Hoarding and how to approach it
Statutory powers and draft guidelines
Hoarding
and how to approach it
- a guide for EHOs and others
Statutory powers and draft guidelines
Revised from a presentation first made to the Royal Society of
Medicine in May 2004 by Dr Sarah Holroyd, then Consultant Clinical
Psychologist, Surrey Oaklands NHS Trust and Howard Price,
Principal Policy Officer, CIEH
Hoarding – statutory
powers
• mental health powers
- Mental Health Act 1983
• necessary for own or others’ health and safety and treatment
cannot be provided otherwise
- National Assistance Act 1948
• chronic disease, age, infirmity or incapacity
• insanitary conditions
• unable to devote proper care and attention and in the subject’s
interest
• European Convention on Human Rights
Hoarding – statutory
powers 2
• environmental health powers
from the treatment of hoarders to the treatment of hoarding
- complaints of smells, unsightliness or pests
may lead to a duty to investigate
- investigation may lead to a duty to intervene
- “health” powers and “amenity” powers
Hoarding – statutory
powers 3
• the “health” powers
- Public Health Act 1936
- “filthy and verminous premises”
- Environmental Protection Act 1990
- statutory nuisances, esp
“accumulations”
- Prevention of Damage by Pests Act 1949
– harbourage for rats and mice
Hoarding – statutory
powers 4
• the “amenity” powers
- Refuse Disposal (Amenity) Act 1978
- anything abandoned in the open air
- Town & Country Planning Act 1990
- adversely affecting amenity of area
- Environmental Protection Act 1990
- Litter Clearance Notices
Hoarding – statutory
powers 5
• the enforcement model – appropriate?
- complaint / observation / information
- enforcement criteria satisfied
- statutory notice (reasonable time)
- compliance enforced by prosecution / work in
default
• a rational model in irrational circumstances
Hoarding – statutory
powers 6
• pressures and constraints
- the “Respect Agenda”
- political pressures
- Ombudsman
- Human Rights Act / Convention
- disability discrimination?
A case study
The original complaint
• Oct 1993 – complaint of smell from
accumulation in rear garden
• abatement notice under Public Health
(Ireland) Act
• notice not complied with – summons issued
• nuisance order made – 10 days to clear up
A case study 2
Further complaints
• nuisance order ignored – further summons
• Oct 1994 – fine. Attempt at clearing up
• Feb 1997 – further complaints
• statutory notice not complied with
• court hearing adjourned – “good samaritan”
steps in
A case study 3
Inside
• complaints of mice – entry to house for first
time
• heavy infestation, rotting food etc
• statutory notice not complied with
• summons – conditional discharge and costs
• enforced by Work in Default – 11 skips!
A case study 4
Conclusion?
• problem recurred
• further court hearing in 2002
• house unfit for human habitation
• 7 EHOs, 19 court appearances, £14,000
of work
The survey
The subjects
• 77 local authorities
• 209 cases active during 2003
• Men and women in roughly equal numbers
• 52% over 60y, 8% under 40y
• 82% living alone, 5% with partner
• 86% not working
The survey 2
The subjects
• 27% substance abusers
• 16% physical disabilities
• 21% family separations, mainly bereavements
• 37% receiving any care etc
The survey 3
The nature of the hoarding
• 50% were multiple collectors
• 11% undifferentiated household refuse
• 5% newspapers and magazines
• 4% clothing
• 4% animals
• Mechanical / electrical goods: 9% men, 2% women
• Clothing: 6% women, 2% men
The survey 4
The effects
• 33% spilt over outside the home
• 55% affected others
• 86% significantly affected habitability
• 70% presented significant fire hazard
• 59% presented serious risk of personal harm
• 65% contributed to infestations
The survey 5
The response
• Social services involved in 49% of cases
• Community health services involved in 31%
of cases
• Landlords involved in 26% of cases
• Family / friends involved in 20%
• In 11% of cases, only EHOs were involved
The survey 6
The response
• Public Health Act - 27% of cases
• Environmental Protection Act - 15% of cases
• Pests Act used - 11% of cases
• Follow-up action needed in 23% of cases
• Rehousing in 24 cases
• Possession proceedings in 9 cases
• Animals removed in 9 cases
The survey 7
The outcome
• Effectiveness – short-term:
- statutory notices, rehousing,
removal of animals
• Effectiveness – long-term:
- social / mental health services,
informal support, combination
The survey 8
The outcome
• 52% of cases reported “resolved” within the
year
• 9% had recurred already, ie within months
• 44% had arisen before
• In 60%, EHOs expected to be called in again
The survey 9
Conclusion
• Small sample of authorities – diverse range of
cases
• Generally reflect the clinical picture
• EHOs’ powers provide temporary relief
• More hope from long-term, informal support
• Permanent resolution often remains elusive
Guidelines
Why?
• How best to approach cases in the future
• Reconcile conflict between duties and more
sensitive approaches
• Lead to higher long-term resolution rate
Guidelines 2
• Gather as much information as possible;
assess it carefully
• Do not make assumptions. Do not judge
• Rational arguments are not likely to succeed
Guidelines 3
• Try to see the hoarding through the subject’s
eyes; use neutral vocabulary
• Be clear about the goal and its justification
• Enlist help from family and friends if possible
Guidelines 4
• Know in advance what other help is available
• Be aware of the likelihood of recurrence;
revisit sooner rather than later
• Be aware of the need to refer where serious
risk of harm to subject or co-habitees or
animals
Hoarding
and how to approach it
The mission of the CIEH
is to promote the health
of people through
education, training and
knowledge.