Putting Partnering into Practice: Collaboration on Complex Issues – Healthy Homes

7. Emerging Challenges for Healthy Homes Initiatives

Bringing together diverse partners, sectors and ways of working is never easy. As noted earlier in this report, getting to the outcome of healthy homes requires supported interagency work at both national and local levels. This section summarises some of the emerging challenges for healthy homes initiatives.

Reflection, learning and feedback loops

Act, reflect, adapt

Complex issues require innovative solutions – many come from trials and experiments rather than pre-determined or heavily evidence-based strategic plans. In the complex space, models that are more organic and emergent are generally viewed as more appropriate, with collaborations often “developing the road as they walk upon it.”

Best practice in working with complex issues suggests that collaborations that build in an ‘act, reflect, adapt’ approach have a better chance of reaching visions and outcomes (37). Given this, time for reflection needs to be valued and proactively built into collaborative processes.

Improving information sharing

Getting, compiling and sharing the right information and research from a range of academic and grassroots organisations is essential. This enhances current and future phases of healthy homes policy, investment and programme development. Sharing experiences of what is and is not working and why, need to be seen as a continuous loop, working concurrently at operational (planning, doing, delivery) and strategic levels (policy, funding, enabling frameworks).

As the healthy homes sector continues to grow and develop, many contributors to this report felt that there is room for more reflective thinking, better local information to help reach those in need, and shared learning of what works, how and why.

	“We need to build in more capacity to think innovatively. Innovation often comes at the fringes – it is not Government who always has the best ideas.” “We need more local information about where there are uninsulated homes and occupants who have the highest respiratory health needs.” “There is not nearly enough reflection within the sector and we need it at regional and national levels.” “At the first Healthy Homes National Hui, we had the opportunity for shared dialogue and learning. At the 2008 Hui, it was much more about being ‘presented at’ – we actually need more opportunities for both.” “There is more potential to identify relevant information and knowledge in the various organisations that are collaborating - things like deprivation, pollution levels, hospital admissions, and tenure. We could then tailor it to a coherent local picture of housing, which would really help with targeting.” “The community providers’ industry network has been really helpful nationally. It has meant that more policy feedback is getting through than ever before. Personal ideas and networks have a huge effect in New Zealand which makes key messages sometimes easier to get through the channel.”

“We need to build in more capacity to think innovatively. Innovation often comes at the fringes – it is not Government who always has the best ideas.”

“We need more local information about where there are uninsulated homes and occupants who have the highest respiratory health needs.”

“There is not nearly enough reflection within the sector and we need it at regional and national levels.”

“At the first Healthy Homes National Hui, we had the opportunity for shared dialogue and learning. At the 2008 Hui, it was much more about being ‘presented at’ – we actually need more opportunities for both.”

“There is more potential to identify relevant information and knowledge in the various organisations that are collaborating - things like deprivation, pollution levels, hospital admissions, and tenure. We could then tailor it to a coherent local picture of housing, which would really help with targeting.”

“The community providers’ industry network has been really helpful nationally. It has meant that more policy feedback is getting through than ever before. Personal ideas and networks have a huge effect in New Zealand which makes key messages sometimes easier to get through the channel.”

Reflecting on why things aren't working

Some talked of the importance of reflecting on why things were not working as early as possible and how involving others in that process can add value straight away.

	“We have had some spectacular failures. We realised we were not getting forms back from Māori and Māori organisations – we contacted key Māori service providers for their advice and they agreed that direct contact with families was needed, they took forms out and got them filled in on the spot.” “There has been a lot of learning along the way. EECA’s policy of requiring 1 - 1 funding matches was about maximising returns but it did not work so well. The 60 - 40 funding policy they went to next though has had a really positive impact all round.”

“We have had some spectacular failures. We realised we were not getting forms back from Māori and Māori organisations – we contacted key Māori service providers for their advice and they agreed that direct contact with families was needed, they took forms out and got them filled in on the spot.”

“There has been a lot of learning along the way. EECA’s policy of requiring 1 - 1 funding matches was about maximising returns but it did not work so well. The 60 - 40 funding policy they went to next though has had a really positive impact all round.”

Impact of time and resource constraints on reflection

Other contributors to this report were upfront about the time and resource constraints that local initiatives face. This has an impact on the ability to think, reflect and elevate wider systems and policy issues.

	“There are real capacity issues with community sector organisations that need to be acknowledged. Many small organisations have issues and concerns but have no capacity and power to lift them to influence policy and systems change.” “The issue for providers is that they are so involved in doing the work that they do not put enough time into helping close policy/feedback loops.” “We see the real gaps at the whare end of the process – hearing people’s stories of the difference being made for them, how things are going and how we could grow and get all the houses in our area healthy.”

“There are real capacity issues with community sector organisations that need to be acknowledged. Many small organisations have issues and concerns but have no capacity and power to lift them to influence policy and systems change.”

“The issue for providers is that they are so involved in doing the work that they do not put enough time into helping close policy/feedback loops.”

“We see the real gaps at the whare end of the process – hearing people’s stories of the difference being made for them, how things are going and how we could grow and get all the houses in our area healthy.”

Communication with funders

Some contributors also made a connection between reflective story-telling and communication with funders.

	“Sometimes it feels like we are not doing enough to give back to our funders, who are often one step removed from what happens on the ground. We are currently doing a story-telling DVD so they can hear about the impact on the ground and be better able to promote healthy homes within their organisations”.

Improving the use of research

Other contributors expressed a desire for research to improve local programme implementation and targeting. However, access to information is not the only problem in helping the sector move forward.

	“The real problem is that government is not acting on the research they have. In this case, the problem is not a research gap, it is that conceptually they have not gotten their heads around what it is they really want to achieve.” “I would argue we do not have a proper outcomes focus yet. Rather we have had a fixation on isolation as the solution rather than standing back and asking what multiple actions are needed if we are to address the outcomes we seek”.

“The real problem is that government is not acting on the research they have. In this case, the problem is not a research gap, it is that conceptually they have not gotten their heads around what it is they really want to achieve.”

“I would argue we do not have a proper outcomes focus yet. Rather we have had a fixation on isolation as the solution rather than standing back and asking what multiple actions are needed if we are to address the outcomes we seek”.

Leadership and collaboration

Visible and effective leadership is identified as a key aspect of successful healthy homes collaborations.

Leadership in the context of collaboration is about inclusively and proactively growing movements of people and organisations with shared intent. It is a style that focuses on the good of the collective, actively listening and responding to the ideas and needs of the group and finding ways to achieve shared visions.

Leadership is more than just mandate, it’s also about skilful collaboration ‘know how.’ Bringing and keeping partners inside the collaboration tent, and growing broader movements for change, is a key ability.

Leadership at a national level

Many contributors were concerned about the impact of a strong intersectoral leadership gap at the national level. Collaborative leadership at the national level is important for enabling:

mandate
resourcing certainty
supportive frameworks for local-level partnering action.

	“No agency has the overarching sector development as one of its core funded goals – if we are to move forward together we need to address this quickly.” “What is clearly needed in some areas is strong leadership – someone or some organisation needs to offer leadership and be the linking force between agencies both nationally and locally.” “Having national leadership for the healthy homes concept would take away the need for local project groups to always have to push it so hard at the local level.”

“No agency has the overarching sector development as one of its core funded goals – if we are to move forward together we need to address this quickly.”

“What is clearly needed in some areas is strong leadership – someone or some organisation needs to offer leadership and be the linking force between agencies both nationally and locally.”

“Having national leadership for the healthy homes concept would take away the need for local project groups to always have to push it so hard at the local level.”

Barriers to intersectoral leadership

These comments reflect on the importance of leadership to support intersectoral collaboration and also the challenges. Sometimes, when multiple sectors are involved, there can be reluctance for one sector to take the lead because they:

may be seen as dominating, especially if they are larger or more powerful
may be fearful of being seen as responsible for outcomes and funding of the sector
are concerned others may opt out of shared responsibilities
fear brand association and communications may become too tightly coupled with their particular agency or sector.

	“We need champions for growing the healthy homes movement at the local level but also nationally more now than ever. We need the new Government to see that healthy homes is very much about infrastructure development and practical employment outcomes.” “The name healthy housing or healthy homes runs the risk of reducing benefits – they are so much wider than just health. There is a risk that the health sector will see it as theirs and that is not helpful for growing a shared movement.” “Many of the environmental agencies who started insulating houses had no social sector connections so only thought with an environmental hat on. The same happened with groups who got involved for training and employment reasons; they didn’t get the environmental benefits. It means cross sector connections and leadership is still only happening slowly across the board.”

“We need champions for growing the healthy homes movement at the local level but also nationally more now than ever. We need the new Government to see that healthy homes is very much about infrastructure development and practical employment outcomes.”

“The name healthy housing or healthy homes runs the risk of reducing benefits – they are so much wider than just health. There is a risk that the health sector will see it as theirs and that is not helpful for growing a shared movement.”

“Many of the environmental agencies who started insulating houses had no social sector connections so only thought with an environmental hat on. The same happened with groups who got involved for training and employment reasons; they didn’t get the environmental benefits. It means cross sector connections and leadership is still only happening slowly across the board.”

Different leadership for different stages

Many contributors to this project reflected that different kinds of leadership and leaders are required at different stages of partnering processes.

	“In the beginning of Warm Homes Clean Air Tokoroa, research and planning roles were prominent with generally DHB or Council staff taking the lead. During the implementation phase the community partners were at the helm as they were the ones who could best identify the highest need areas, broker relationships within the community and enlist participants. Without our community partners endorsing the project and fronting it with the community we would not have achieved what we did.”

“In the beginning of Warm Homes Clean Air Tokoroa, research and planning roles were prominent with generally DHB or Council staff taking the lead. During the implementation phase the community partners were at the helm as they were the ones who could best identify the highest need areas, broker relationships within the community and enlist participants. Without our community partners endorsing the project and fronting it with the community we would not have achieved what we did.”

‘Top down meets bottom up’ - one size does not fit all

Achieving healthy homes outcomes requires many sectors, agencies and levels of government to work together.

Given the extent of damp, cold housing in New Zealand, leadership and funding for retrofits by government is essential. However, success is dependent upon careful balancing between ‘top down’ and ‘bottom up’ needs and aspirations for change.

National outcomes supporting local needs

Contributors to this report agree that there is a clear need for national (and/or regional) outcomes to be delivered in a way that strengthens goals and capacities of local places, communities and locally based organisations. ‘Sideways’ tensions – within communities, within large organisations playing a variety of roles (38), and between government agencies - were also acknowledged.

	“What we really need is a national framework with localised approaches to delivery – things like climate, geography, where houses were built and the nature of communities means that healthy homes needs to look different in different parts of the country.” “It now feels like decision-makers are becoming more aware of the potential from healthy homes, it is not just stuck at the local level any more.” “It is tricky working with other agencies given our strict key performance indicators and where the money must be spent – it potentially imposes restrictions on a wider group of agencies and what we might do together locally.”

“What we really need is a national framework with localised approaches to delivery – things like climate, geography, where houses were built and the nature of communities means that healthy homes needs to look different in different parts of the country.”

“It now feels like decision-makers are becoming more aware of the potential from healthy homes, it is not just stuck at the local level any more.”

“It is tricky working with other agencies given our strict key performance indicators and where the money must be spent – it potentially imposes restrictions on a wider group of agencies and what we might do together locally.”

Local solutions for local communities

While strong national leadership and direction for healthy homes was supported, the need for local solutions for local communities, rather than top heavy governmental control, was emphasised by contributors.

A number of interviewees reinforced the need for timely and respectful processes for introducing national policy changes that impact directly on what happens at the local level. Early dialogue is important to ensure potential impacts could be worked through ahead of time, and potentially unworkable changes identified ahead of implementation phases.

	“’Top down’ and ‘bottom up’ dialogues during decision making processes can save a lot of angst.” “There needs to be better understanding about local collaborations and not-for-profit community providers and their place in the healthy homes landscape. We want to see engagement not control.” “As a government agency, it is sometimes hard to commit to projects given timeframes for making bids and budget processes and when the money comes in. I acknowledge that available funding can limit and vary the areas of coverage and how we might extend our healthy housing work.”

“’Top down’ and ‘bottom up’ dialogues during decision making processes can save a lot of angst.”

“There needs to be better understanding about local collaborations and not-for-profit community providers and their place in the healthy homes landscape. We want to see engagement not control.”

“As a government agency, it is sometimes hard to commit to projects given timeframes for making bids and budget processes and when the money comes in. I acknowledge that available funding can limit and vary the areas of coverage and how we might extend our healthy housing work.”

Inevitable tension when 'top down meets bottom up'

As noted in section six, conflict needs to be expected in the ‘top down/bottom up’ space, with processes put in place for dealing with conflict ahead of time.

In Northland, the tension around process and decision-making was tested when it came to deciding who would be funded to deliver local insulation retrofits and what weightings to use in the tender process. In the end, conflict was resolved and the experience in Northland is seen as positive learning for EECA, local agencies and community providers.

	“Trying to improve the attitude within EECA towards healthy homes partnerships is important. We need to be working with people and listening. A flexible principles-based approach, which makes time for relationships and local contexts, is ultimately more helpful than a rule-based one.” “In the end, the fact that the tender process included criteria around local track record and local employment outcomes gave us confidence that it was worth putting in a tender. We got loads of help from other community-based providers. The tender process also gave us a reason to forge a closer connection with another community organisation in the area that we had always had a relationship with, but had no real excuse to work with before now.”

“Trying to improve the attitude within EECA towards healthy homes partnerships is important. We need to be working with people and listening. A flexible principles-based approach, which makes time for relationships and local contexts, is ultimately more helpful than a rule-based one.”

“In the end, the fact that the tender process included criteria around local track record and local employment outcomes gave us confidence that it was worth putting in a tender. We got loads of help from other community-based providers. The tender process also gave us a reason to forge a closer connection with another community organisation in the area that we had always had a relationship with, but had no real excuse to work with before now.”

Commercial delivery models versus community sector delivery models

Unease between commercial and community sector-based models

Within the healthy homes sector, the growing tension between commercial and community sector-based models (39) of delivery was highlighted by almost everyone who contributed to this report. The unease was also evident at the 2008 Healthy Homes Hui.

At the heart of the debate is:

which kind of service provider or partner is best to deliver on outcomes
whether decisions on provider selection should be made on lowest unit price or weightings should also include other factors, such as local employment generation
community connections and networks
potential to ‘add-on’ other interventions within the same visit
willingness and ability to actively participate in sector development discussions.

Community sector providers

Some contributors to this report suggested community sector providers are more effective in providing retrofit services to lower income families and/or healthy homes initiatives that have a targeted locality focus, especially those servicing more rural communities. This is because community based service providers are more likely to have existing local networks and relationships to leverage from and are more focused on concurrent achievement of household and community outcomes, rather than profit for personal gain.

	“We saw the slim margins and still went for it. As long as we covered our costs, we knew there would be many wider benefits for our community including warmer, healthier houses and local employment.”

Insulation retrofits also tend to be one of a range of services and activities community based providers are involved with, strengthening the ability of community service providers to link across multiple initiatives and services to support lower income families and whānau. It is also recognised that healthy homes retrofit connections with lower income/high needs families tend to be made via local networking, word of mouth and personal referrals from trusted helpers or friends rather than broader marketing campaigns.

	“A lot of referrals in rural communities are about whānau networks and connections, knowing all the local key referral people and building up trust with them over a long time –they call and know we’ll be there to help.”

Commercial providers

In contrast, middle to higher income families were said to prefer to engage with commercial providers rather than community based ones. Some felt this was because these households wanted a more professional transactional service and saw commercial companies better able to deliver this. Others commented that higher income households are more likely to connect with healthy homes via large scale marketing and promotional campaigns that larger commercial companies are able to invest in.

	“In the big cities, it makes sense for private companies to do big mass marketing because there are so many people to reach. Higher income people read newspapers and use the internet and will respond more readily to these kinds of approaches.”

Support for commercial and community sector-based models to co-exist

At a national level, an EECA review of the EnergyWise Home Grants in 2007 noted the benefit of commercial and community sector providers delivering retrofits, with EECA itself continuing to fund both types of organisations.

The clear view from contributors to this report is that there is room for both models to co-exist and that both models need to be part of the future healthy homes landscape.

However, a lack of robust, open and transparent public debate about which type of delivery agent is preferred, when, and why, continues to cause significant nervousness and scare-mongering within the sector. This debate needs to be brought to the forefront and resolved.

Key issues within the community/commercial debate

Key issues within the debate that were raised by contributors to this report include:

lack of clarity and transparency within EECA and other large funders as to how they interpret and value the differing benefits of both community based and commercial models in different situations
perceptions that commercial providers are cheaper and therefore the preferred supplier of Government
perceptions that some commercial providers are currently intentionally undercutting prices, pushing not-for-profit community providers out of the market place, therefore becoming the preferred supplier (or the only supplier)
fears that in the long-term, commercial providers will significantly increase the price of installing insulation after they have a monopoly in the market place
lack of shared understanding of the added-value that community enterprises delivering retrofit services can have within local communities (i.e. income generated from retrofit contracts enables delivery on other local social, cultural, environmental and economic goals as profits are reinvested directly back into local communities)
the potential negative effects within communities if community delivery models are forced out of the market, as they have been already in some localities
time pressures for delivery that hinder effective dialogue and relationship building processes between commercial and community sectors
inconsistent information and direction about best quality and best value insulation products to use across the country (40).

Many of the challenges currently faced by community sector providers will also be true for private sector providers. It should be noted that commercial insulation installers were not interviewed in the preparation of this report. It will be important for their views and voices to be incorporated as the community sector/commercial model debate progresses.

	Comments for a community sector model include: “Funders need to understand that it is not just about the gain of one entity – contracting with a community-based organisation means local people are employed, we use local support services and if there is any profit it is used to support other community projects.” “It could be argued that the main benefit of ‘community based delivery’ is actually at the front end of projects – the conceptualisation of what is needed, partnership development, co-ordination across sectors, individual house and household scoping, and ongoing project management at a locality level.” “The advantage community-based providers have over commercial ones is networks. We have never had to spend money on marketing because of the networks and relationships we have in place. Word of mouth is everything – if you do a good job then others in the whānau network will come on board.”

Comments for a community sector model include:

“Funders need to understand that it is not just about the gain of one entity – contracting with a community-based organisation means local people are employed, we use local support services and if there is any profit it is used to support other community projects.”

“It could be argued that the main benefit of ‘community based delivery’ is actually at the front end of projects – the conceptualisation of what is needed, partnership development, co-ordination across sectors, individual house and household scoping, and ongoing project management at a locality level.”

“The advantage community-based providers have over commercial ones is networks. We have never had to spend money on marketing because of the networks and relationships we have in place. Word of mouth is everything – if you do a good job then others in the whānau network will come on board.”

	Comments for a commercial sector model, and finding room for both to co-exist, include: “There are issues of scale that matter here – competing on price and volume, being able to resource large scale social marketing campaigns, having the capacity to network and collaborate with other potential partners – the reality is that many small agencies do not have that breadth and depth of in-house capacity.” “There are some very good private operators working in the community, mostly with people who can afford that level of service.” “There is and needs to be, room for both commercial and community-based methods of delivery. I’d hate to see just one large commercial company left. We need to have lots of mid-sized firms and work on how we share and define our strengths and spaces together.” “There is scope for both models to work side by side. It is always good to look at what private sector businesses are doing and learn from (and potentially partner with them) too.” “We need some transparency around standard costs and prices. That would stop competition and rumour mills and provide some certainty to the sector. We also need to work out how to strike a subsidy rate nationally to allow for higher delivery costs in rural areas. It can be done. In the health sector, transparent population based health formulas have made things much fairer.” “I do wonder that when it comes down to just installing the retrofits, does it really matter whether installers are employed by an NGO or a private company? In some ways the current funding model might be enhancing the tensions?”

Comments for a commercial sector model, and finding room for both to co-exist, include:

“There are issues of scale that matter here – competing on price and volume, being able to resource large scale social marketing campaigns, having the capacity to network and collaborate with other potential partners – the reality is that many small agencies do not have that breadth and depth of in-house capacity.”

“There are some very good private operators working in the community, mostly with people who can afford that level of service.”

“There is and needs to be, room for both commercial and community-based methods of delivery. I’d hate to see just one large commercial company left. We need to have lots of mid-sized firms and work on how we share and define our strengths and spaces together.”

“There is scope for both models to work side by side. It is always good to look at what private sector businesses are doing and learn from (and potentially partner with them) too.”

“We need some transparency around standard costs and prices. That would stop competition and rumour mills and provide some certainty to the sector. We also need to work out how to strike a subsidy rate nationally to allow for higher delivery costs in rural areas. It can be done. In the health sector, transparent population based health formulas have made things much fairer.”

“I do wonder that when it comes down to just installing the retrofits, does it really matter whether installers are employed by an NGO or a private company? In some ways the current funding model might be enhancing the tensions?”

Community sector capacity

The need to have viable and sustainable commercial and community sectors working in complementary ways is essential for achieving healthy homes outcomes. While the important role of community sector enterprises is valued and acknowledged, there are key issues of capacity and support that need to be addressed if community sector partners are to sit as equals around healthy homes partnering tables. Issues around community sector capacity to effectively participate in partnering have also been noted in previous Putting Pen to Paper (41) reports.

	“It is hard for small community organisations to grow and build capacity while still focusing on the core work of retrofitting.” “Smaller community trusts have lower capacity to deliver in big numbers but what they do have is hugely supportive organisational philosophies and visions.” “It’s been a bit of a struggle to improve the capacity of the not-for-profit sector. It was hard for them to move from a target of 200 to 2000 homes - that requires a different kind of growth and investment strategy.” “EECA would like more capacity in the field but the funding is not there to support community organisations to grow and develop.”

“It is hard for small community organisations to grow and build capacity while still focusing on the core work of retrofitting.”

“Smaller community trusts have lower capacity to deliver in big numbers but what they do have is hugely supportive organisational philosophies and visions.”

“It’s been a bit of a struggle to improve the capacity of the not-for-profit sector. It was hard for them to move from a target of 200 to 2000 homes - that requires a different kind of growth and investment strategy.”

“EECA would like more capacity in the field but the funding is not there to support community organisations to grow and develop.”

Uncertainty of long-term funding

Underpinning the issue of sector capacity is uncertainty about long-term funding. This was seen as the most pressing issue effecting the ongoing growth and development of community sector service providers and their potential ability to both deliver larger volumes and a larger range of complementary services and added benefits.

	“The reality is that the community sector either has a feast or a famine – one minute they are gearing up to do $1 billion worth of retrofits, the next they are gearing down to only a few thousand. You cannot build a strong sector with that kind of uncertainty.” “We cannot think about growing our sector and add-ons until there is some security and certainty about funding. You cannot grow volume and organisational capacity without certainty around funding.” “With so much uncertainty around funding, there is not much scope to innovate. Having security of funding means that we can look at other things like borrowing against a five-year contract.” “If there was certainty of funding then community sector capacity could be stretched to invest in training and professional development, new plant and the like. With the current shifting of sands, there is no incentive to make that long term investment.”

“The reality is that the community sector either has a feast or a famine – one minute they are gearing up to do $1 billion worth of retrofits, the next they are gearing down to only a few thousand. You cannot build a strong sector with that kind of uncertainty.”

“We cannot think about growing our sector and add-ons until there is some security and certainty about funding. You cannot grow volume and organisational capacity without certainty around funding.”

“With so much uncertainty around funding, there is not much scope to innovate. Having security of funding means that we can look at other things like borrowing against a five-year contract.”

“If there was certainty of funding then community sector capacity could be stretched to invest in training and professional development, new plant and the like. With the current shifting of sands, there is no incentive to make that long term investment.”

Recent announcements of an agreement by the National Party and Green Party that they will work together to implement a nationwide home insulation programme and update New Zealand’s energy efficiency strategy was welcome news for all in the healthy homes sector (42).

Funding for home insulation was announced in the May 2009 Budget (43). This greater certainty around future funding streams is likely to generate renewed confidence and enthusiasm within the sector.

Reaching out to specific groups

Low-income households

It is generally recognised that those living in the coldest houses frequently earn lower incomes. These households also tend to have the highest health needs.

Despite insulation retrofits often being free for low income households, the incentive of no cost is not always able to entice these households to apply to have their home insulated. Some contributors reflected that New Zealand’s prevalent culture of cold was one of a number of barriers that need to be addressed collectively.

	“There is still a huge culture of whakamā (shame) for Māori families in coming forward and saying my house is not up to scratch or that we are poor. Many families distrust mainstream agencies who may recommend home insulation schemes – just because it is free is not enough.” “Evidence from the Bay of Plenty shows that self-referral models tend to attract more resourced, predominantly Pakeha participants.”

“There is still a huge culture of whakamā (shame) for Māori families in coming forward and saying my house is not up to scratch or that we are poor. Many families distrust mainstream agencies who may recommend home insulation schemes – just because it is free is not enough.”

“Evidence from the Bay of Plenty shows that self-referral models tend to attract more resourced, predominantly Pakeha participants.”

Contributors to this report strongly support the existing policies that target free or reduced-cost (44) retrofits to certain households. Targeting is judged as an appropriate way of ensuring best value from available resources. There is still debate as to whether it is better to provide a wider range of interventions to fewer selected houses, or a smaller number of interventions to a larger number of households.

	“From the health sector’s point of view, we need to be sure our effort is firmly focused on meeting the targeted need population of high deprivation and poor health.” “If we fix the substandard houses, over time, they will be lived in mostly by the poorest populations and people. These are the houses we should focus on first.” “We have got to peel off households and dwellings to get the biggest bang for our bucks. There are different levels of expenditure that bring different returns. In the warmer areas, do a bit of upgrading and target low-income earners – this brings a big return for a small investment. You get a big return for a small investment with a subsidy that is pitched right to medium income households. The reality is that there are also dwellings that need substantial retrofits because they are poorly maintained cold houses that need heating as well as insulation.”

“From the health sector’s point of view, we need to be sure our effort is firmly focused on meeting the targeted need population of high deprivation and poor health.”

“If we fix the substandard houses, over time, they will be lived in mostly by the poorest populations and people. These are the houses we should focus on first.”

“We have got to peel off households and dwellings to get the biggest bang for our bucks. There are different levels of expenditure that bring different returns. In the warmer areas, do a bit of upgrading and target low-income earners – this brings a big return for a small investment. You get a big return for a small investment with a subsidy that is pitched right to medium income households. The reality is that there are also dwellings that need substantial retrofits because they are poorly maintained cold houses that need heating as well as insulation.”

Understanding the best way to approach specific groups

Some contributors to this report emphasised the need to better understand what kind of approaches work best for which type of communities (e.g. rural, migrant, lower income, renters etc). Other contributors pointed out that priority also needs to be given to developing new, creative ways to more effectively engage.

	“Spread out rural communities are very different to urban ones, there are different factors at play. A lot of referrals up here come out of whānau networks and connections, we know all the key referral people and have built up trust with them over a long period of time. I imagine it is quite different in the cities.” “The biggest impact for us comes from word of mouth referrals and people who have seen or heard about the programme three or four times before – then they might ring up to apply. The other major influence is when the agency working with a family is really trusted – then what they recommend actually has some impact too.” “We need more staff capacity to assist Māori, Pacific and refugee and migrant families – these communities do not respond to flyers and social marketing in the same way.” “Contracting community based organisations to deliver locally to hard to target groups like Māori helps. In our case we work within a Māori cultural context, 90% of our staff are Māori. Contracting a Māori health provider who then sub-contracts to a large commercial firm to do the installations is not the same thing.” “What it meant in practice was that Raukawa Trust Board and the South Waikato Pacific Health Committee contracted community liaison officers to interface between the community and the service provider Energy Options. With clearly defined criteria, they recruited priority groups and referred them to Energy Options. The usual ‘phone 0800 to see if you’re eligible’ would never have worked in Tokoroa.” “In the first year anyone who fitted the criteria and applied was eligible, even though they did not necessarily meet the specified target group of Māori and Pacific. However in the second year, we are now exceeding our targets for these population groups. It is best to take a long-term view and not get hung up too early on the detail.”

“Spread out rural communities are very different to urban ones, there are different factors at play. A lot of referrals up here come out of whānau networks and connections, we know all the key referral people and have built up trust with them over a long period of time. I imagine it is quite different in the cities.”

“The biggest impact for us comes from word of mouth referrals and people who have seen or heard about the programme three or four times before – then they might ring up to apply. The other major influence is when the agency working with a family is really trusted – then what they recommend actually has some impact too.”

“We need more staff capacity to assist Māori, Pacific and refugee and migrant families – these communities do not respond to flyers and social marketing in the same way.”

“Contracting community based organisations to deliver locally to hard to target groups like Māori helps. In our case we work within a Māori cultural context, 90% of our staff are Māori. Contracting a Māori health provider who then sub-contracts to a large commercial firm to do the installations is not the same thing.”

“What it meant in practice was that Raukawa Trust Board and the South Waikato Pacific Health Committee contracted community liaison officers to interface between the community and the service provider Energy Options. With clearly defined criteria, they recruited priority groups and referred them to Energy Options. The usual ‘phone 0800 to see if you’re eligible’ would never have worked in Tokoroa.”

“In the first year anyone who fitted the criteria and applied was eligible, even though they did not necessarily meet the specified target group of Māori and Pacific. However in the second year, we are now exceeding our targets for these population groups. It is best to take a long-term view and not get hung up too early on the detail.”

Engaging landlords

It is not just low-income, high health-needs homeowners who were seen as hard to reach. Contributors to this report saw an even bigger challenge in engaging the rental or landlord sector.

	“I wonder if we should be focusing on incentives for people to insulate rather than just give subsidies. It would require some more policy thought but it is something we should be exploring.” “Landlords, both private and public, do not see healthy homes as a good long-term investment yet. We have got a lot to do to hook them in.” “There are subsidies available to landlords but more effort is needed to convince them and encourage take up. EECA is building relationships with developers’ associations and accountants to reach landlords, but it all takes time.” “It has been very hard to convince individuals that retrofitting is a good idea, let alone landlords. Insulation is not a visual thing so it does not compare to spending the same amount on a big screen TV that you see every day.”

“I wonder if we should be focusing on incentives for people to insulate rather than just give subsidies. It would require some more policy thought but it is something we should be exploring.”

“Landlords, both private and public, do not see healthy homes as a good long-term investment yet. We have got a lot to do to hook them in.”

“There are subsidies available to landlords but more effort is needed to convince them and encourage take up. EECA is building relationships with developers’ associations and accountants to reach landlords, but it all takes time.”

“It has been very hard to convince individuals that retrofitting is a good idea, let alone landlords. Insulation is not a visual thing so it does not compare to spending the same amount on a big screen TV that you see every day.”

On a positive note, EECA reports a considerable increase in landlord uptake of EECA’s retrofit scheme, with all 2008-09 funding committed.

(37) This is also a key conclusion of Better Connected Services for Kiwis project (http://ips.ac.nz) which concluded that “learning is at the heart of joining up the vertical and the horizontal through collaboration”

(38) For example some large organisations may be concurrently involved in any combination of funding, delivery, regulatory, referral, policy or strategy roles.

(39) Here this term refers both to not-for-profit community organisations and community enterprises. Community or social enterprises can be described as “…a business with primarily social objectives whose surpluses are principally reinvested for that purpose in the business or in the community, rather than being driven by the need to maximize profit for shareholders and owners.” The United Kingdom Department of Trade and Industry (2002). Community enterprises can also be seen as part of a community economic development approach which is defined as a process by which communities actively work to nurture opportunities to grow their local economy while producing social, cultural, environmental and/or employment benefits.” Lancaster Sue (2006) Innovative Communities, Master of Business Administration Project, University of Canterbury.

(40) The opportunity to further maximise employment benefits for New Zealand by sourcing all product locally (rather than installing overseas imports) was also noted by some contributors.

(41) See www.communityoutcomes.govt.nz

(42) Green Party Press Release 8 April 2009 – see www.greens.org.nz

(43) See www.beehive.govt.nz

(44) Low income households (usually those with community services cards) living in pre-2000 rental properties are also encouraged to apply for installation retrofits, with landlords receiving up to a 60% subsidy on the insulation upgrade.

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