The Victorian Healthy Homes Program

Rosalie Viney:

Good afternoon everybody, and welcome to this lovely space here at UTS. I'm Rosalie Viney. I'm the director of the Centre for Health Economics Research and Evaluation here at UTS, which is part of the INSIGHT Institute, which you'll hear more about in a moment. So that's an introduction to me.

I'd like to begin by acknowledging and paying my respects to Elders past and present, to those who have passed before us, and to the members of the Aboriginal and Torres Strait Islander community who are also attending here today. I want to acknowledge the Gadigal people of the Eora Nation, the traditional custodians of the lands on which the UTS campus stands, and acknowledge them as the holders of knowledge for these lands. I'd also like to acknowledge the traditional owners of the lands in Victoria on which this programme was delivered: the Bunurong, Wurundjeri, Wadawurrung and Taungurung Peoples of the Kulin Nation and the Yorta Yorta Peoples.

Before we start, I'll just give you a bit of a picture of the agenda. I'll introduce people in a moment. We're going to hear from a number of people. As I said, I'll introduce them before. Also need to do a little bit of housekeeping, so to say, in the event of an emergency, and I'm sure there will not be one, the exit is kind of obviously there and you proceed down the stairs and out into the main area. I'm just checking yes so we know that I've got that right.

It's a real pleasure to be able to have this seminar today to present the findings of what was a really exciting programme of research for us. I'm going to begin, so as I said here, I'll do some introductions and provide a bit of an overview of the project, and then we'll have some other speakers who are the researchers on the project presenting the findings. Then we'll also have the great pleasure of having Dr. Toby Cumming from Sustainability Victoria, who were the funders of this research and who delivered the programme to give us some insight into the implications as well.

What I'm going to do is begin by introducing Professor Susan Morton, who is the director of UTS's Institute for Innovative Solutions for Well-being and Health. This is a newly established institute and, CHERE is part of that institute. Susan has recently joined UTS from the University of Auckland to be the director of INSIGHT. She's a public health physician and a life course epidemiologist, so a really beautiful fit for our work. She has an outstanding track record. Notably, she was the foundation director and principal investigator of Growing Up in New Zealand, the longitudinal study of children's health and wellbeing. She's also a fabulous researcher. It's a great honour to have her to introduce this seminar and say a few words about how this work relates to the work of INSIGHT. Thank you, Susan.

Susan Morton:

Here you go. Well, thank you very, very much Rosalie. It's a real privilege to be here, and actually wonderful to probably be the last one in the door at UTS and yet the first one to be introducing this amazing seminar. It is super exciting to be here to lead this new institute called INSIGHT that Rosalie has just talked about. While INSIGHT wasn't in existence while this Victorian Healthy Homes project was underway, there are so many things about that project that actually act as an example of the sort of things that we are really excited to be taking forward at UTS and INSIGHT.

As many of you will know and you'll hear about today, the Victorian Healthy Homes project has been a really innovative project that has had some particular characteristics that fit really nicely with what INSIGHT is trying to achieve. Firstly, it's really a living example of how to address a wicked real-world problem. It has basically taken an issue, brought together multiple disciplines, multiple experts, multiple great minds together to work across multiple disciplines. So we've got health economics, we've got sustainability, energy research, we've got epidemiology, and together experts have come together to solve a wicked problem, the problem that exists for some of our vulnerable population, some of our older population who have chronic conditions, who are living with low income, who are energy poor sometimes, and who are struggling to actually be comfortable and to have good wellbeing.

This group of researchers have come together, and they've used their expertise to develop this project that you're going to hear about today. It has been incredibly successful. It's been successful because it's brought together experts across different disciplines and allowed them to actually work across traditional boundaries. It's also focused in on a vulnerable population. It's talked about things about the equity, so trying to address some of the issues that exist for some of our more vulnerable populations where they are missing out on some of the services that they actually need and deserve to actually give them good wellbeing and a good quality of life. So those things there, addressing inequity and also actually working across disciplines are some of the things that actually INSIGHT is wanting to take forward and this project has been a living example of that.

I think as well, there's been an important partnership at the heart of this project. The partnership with Sustainability Victoria has been really, really critical to the success of delivering this project and making a difference in these people's lives who are part of this randomised controlled trial, so a robust, scientific approach, but in partnership with external partners who are interested in the research and the findings as well. That partnership is also a key to the sorts of processes that we want to set up for the projects that go forward in INSIGHT.

I'm really excited to be able to be here today as perhaps one of the newest members of UTS to actually celebrate the success of this research that Rosalie and her team have led. I'm really excited to hear the results of what has gone on. I'm eager to hear all of the different pieces that have gone on. I'm thrilled that, despite COVID going on in the world, this project has succeeded, and I think that's testimony to the group of people who were committed to making sure that this innovative project actually took off.

It's really my great pleasure to have been able to introduce this team of people when I am so new to this institution, but I'm so excited about all the things that can be achieved here. I think today is just a really good example of the sort of work that we're able to do at this institution to actually really make a difference to people's lives. I'm going to hand back to Rosalie who's going to talk about the project in more detail. And just say thank you again for the opportunity to be here today and to celebrate the success of your project. Thanks.

Rosalie Viney:

Thank you, Susan, for that very enthusiastic introduction on your behalf. I'm going to begin by providing a brief overview of the study before other presenters go on to present the details of the research and then discuss the implications. As you've just heard, it's quite a complex project, and so we do have a number of presenters to reflect the different aspects of the project.

What I want to do before I do that is acknowledge the incredible and complex partnership that this research involved. As you can see from the number of logos on this slide, there were an incredible number of partners involved, from Sustainability Victoria who led the programme and commissioned the research, the local councils who were recruitment partners, the programme delivery partners who assessed the home and installed the upgrades, and then the liaison officers who actually undertook the home visits and data collection. So there was a lot of complexity in terms of that organisation. It also had a very large research team, all of whom are listed here and many of whom are here today, which is great to see. So we may call upon them to answer questions as well. I really want to thank them for all their work on making the project a success. As I said, the results will be presented by some members of the team. I'm going to, in the interests of streamlining, introduce them all now, and then they will seamlessly hand over to each other.

As I said, I'll start by giving an overview. Then Dr. Yo Han Kim, from the Institute for Sustainable Futures, will present some of the energy findings. Yo Han's a senior research consultant with expertise in data analytics and modelling at the Institute for Sustainable Futures, ISF. I think I'll say ISF from now. Then Dr. Katie Page. Katie's a senior research fellow with expertise in health services research at CHERE. She'll be presenting the health and economic outcomes. Then as I mentioned before, we're delighted to have Dr. Toby Cumming coming here. Toby's the programme lead from Sustainability Victoria and is the head of evaluation research at Sustainability Victoria. He's got also an incredible wealth of experience in health research before he joined Sustainability Victoria, so he was an ideal programme lead for this. Then associate professor Kerryn Wilmot, who's the programme lead for Healthy Environments at ISF, whose training was in architecture and who has extensive research and practical experience in sustainability, will discuss some of the implications.

With those introductions, so we are going to not introduce everybody over and again, I'll just go into some of the background. I guess the first question is, and it's relevant to us in Australia, why does cold temperature matter? There is evidence internationally that there's higher cold-related mortality in temperate regions, and we can see that from these examples there. Also, that thermal efficiency in homes is a major factor in that mortality. The WHO Housing and Health Guidelines recommend that indoor housing temperatures are greater than 18 degrees Celsius. There's international research that indicates that thermal insulation will improve health, but there isn't a lot of evidence in Australia. I probably don't need to say to anybody who lives in an Australian home that we have pretty poor quality housing stock for the purposes of maintaining thermal comfort. Everybody complains about draughts and draughty homes, even in warm places like Sydney or relatively warm places.

Just to give you a little bit of an overview of what the Victorian Healthy Homes programme is, it's a study that investigated how improvements in thermal performance of houses for low-income Victorians who had existing health or social care needs would impact on their thermal comfort. Would it improve thermal comfort in winter? Would it improve health and reduce healthcare costs? Would it reduce energy costs, and would it provide value for money? So those were the questions that we were asking overall.

What was involved in this, and I think this is an important feature of this programme, that it wasn't just a research programme, it was a delivery programme that actually delivered health benefits and energy benefits to people. A thousand households across Western Melbourne and Golden Valley were involved in this study, and I'll come to that in a moment. Those households were eligible for a free home upgrade. It was a relatively modest home upgrade, up to $3,500, with a focus on thermal comfort and energy efficiency during winter. What we mean by that is things like insulation, draught ceiling, efficient heating, window coverings. They're not like major upgrades to houses that really change them, but make important differences at a relatively low cost. As we've said, it was targeted at vulnerable populations. The mean age was 75 years, they were low income, and they often required home care services. So these were some of the eligibility criteria.

It's also a first-in-Australia randomised controlled trial investigating these questions. The process was that the household expressed interest and were deemed eligible. There was then questions of consent. Then there was a... I was going to say RES score, so I might as well say it now, residential energy scorecard visit to establish the quality of the house. Then the households were randomised to either receive the upgrade or to be on a wait list effectively. So the important thing about this is that the randomization was that people either received the home upgrade before winter or after winter. Everybody in the programme had their houses upgraded. But the randomization allowed us to evaluate the impact of the thermal upgrades or the home upgrades on thermal comfort during winter.

Just a schematic overview of that to show you. Effectively in the control group, they had a pre-winter visit, then they had winter, and then they had a post-winter visit survey, and then they had their home upgrade. Whereas the intervention group had the same things, but they had the upgrade before winter. Now I'm going to say that now, and just let you know a couple of other things.

As it happened, we ended up having recruitment over three winters. That wasn't what was originally intended, but for various reasons, it ended up being over three winters. You all know what's happened in the last three years or so in the world. So the three winters were 2018, 2019, and 2020. As you can see, the majority of the households were in the 2020 cohort. So those three cohorts all had the same thing, but that meant that there was a delay in a lot of the home upgrades in Victoria because of the very strict lockdown in Victoria. That means that some of our intervention households receive no or partial upgrades, and that reduce the overall sample size and the power of the analysis.

In the analysis that we've done, we've presented both intention to treat, so treating people as if they received the home upgrade, and then a per protocol analysis, taking account of whether the actual upgrade happened, and some of the results will be for various versions of that. But really we found consistency across both with just less power in the intention to treat. I'm now going to hand over to Yo Han to start presenting the research findings from an energy point of view.

Yo Han Kim:

I'll be representing on the energy outcomes that we've learned. Before we have to answer the question, we have to understand, we have to measure to find out. The first thing to understand the impact of intervention is, we have to understand the cold conditions that each household experiences, so we collected the external temperature data in 30-minute intervals from [inaudible 00:15:27]. Then we have to know the characteristics of each house that experiences this condition. This includes the overall quality of the home, which is measured by, as Rosalie said, the RES scorecard, which rates the house from one, very bad, to 10, as good as it can get. From that star rating data, we actually know the size of the house and other features such as the presence of solar panels that affects the energy consumption. So all of these factors have to be taken into account when we analyse the effective intervention.

Of course, we collected the amount of gas and electricity used by each household from the energy distributors. This is to understand just how much energy that each household used to fight against the cold weather. Finally, we have the primary measure of outcome, which is the internal temperature that is influenced by the combination of all of these factors on the left. Even though the title of this presentation is called Energy Outcomes, thermal comfort is actually the primary outcome measure. What really sets this project apart from other previous studies is that we considered the internal temperature, whereas previous studies only consider the energy consumption. Again, in summary, what we're trying to find out is just how much marginal impact the intervention makes on both energy use as well as internal temperature.

Basically, what did we find out? We found that interventions led to an increase of about 0.33 degrees in mean indoor temperature over winter, so a third of a degree. You might be thinking that this number is very small. Who knows what it feels, a third of a degree? But this means that each participant experiences actually about 43 minutes each day less below 18 degrees. As Rosalie has mentioned, 18 degrees is what WHO considers to be the threshold below which it is unhealthy living condition. That figure is actually also equivalent to saving about $33 in gas bills each winter. For most of us, $33, it's lunch money. But we have to keep in mind that these are vulnerable households with little to no income, and every dollar counts for them towards improving the quality of life.

It's worth noting that our cohort uses on average about 14 kilowatt hours of electricity per day. For those houses that only have electric heaters at home, using an extra one kilowatt hour per day, up from 14 to 15 kilowatt hours, actually only increases the mean indoor temperature by 0.08 degrees. So an indoor temperature increase of 0.33 degrees Celsius can save a great deal of energy consumption for those that only have electric heaters.

The next question then we want to answer was, what about the time of day? When do they actually receive this benefit? Since we are measuring the indoor temperature in half hour increments, we can analyse the temperature increase by time of day. We found that the intervention lead to highest increase during the mornings where it increases temperature by nearly half a degree on average compared to a third of a degree on average for the entire day. That's really good because we were originally interested in the mornings because it's usually the coldest time of day, as you might have experienced yourself. Studies have actually shown that cold mornings are associated with increased mortality rates more so than any other time of day. So it is especially important to improve morning temperature for vulnerable households, and we can see that the intervention actually does that.

Next question. Oops. Who benefits the most? We've asked when. Now we want to know who. This graph here actually shows the average indoor temperature by the RES star rating, so the numbers one to 10 in the bottom shows the quality of the home. We know that the average star rating for our cohort is about five, so you can see that those households below five, so that red box there, actually have very, very low indoor temperature. So these are the households that we need to target, that needs benefit more urgently from the intervention.

It is interesting really to note that for the one-star rating homes all the way on the left, the average indoor temperature is around 15 degrees throughout winter. So out of 1,000 homes, about 40 of them belong to this category. Ideally, we want to target those people on the left in the red box. Is that the case? Thankfully, what we found is that households with below average quality experience nearly double the increase in mean indoor temperature compared to better quality homes. So those who are in need do experience much more benefit from such intervention. That's what we found.

What about benefits beyond just the temperature increase? What kind of benefits can you expect? These were analysed from the survey results, two sets of surveys we did. We found that the intervention group is about 40% less likely to go to bed early to keep warm, and 57% less likely to use a portable electric heater to keep warm at night. So what we're seeing here is that the intervention is reducing really the worst form of keeping warm that are either detrimental to people's mental health or wellbeing, as well as really highly cost inefficient ways of heating. So we're seeing those benefits. The survey results also show that the intervention group is 37% more likely to report use of the main heater only when they're feeling cold. This reflects in the fact that houses with intervention have improved passive thermal performance, where they don't have to turn on their heater as much to stay equally warm. So they're saying, "We don't need a heater most of the time. It's only when it's really cold that we need turn it on." That's what we're seeing from the intervention.

That's about the thermal benefit. What about energy? Do interventions actually save energy? This is the more conventional question. Well, we found that actually intervention does not lead to reduction in electricity, but that's expected because most households use gas as their main heating in Victoria. In our participating household of 1,000, about 74% of them had gas as their main primary heater, and we do see a significant reduction in gas use by about 25 megajoules per day, which is equivalent to about 12% savings on average for each household.

Again, we asked this question, who benefits the most? This graph here shows the average gas consumption of our participants by the star rating, and that's the Victorian statewide average, that green line. Again, similar to indoor temperature. We can see that the below average homes in the box consume significantly higher amounts of gas per day, in fact, actually much higher than the state average. Again, we'd like to see more benefit going to them from the intervention. It's also again interesting to note that for the one-star rating households, there's actually a huge sudden drop. They used very little gas. This isn't because they have super nice efficient homes, but it's an indicator that it's a sign of energy poverty for the most vulnerable portion of our cohort. They just don't have the funds to even use gas heating. What we did find is that households with below average quality homes experience about 50% more gas savings, where they save about 70% as opposed to 12% on average. Again, the intervention is generating much higher benefit to those who are more in need. That's what we found.

To sum it up, what we first found is that the home upgrades do improve thermal comfort and energy use for vulnerable households. We see the biggest benefit during the mornings, which is what we'd like to see. Again, below average poor quality dwellings benefit significantly more from intervention, about twice as much in terms of thermal benefit and about 1.5 times for energy benefit. That's my presentation. I would like to bring on Katie for the next section.

Katie Page:

Good afternoon. My name's Katie Page. I'm presenting the health outcomes, costs, and implementation lessons. This is very much on behalf of the large CHERE team who were involved in this project over several years. "I wouldn't have family come and visit me in winter because my house was too cold. Here I am, sitting under a split system with visitors, how good is that? In the middle of winter? So this is great. I've got my life back." "This has made it a lot more comfortable, a lot warmer, a lot safer in my head, in my mind, because I feel like nothing can hurt me when I'm home." These two quotes from participants who were part of our Healthy Homes programme beautifully capture the qualitative and significant impact that programmes such as this can have on people's lives. But how do we measure these benefits to health and wellbeing? That's what I'm going to discuss today.

In this post-pandemic world, we spend significantly more time in our homes than we did previously. Therefore, I guess it's increasingly important that our homes are comfortable, warm, and safe spaces. Previous research shows that spending time in cold and damp homes can lead to a range of undesirable health outcomes. Specifically, it's been linked to poorer physical health, with respiratory and cardiovascular outcomes being worse. International evidence also suggests there's a link between cold homes and poorer mental health outcomes. Overall, when we have poorer physical and mental health, this leads to a decline in our overall wellbeing, satisfaction, and happiness with life. So vulnerable people, who were the sample in our population, including the elderly and those with a disability and a chronic health illness are at higher risk because they are likely to spend more time in their homes and, therefore, be more exposed to these risks associated with cold homes.

Now, Yo Han's nicely outlined the numerous energy benefits that resulted from this programme, but we really wanted to look at the co-benefits, of which the greatest of those, which is health. What are the health questions we wanted to answer? First of all, we're really interested in self-reported health. Do people after having an upgrade actually report feeling better after a winter home upgrade? Do they go to their GP more or less than they did before? Is their hospital use similar? Do they use more or less prescription medication? Importantly, do they still engage in their usual activities to the same extent as they did before? Do their existing health conditions, of which they have a number, improve or deteriorate? And importantly, do they spend less money on healthcare?

In addition to the health questions, because we're a group of health economists, we also wanted to measure the cost and the cost effectiveness of this programme, so we had a number of questions around the costs. So first of all, how much did the programme cost overall? Specifically, how much were the upgrades. Is the programme good value for money? Ultimately, do the benefits of the programme outweigh the costs? In order to do this, we had both a cost consequence analysis, where each outcome is compared to the costs individually, and also a cost benefit or a cost versus cost savings approach, where we put some of the benefits into dollars and make the comparison with the overall costs.

How do we go about answering these questions? Well, we had two types of data. First of all, we had survey data, self-reported data. As Rosalie had mentioned, there were two surveys, a before-winter survey and an after winter survey. This allowed us to link responses over time before and after winter for both the intervention and the control groups. What did we measure in these surveys? We had a range of quality of life instruments, which I'll talk about more in a moment. We also asked them about their existing health conditions, both their severity and duration of those conditions. Lastly and importantly, we ask them about their daily activities. Because it's an older population, we were interested in the usual activities, but if they were studying or working as well, we also asked them about those things.

Then the second type of data we gathered, health data, was routinely collected administrative health data. We gathered these data over a large period of time from May, 2015, up to December, 2021. This is quite a long period of time, but it was important for us to be able to understand what was happening to their health prior and then also afterwards. We can also account for seasonality in the data when we've got this longevity of data. So what data did we gather? We had Medicare data, so the MBS data, Medicare Benefits Scheme. We also had hospital data, both emergency admissions data and also planned hospital admissions. We had their prescription use from the Pharmaceutical Benefits Scheme. Lastly and importantly, we had in all these data sets costing data so we could cost out these services.

I'll just talk more about quality of life. What quality of life instruments did we measure? How do we measure them, and what did we find? We had three different quality of life instruments. The first of those was the EQ-5D, which is a very widely used and a quite general measure of quality of life. It measures health on five different domains. It asks about their health on the day at which they complete the survey. An interesting finding from this particular instrument was that it showed us that this particular cohort of people had a much significant poorer quality of life than the average population over 75 in Australia. But we didn't find any significant differences between the control and the intervention group on this particular measure. This is perhaps not surprising or unexpected because we're only looking over such a short duration, and this measure's often used over a longer period of time.

The second quality of life measure we looked at was the SF-36. This measures health on eight different domains and has two component scores in the end: a physical health component and a mental health component. Importantly, we were able to show that the mental health score of people in the intervention group was significantly better than those in the control group. This particular measure asks about health in the past four weeks. There was no difference in relation to physical health.

Then the last quality of life measure is the ASCOT. This is a social care related quality of life measure, which was particularly important for our sample. We found that for the mean score, we saw a significant increase over the winter period in the intervention group and not in the control group. As you can see here, the domains which are measured, hopefully you can see it on the screen, are very relevant to this population. They ask about accommodation, dignity, social activities. So overall with quality of life, we have quite positive findings, and we show improvements in mental health and social care related quality of life.

What about other conditions I mentioned? We had a measure of breathlessness, so respiratory health, and we were able to show that those in the intervention group had a significant improvement such that it went from 26% to 36% of people in that group who were reporting no problems with breathing, with no significant increase in the control group. Also, people who had had their upgrade in the intervention group reported having to spend less time away from their social activities, about two days on average, over the winter period. Importantly, they were less likely to delay seeing a specialist, which is important.

What about healthcare service use and cost? The intervention group used less MBS services over winter, about 2.6 over that winter period compared to the control group. In the high service users, so for the intervention groups, about 15 services a month, whereas in the control group it's about 12, the total healthcare costs in the two groups were significantly different. So that is over the whole winter period, about $887 over winter in the intervention group compared to the control group. It's important to note though, you saw that this programme happens over three winters, 2018, 2019, 2020. We saw a significant drop in all services in the 2020 year, as you would expect, which was driven by the likely effect of COVID-19. But we do think that this drop in utilisation for that period of time may help explain some of the lack of significance in the other outcomes which were all trending in the right direction, but sometimes they didn't reach significance. Interestingly, there was no difference in the two groups for prescription use of medications. That didn't change. Also, there were no differences in hospital outcomes, admissions, emergency or otherwise.

One thing I'd like to stress here though is that these findings and all the findings we present here today are only considering the three-month winter period, because it's the RCT design, but it's highly likely that the health benefits of such a programme endure and go beyond that three-month period. Those additional benefits are not captured in these estimates.

What did the programme cost? I have to say that this programme was somewhat challenging to cost with great accuracy because it was quite a complex programme spanning several years, as you heard, with lots of different stakeholders. However, we decided in the end that the best approach was to break it down into cost phases, as we've called them. We called them cost buckets here. Each of these stages represent distinct steps or stages, phases in the programme.

What we've called development costs here, which is about $450,000, this was really kind of the first 18 months of the programme. This includes the necessary steps and requirements to enable the programme to actually commence. It's a lot of startup kind of costs. That happened during this time period. It included a lot of legal and communications along with the staff time needed to make this programme happen. We then had a second phase of costs, which we call the establishment costs. This was about $780,000. This was over a 12-month period. Included things like auditing, risk management, promotional materials, contracts, staff time, etc. So this was really the organisation to get the first set of households up and running and to get the programme off the ground and started. Then the third phase we've called the expansion costs. This was the largest phase and the most costly part of the programme where we really got things up and running. We were expanding the programme out to the remaining households. So this equates to about $2.7 million.

Of course, which we haven't touched on yet, there's the cost of the actual upgrades themselves. I think Rosalie mentioned, it was up to $3,500. But in the end there were some adjustments, and the total average cost of the upgrades were about $2,800 per household. So taken together, we had costs coming from both the delivery partner, from the Australian Energy Foundation, AEF and also costs from Sustainability Victoria. The way in which we conceptualised this was to make it at a per household level, so how much does it cost per household? So we took costs from the expansion, and we took costs from the upgrade. This yielded a total cost of approximately $5,500 per household, which, when we multiply that out obviously by 1,000 households, yields a programme cost when we're just considering expansion phase of $5.5 million.

This is important from a health economic perspective because we're really interested only in the marginal costs of expanding this programme out to further homes. You may ask yourself why we eliminated these first costs, why don't we include them? But a lot of them are fixed costs. We think we're only going to incur them once. So we're interested more in the marginal costs. I should also note that is a full societal cost. It's not the out-of-pocket costs to the householder. All of the costs of the research, which of course there were many, they were excluded from this estimate as well.

Then I guess the natural question is to ask yourselves, well, if it cost $5,500 per household, is this a good use of the money given the cost savings that we are generating, or that Yo Han and I have mentioned so far? So this is fairly... It's some cost savings, so not the full cost benefit analysis. But if you take the total costs, $5,500, and you project that out using the cost savings from both the health and the energy, you can look at the time at which the programme starts to pay for itself. If you take the full programme costs, that's before year seven, so between year six and year seven. There's also, I guess, a case to be made for if we do that, but only with the upgrade costs, so if we eliminate some of the programme costs, how long does the programme take to pay for itself? It becomes cost neutral in under three years, so between two and three years.

It is worth noting again here though that we've only captured a small amount of the benefit in this particular picture, those that come from the health, which I showed you from MBS/PBS, and also from the energy that Yo Han mentioned. There are many other benefits which are not monetized and put into this estimate. So I think we would argue that this is a fairly conservative estimate, and we're likely to be underestimating the benefits. More over the benefits, the upgrade is a kind of permanent change to the household, and these benefits are going to continue over time.

I'll just change tack now a little bit because this is a kind of passion of mine, I guess. Because it was such a large and complex programme, we really wanted to get a greater understanding of what worked really well and why and perhaps what could be improved in the future. So we did a retrospective evaluation of the implementation. This involved interviewing 14 people from various delivery partners, the research partners, and Sustainability Victoria. We conducted a thematic analysis of the different factors that we thought were driving the successful implementation, also lessons that we could learn.

I'll just cover this briefly. I won't go into too much detail. Just from each of the different partners involved, so from the delivery partners' perspective, we think that regular communication with the householders about the process, about the nature of the upgrade, particularly between the pre and the post when the upgrade is very important and highly beneficial to such programmes. Also, we discovered that investment in really good high-quality record keeping is essential in order to keep track of everybody and to make sure everything is going as planned.

From the research point of view, so from our point of view, it was very important to streamline and to minimise the response burden. This was in part driven by the nature of the sample, the vulnerable elderly population. Also, it's important to pilot these kinds of programmes with this on a very small scale in order to learn the lessons and to iron out any problems in advance.

Lastly, from a kind of government point of view, an interesting take-home message, I guess, is there's a real need for greater workforce capacity in this space. It was often difficult to find the trades people to do these retrofits. So if these kinds of programmes are going to be rolled out on a wider scale, there's a definite need to upskill people in this area and for governments to invest in this workforce capacity. I guess, like any big kind of government programme, it's very important, we can't predict what external factors are going to impact a priori, so project and budget contingencies are really needed to be embedded for these kinds of external, unpredictable forces.

I'll just leave you with some take home messages. This programme, we believe, is very good value for money. It pays for itself in under three years if you consider upgrade costs and for the full programme costs in under seven years. Very importantly, the health savings were 10 times those of the energy savings. As I've said a few times, these results we've presented here today only cover this three-month winter period, so we really do think we're underestimating the benefits because they're likely to endure over time.

I've only talked about the health overall. Some future work we're going to do, which we might allude to, is looking more specifically at health-related conditions like cardiovascular, respiratory, and mental health where the links between the cold homes and the outcomes are clearer, but at the moment they're all together. RCT evidence, as we know, is paramount for getting a good evidence base, but there are significant challenges when doing it inside a government programme where there are a lot of external and contextual factors which impact success.

I'll just leave you with this, that investments in such housing programmes are really paramount to combat both rising energy and health costs and to maximise the health and wellbeing of our older and more vulnerable populations. This research is really important. It's provided a really solid evidence base on which to base future home upgrade programmes. We, in the process, have also learned a significant amount about what works well and also why. Both of these aspects are really fundamental to ensuring a warm, safe house, and happy and healthy populations. Thank you very much.

Toby Cumming:

Thanks, Katie. I'm Toby. It's really great to be here. This feels like the culmination of years and years of work from a lot of different people. This is actually my first time to UTS. I feel like I've had years on the other end of a video conference to UTS but never in person, so it's really good to be here. I just wanted to mention, too, that Adam Shalekoff is in the audience, if you just want to put your hand up, Adam. Adam was actually part of the SV project team before I was. So maybe after the session when you're having a drink, seek out Adam, and hear the real true story of how this played out.

Anyone that knows me knows I'm mad for data, but as Katie flagged, there were some really important personal stories as part of this programme. I think the innovative part is that it was a randomised control trial embedded in a delivery programme. Government doesn't usually do that. I think having UTS as our research partner, given that they crossed over between energy and health economics was just a really productive collaboration, and it worked really well.

But stepping away from the data a bit and getting back to those quotes, I wanted to talk a bit more about the participants. Here you see, well, Matt Genever, our CEO at SV, with one of our householders, Heather, and you can see the split system behind her. Heather had an all-electric house for various reasons, always been all-electric. She had a couple of very inefficient heat banks that sat there and didn't get the house much above 13 or 14 degrees and yet used a lot of electricity. So you can see there, what we did was pull those two heat banks out, put in one pretty big split system because she had a very open living area/kitchen. But the before and after kilowatt hours per day there went from 43 to 11 over winter. So you can see the enormous difference. Actually, while that translated into a huge saving for her, like we're talking $650 down to $250 for a single pensioner is a massive saving in winter, the really impressive thing were the health benefits. Here's a couple of quotes. She was totally crossed the numbers, knew every dot and dollar in her bill. She's excited to get her bills. "It's such a funny turnaround."

But actually quite apart from the health benefits that we've talked about, the really solid linked administrative data from health, one of the things that Heather said was actually she was going outside more in winter. Before, she felt like she had to stay inside. The heat banks was costing her so much. She knew she couldn't leave the house because she had to be in her lounge room because she knew how much she was paying for that weak attempt at warmth. With the split system, because it was so much more responsive, she was happy to be outside during the middle of the day in her garden, come in 4 o'clock, put the split system on for a couple of hours, heat up the house. So I would argue there's even more to the health benefits that we didn't necessarily quantify.

Carol was another very interesting participant. She had a long history of physical and mental health problems. We did quite a comparatively comprehensive upgrade to her house, so curtains, draught ceiling. Here the split system actually wasn't in the living area. We normally concentrate on the living area. But Carol's problem was transferring from her wheelchair into the shower in the mornings. It took her a long time. She moves pretty slowly, and she was just too cold. So they actually asked for a small split system in the bathroom, and we agreed. We thought, yep, this is a good idea, and it really changed her life.

"I want to stay as independent as I possibly can. Staying warm is the best thing." The physical translated into the mental for her. As Katie's quote showed, she really felt like home was a sanctuary. When it was warm, it was a really safe place to be and that really kept her anxiety and her PTSD at play. So I would argue if you're thinking about these home upgrades as an energy intervention, you're thinking about it all wrong. It's a public health intervention, what we're doing here, that also has some energy co-benefits.

Getting onto the implications, because the whole idea for doing this study was to put some really rigorous evidence behind what we should go and do. What are we doing now? Can we scale this up? Can we use these data for good? That's the whole idea. Going back a little step on the Victorian context, I realise I'm not in Victoria here, and there are actually some meaningful differences. For example, Victoria's much more reliant on gas for heating in winter than New South Wales is. Parts of New South Wales get pretty cold, but our reticulated system and that cheap gas and gas rate just meant we are very reliant on gas for winter heating.

We've got about two and a half million households. We know that more than half of them were built before 1990, which is when any energy standards came in. So this is a really huge issue. We're going from six to seven stars in new builds. Meanwhile, we have more than half of the houses out there that are less than two stars. That's really what Healthy Homes was trying to address. But really a thousand is a drop in the ocean. What are we doing with these other median homes that we know about?

Importantly, Victoria's pretty cool. About two thirds of the year is spent under 18 degrees if you just don't heat the house at all. So we've got heating needs for a while to come even with climate change. On gas, this is just a quick graph. All I want you to concentrate on is that light blue line that's going up and getting higher than everything else. That's residential gas use in Victoria. So while we're trying to do our best to get off gas, it's still going up, and that's part of the issue we're trying to address here.

What have we learned? In a sentence, I think Healthy Homes has told us that a minor thermal shell upgrade can raise indoor temperatures while significantly reducing gas use and improving health and quality of life of householders. I think that's a pretty impressive intervention. In government, when we have these conversations, the really important thing that came out of Healthy Homes are the health cost savings. This is where we can argue the cost benefit. These are the savings between the control and intervention group broken down by year there, 2018, 2019, 2020. You can see pretty consistent healthcare costs savings to the intervention group across the board. When I go and talk to the Department of Treasury and Finance, this is the sort of information that I'm giving them. Actually, going on from Katie's graph, this is another way of putting the upgrade cost and savings over a 10-year span. This is what I talk about. This is what you can expect savings in the health system to be.

The other really important thing to fall back on as well as the randomised trial design is the fact that they're linked health data. When I talk to the Department of Health, they appreciate that it's not just self-reported health data. It's robust, administrative linked health data, and that is a real positive in the argument to get this scaled up across more households. That's it from me. I'll pass over to Kerryn.

Kerryn Wilmot:

Thanks, Toby. Thanks everyone. I'm not as tall as him. Thanks to our research team for summarising the project finding so far. You can see that we collected a lot of data. It's a rare opportunity to have such a rich data set that allows us to combine information about health and energy and temperature and behaviour, so we've really only touched, skimmed the surface of it. There's a lot more that could be discovered out of the data that we've got.

To give you an idea of what we'd like to do with the data, if only we can get the chance, the health team's already mentioned that they've got a lot more health data than we've currently investigated, so there's more opportunities there to see just what the impact is on the health of the participants. We also really looked at the energy and the health as separate bits of information. So it would be great to look at the correlation of the temperature on the health and wellbeing of the participants to see if we can actually track that relationship.

For those of us in the energy efficiency and the built environment sector to examine the occupant behaviour relating to keeping warm and to saving energy would give us some interesting insights. We're also interested in looking for evidence of the rebound effect. Can we prove that some people took the benefit in warmth and others took the benefit in energy savings? There's a lot of assumptions around this in the sector, but it's hard to prove, and we think we've got enough complex data that we might be able to see that. So that was work we'd like to do in the future with the data from this project.

I'm also interested in what it means for other work in this sector. The Healthy Homes, because it gave us the hard evidence on the benefits to the occupants of the better quality homes and it also gave us a little bit of information regarding housing policy and programme design, so the question is, how can it be applied? Do we really need to do anything more with this sort of information?

As Toby was talking about in Victoria, the quality of our homes is really poor. In fact, the data that I extracted showed that Victoria has nearly 1.4 million homes that are below the average of 2.1 stars. Just at the moment, until the level goes up to seven stars in September, six stars is the level for new homes. We've got over two million homes in Victoria that are under six stars, so there's a huge number of homes that are ripe for upgrade and needing it. There's a lot of discussion in the press at the moment about poor quality housing. With the rental crisis, renters are being forced into increasingly poorer quality homes. There's a huge need out there where people haven't got any choice about where they're living and how they're living. All of our discussion really has been around upgrades for thermal comfort and a bit of energy efficiency. I know the sector's talking a lot now about decarbonization and electrification as well as bigger pictures of energy efficiency, and they're all so closely related that all of this evidence is relevant to that way of thinking.

When we're looking at this huge need, we've got a dire need. We know that we've got benefits. The question then is, how do we do it at scale? Because there's a lot to be done. We can't just do a handful of houses at a time. We've got to look at how to upgrade the whole housing stock. We're involved in a whole bunch of projects that are trying to look at those questions. What is it needed to do it at scale, and can we test it out? I've listed four on the screen there where we're involved or have been involved in trying to define what the need is and then trial how to do an upgrade programme or scheme that has the ability to be picked up and run with and operated at scale. There's a lot of requirements in there.

Because we're sort of talking about this, we've identified there are other things that could be done even beyond the idea of upgrades at scale, the more researchy questions. A couple of examples here. One is our cohort for this project was vulnerable people, but can we also show health and wellbeing benefits from a healthier population? Just what happens if it happens across the general population? Of course being in Australia, we're interested in whether we can demonstrate benefits for upgrades against extreme heat. Obviously for Western Sydney, that's a massive issue. So we're interested in seeing if we could perhaps replicate this project in that different context and get matching data for that. So lots of opportunities, lots of needs. I shall hand you back to Rosalie.

Rosalie Viney:

Thank you to all of our speakers. I think they've given you a really fantastic overview of the programme. This is an opportunity now for you to ask any questions. I might get our four speakers to come and sit up on the chairs here just because I like making people climb up on here again. We do have some people with roving mics. I can see a question over there.

Speaker 7:

Oh, hello. Your last point about the future with this, and of course you said what I was going to say, which is, what about a matching research project in Western Sydney? Because over the last month, I don't need to tell you, people had to leave their homes and shelter with relatives because they were just burning up in there. Hospitalisation was through the roof. None of this was particularly reported, but through family networks you heard about it, so it was quite serious. It would just seem to me the opportunity, especially with UTS in the hub of this, I don't know whether there's a Sustainability New South Wales, I presume there is, but you would think that would be just an automatic next step and with an enormous cost saving in the whole process.

Rosalie Viney:

You might hope that a new government coming in is looking for programmes.

Kerryn Wilmot:

The challenges of increasing heat are recognised. There's a lot of work in the space with a particular focus on Western Sydney. But as you heard from Toby, having the hard evidence can be used inside government to make changes. It could be a legislative change, it could be a policy change, or it could be an impetus for a programme. So we believe that having that data is powerful. We would like to do that work. If you could find somebody to fund us, we're in there.

Speaker 7:

Well, that's again... Sorry, a follow-up thing on the funding because that wasn't totally clear. There's obviously government money in there. As usual, what was really, if you like, the driver for getting it funded properly?

Rosalie Viney:

Maybe Toby might be the right person to answer that question.

Toby Cumming:

The driver really went back to the New Zealand research that happened in '07 and '08 from Philippa Howden-Chapman's group with some really impressive epidemiological work showing that minimal insulation and efficient heating going into houses there, their temperatures were lower than ours. Some of those houses were averaging 13 or 14 degrees, really quite unhealthy. Lots of mould. They showed really impressive health effects. Kids going to school more, adults going to work more, less wheezing, cardiorespiratory stuff. So the Victorian Healthy Home study really was off the back of that. People think Australia's warmer than New Zealand, but when you actually look at the cold-related mortality and health effects, it's greater than the heat-related effects. Some of the heat related stuff's pretty visible. But I think what Healthy Homes brought home is that even in temperate areas where you think cold is not a problem, being too cold for four months of the year, even slightly too cold is a health problem.

But I totally take your point. We should be addressing heat as well. Probably a very good way to do that is to focus on efficient heating and split systems that can cool your home in summer and heat your home in winter while also helping us get off gas. But I'd love to see some data in the Australian context on reducing heat in homes.

Rosalie Viney:

Other questions? I think there was... I can see one there, there, and someone over here.

Speaker 8:

I'm just interested in whether the teams thought about the opportunities for following up with the cohort that you've been researching, particularly in regards to the linked health data. Obviously, you no longer have this control group, but there are other ways of kind of baselining, and whether you can follow that cohort forward through the health data and see if those health benefits are maintained over time.

Rosalie Viney:

Do you want to answer that Katie, or do you want me to?

Katie Page:

[inaudible 01:05:04]. Thank you for that. We have thought about it. Embedded into the project, we had permission to get data for the cohort up until a year post their upgrade. As it turns out, because it was staggered over the three years, '18, '19, '20, we do have longer follow up for the earlier cohort, but at present we don't have the consent or the permissions to go beyond 2021. And we're still waiting for some data to come in. But it is very much our intention to look at these effects over time. Something I didn't present today was we've also looked at death data as well because this is an elderly... the average age was 75 years. So that's something we're going to look more at when we've got some more data. Do you want to say something more, or is it on that?

Rosalie Viney:

The only other thing I was going to say is we did take the opportunity to ask the later cohorts whether we could follow them up, particularly in relation to COVID.

Katie Page:

Oh, yes, that's right. In the last wave of the survey, we added in some extra questions which were COVID-related questions. Again, we didn't present those today. At the moment, we can't go beyond the end of 2021.

Rosalie Viney:

Other questions? There's somebody here, and then... Yes, you've been patiently putting your hand up each time.

Speaker 9:

Can you advise us on the range of housing you actually looked at? Because you've got the inner city area of Melbourne, which is Victorian, federation-type housing, and then you've got what I'd call the mass-produced spec housing or project housing that Sydney's got, which is brick veneer and poorly insulated. But there's a big difference between a seven-foot ceiling and a 13 or 14-foot ceiling in a house. So what sort of range of housing did the study undertake?

Rosalie Viney:

Perhaps between Kerryn and Toby.

Toby Cumming:

Is that on? Yeah? It's a really good question. Actually, our eligibility criteria didn't specify anything about the house. It was about the person. It was low income and chronic health or social care needs, so it was really focusing on a vulnerable population. There was nothing necessarily to stop them having a 10-star house and still getting into the programme, so it meant we had quite a variance in housing types. In some of the newer parts of Western Melbourne, it was a little bit challenging to find the right upgrade because some of these houses were built in 2010. They did have energy standards and their ceiling was well insulated. Often that upgrade was more a split system upgrade or something like that.

In terms of the housing type, I would say it was all types, pretty leaky, brick veneer, weatherboard. It was really good to have the Golden Valley as a slightly different focus, different climate zone and different housing type. But one of the challenges of a programme like this is that no intervention's the same. You go into every individual house, you individualise every upgrade according to what it needs, and we saw everything really.

Rosalie Viney:

Did you want to add to that Kerryn?

Kerryn Wilmot:

No, I think that's answered. We did have the full range. I think some of the people were income poor but asset rich. They were retirees that had maintained their homes well over time, which is why we had good quality homes in the programme. As Yo Han's data showed, we had everything from one to 10 stars represented. I think Western Melbourne had quite a range of old and recent houses, and the Golden Valley had, to generalise, older stock. So one of the lessons was a future programme should have the quality of the home as one of its eligibility criteria.

Rosalie Viney:

Thanks. The person down the front here.

Speaker 10:

My question is, how do you see the possibilities of using maybe in the future smart technologies or sensors to help these people, maybe like a simple mobile application connected to...? I mean, it's a bit too technical. My question is, do you see it's possible given that probably these vulnerable people are not very highly educated or very old, not very familiar with all these tech things? There are opportunities to use these sort of technology to help them maybe just better use their energy, maybe shift from the high demand energy usage to less high demand and give them those sort of information. This is possible?

Kerryn Wilmot:

I think we're open to anything that helps. Some of those other projects that we're working on are looking at a much broader range of interventions that would include solar and other things. So if we could see a useful application, it's not off the cards, but the reality was for this particular cohort, I reckon that it'd be beyond them. Even just answering the surveys, doing phone conversations, it was a lot of stress on them for even participating in this programme. So I think you have to pick your participants for that sort of thing. But I think there's room for that in the future.

Rosalie Viney:

One of the interesting things that we found early we learned in this programme was that the energy liaison officers who were doing the surveys and looking at the energy bills were people who actually kind of do that for a living. Their temptation was to say, "Oh, I could save you with energy costs." There was a question about whether should that happen because it would impact upon the results. There are obviously lots of different ways that you can improve wellbeing for people. I think there was a question over here.

Speaker 11:

Two quick... I'm sorry. Two quick questions if I may. Firstly, the ownership of the selected properties, were some of those private not public? Secondly, insulation is, in my observation and experience, the quickest money saver cost benefit for improving thermal efficiency. I didn't see that mentioned in this talk. Was there any inclusion of that in the study?

Rosalie Viney:

Insulation was one of the upgrades. As Toby said, it was tailored to the house to what was needed, and that was one of the possible upgrades. Then maybe just quickly... No, Toby, you go.

Toby Cumming:

Insulation was actually a very big part of it. We had a priority list, and insulation and draught ceiling were at the top of that list for bang for buck, for thermal envelope. What was the first part? Oh, ownership of the house. We were actually surprised, as Rosalie mentioned I think, quite a lot of this cohort were asset rich/income poor, so retirees, pensioners that owned their homes, I can't remember the exact numbers, but it was like 60% or 70%. We didn't exclude other occupancy types. So there were tenants here. There were social housing tenants here. That comes with its own complexities of getting upgrades approved with another layer. But we wanted to be as open as possible, and yet still we had quite a few older people who owned their home.

Rosalie Viney:

There's a question down the front here and one up the back and over in the corner.

Speaker 12:

Hi. Can I ask about temperature monitoring in the houses? Was there only a single point of measurement, or were there any other measures like radiant comfort?

Yo Han Kim:

We only had one centre that was located in the main living room area, so we measured that. That was one of the limitations. If we had more sensors, that would give us some better insight in the future, yeah, for sure.

Rosalie Viney:

A question over the back and down the front. Maybe just [inaudible 01:13:47]. I know you've had your hand up for a while.

Speaker 13:

Hi. I was just interested in your experience working with government departments in trying to get upgrades to social housing. Any tips?

Rosalie Viney:

Work with Toby?

Kerryn Wilmot:

That's a really good question. We're working on that at the moment. It's a very live question, and I know it's a fraught area. But one of the things is that by having the evidence from this project, that gives us a better entry into that conversation about why it should be considered and why there should be extra effort. It's not just about doing maintenance, and it's not just about energy saving. There are so many other benefits. So really we're using this project as part of our Trojan horse, if you like.

Toby Cumming:

It did definitely come with extra complexities. For us, it was DHHS at the time, Department of Housing and Human Services, Health and Human Services. It took more time and we could make it happen. But, yes, it definitely came with some delays. Adam's a good person to talk to about that, too, because he's now at Homes Victoria. In Victoria, there was recently quite a lot of funding to upgrade 35,000 of our social housing properties. We had a small amount in Healthy Homes, probably less than 10%, I think, that were social housing that got upgraded. But we did have a process for getting it through, and it could happen. So happy to talk to you about that.

Rosalie Viney:

Thank you. [inaudible 01:15:37]-

Kerryn Wilmot:

The other thing is that our programme was prepared to pay for the upgrades. They weren't even being asked to put money in.

Rosalie Viney:

The gentleman down the front. Then I think there's a couple of questions over here.

Speaker 14:

Energy savings means less profit for energy companies which could increase if this is successful. Has there been any obstructionism from energy companies?

Rosalie Viney:

I don't think that we've experienced that. I guess there are other parts of industry potentially who could benefit from this as well. There are always questions about, how do you engage with industry to want to do this? Yes, you're right. There might be some people who don't benefit, but there are other parts.

Yo Han Kim:

I would [inaudible 01:16:24] actually energy experts, enough to speak for myself. I would argue that a lot of them actually would prefer reduction because having more people spending energy means that you have to put in additional new infrastructure. That's additional hardware, new power lines, new things. That's a huge strain for the entire national system. So you could argue actually the opposite is true. They want to maintain the power demand, especially during the peak demand times.

Rosalie Viney:

There were a couple of questions, yes, there and then there.

Speaker 15:

Hi. I was really interested to hear how much you were spending. The first question is, do you think that there's an exponential potential value in increasing slightly more to give a better outcome? Did you have to restrict the types of things that you were doing? That's the first question. The second one is, there's really robust data about the benefits in hospital avoidance and mortality from the programmes that are done to modify homes for elderly people for ramps and rails and bathroom modifications. Is there a way that you could twin the data to suggest maybe, if you're going to intervene to do the energy efficiency, to do this other stuff at the same time to give bang for buck?

Toby Cumming:

I love that way of thinking about it. Make it an incentive in the health system and fund upgrades that way. We are certainly talking to the Department of Health about that. In some ways I see it as government's responsibility to pay given that that's where the savings are being made. You could argue, it's not fair to make the householders pay for this given that it's the health savings coming out of the state and federal government budgets. Remind me of the first question again.

Speaker 15:

[inaudible 01:18:35].

Toby Cumming:

Oh, yeah, yeah. Undoubtedly, the cap was sort of targeted average of $3,500 per home limited us in quite a few of the households. It's a bit of a live question as to what the sweet spot is for how much money you put in and the benefit you get back. Like anything, I think it's the law of diminishing returns. One of my colleagues has done comprehensive upgrades that look great thermally and I'm sure would be good health-wise, but they average about $20,000. I think the sweet spot's probably more like $5,000, a bit more than ours, but not fully comprehensive. There's no real good data on that. That's just me spitballing.

Rosalie Viney:

There was a question just there.

Katie Vines:

Thanks. Hi, I'm Katie Vines. I had a question that actually builds very much on this previous question, so that's neatly done. I'm quite interested, you spoke in your presentation, Toby, that this is a public health initiative, in fact. I'm really interested in the conversations you've been having with health agencies and how they've received this research and, I guess, the direction that those conversations might be heading. Any way you're able to elaborate on that would be great.

Toby Cumming:

They've received it really well. Angie Bone is one of our deputy chief health officers in Victoria, and she was on board with Healthy Homes right from the start. In fact, the first week that I started back in 2019, she gave a talk at one of our seminars in Melbourne around Healthy Homes. Her background in the UK was in similar housing and health initiatives. So [inaudible 01:20:19] are certainly very interested in it. I just think it has to be the angle. We know if you try and argue these upgrades from an energy savings perspective, that the payback period's maybe 25 or 30 years. You saw today that when you add health into the picture, the payback period's suddenly three or, worst case, six and a bit years. So it really changes the equation. I think that that needs to be a change in people's mindset. Housing is a health issue in lots of different ways but certainly in cold temperature.

Rosalie Viney:

Thanks. Now, I think that might be a great note to finish. We do have some refreshments down the back, and there's plenty of opportunity. Before I do that, I'd just like to say, obviously, thank you to all of our speakers for the presentations today. Thank you all for your great interest and questions. I'm going to mention that, as I said, there was a large team of researchers. In addition to the people here, there are some of the other researchers, so Dan, who's holding the microphone at the moment, Kees Van Gool down the back, Patsy Kenny. I think they're the other people who are here today. There's not-

Speaker 17:

[inaudible 01:21:36].

Rosalie Viney:

Pardon? Oh, Lutfun. Sorry, yes, and Lutfun. So feel free to ask them questions as well. I'll thank them for all of their involvement in this, what has been a really fabulous research project for us. Also just in terms of final thanks and closing, I want to make special mention of Dr. Matt Soeberg. Matt was the manager of Sustainable Homes at Sustainability Victoria. He initially conceptualised and devised this project both from the delivery and the research point perspective. He passed away last year before the final report was presented to SV, but I know that he did have the opportunity to see his vision come to fruition.

I also know that I speak on behalf of all the research team, and indeed probably the colleagues at Sustainability Victoria, when I say that Matt was a wonderful, collegial, and committed researcher and public servant, a really unique combination, although Toby's another one of these as well. He approached everything about his work with passion, with integrity and respect for everyone he worked with. It was a real pleasure for us to work with him on this project. What stood out was his utmost commitment to this work and to the integrity of the research. He had an enormous contribution to health and energy research and practise, and we are very proud to be part of that legacy. So in memory of Dr. Matt Soeberg as well.

On that note, thank you for coming. Please come down to the back of the room and join us for refreshments and to have some informal discussion with the research team and amongst yourselves and, indeed, with Adam, who's here as well. Thank you everybody.