]
193 ONS, ‘More than half of heroin/morphine misuse death hotspots in England and Wales are seaside location’ (4 April 2018): [accessed 25 March 2019]
195 Written evidence from Scarborough Borough Council ()
196 Written evidence from: Blackpool Council (); Brighton and Hove City Council (); Furness Economic Development Team ()
197 (Karen Tyrell)
198 ‘Antidepressants prescribed far more in deprived English coastal towns’ The Guardian (14 April 2017): [accessed 25 March 2019]
199 Written evidence from North Yorkshire County Council ()
200 Government Office for Science, Future of the Sea: Health and Wellbeing of Coastal Communities (August 2017) p 5: [accessed 25 March 2019]
201 Written evidence from Professor Rhiannon Corcoran ()
202 House of Commons Library, General Practice in England, Library Note, , 18 September 2018
203 (Sam Crowe)
204 Written evidence from Thanet District Council ()
205 House of Commons Library, Local authorities’ public health responsibilities (England). Library Note, , 13 March 2014
206 Written evidence from Lincolnshire County Council ()
207 NHS England, The NHS Long Term Plan (January 2019), p 40: [accessed 25 March 2019]
208 Written evidence from Scarborough Borough Council ()
209 Written evidence from North Yorkshire County Council ()
210 (Sam Crowe)
211 (Karen Tyrell)
212 Written evidence from the Local Government Association Coastal Special Interest Group ()
213 Written evidence from East Riding of Yorkshire Council ()
214 Written evidence from East Lindsey District Council ()
215 Local Government Association, ‘Funding arrangements’: [accessed 25 March 2019]
216 Department for Environment, Food & Rural Affairs, ‘Flood and coastal resilience partnership funding: an introductory guide’: (accessed 5 December 2018)
217 (Catherine Wright)
218 Written evidence from Cornwall Council ()
219 Written evidence from Felixstowe Forward ()
220 (Catherine Wright)
221 Written evidence from Thanet District Council ()
222 Written evidence from the Environment Agency ()
223 Written evidence from Lincolnshire County Council ()