Levelling-up and Regeneration Bill

Committee (9th Day) (Continued)

Amendment 213A

213A: Schedule 7, page 293, line 35, at end insert— “(5A) The local plan must include policies designed to meet the health and social care requirements of the local planning authority’s area, including the provision of facilities to provide specialist palliative care services.(5B) For the purposes of subsection (5A), planning authorities must have regard to the requirements set out within section 21 of the Health and Care Act 2022 regarding the commissioning of certain health services.”Member's explanatory statement This probing amendment would ensure that local planning authorities must consider what facilities are needed to provide the necessary health and social care facilities for their area including those with a terminal illness.

My Lords, this group is made up of two of my amendments, Amendments 213A and 312L. The first is a probing amendment, designed to ensure that local planning authorities must consider what facilities are needed to provide the necessary health and social care facilities for their area, including for those with a terminal illness. My second amendment builds on this to ensure that local planning authorities must regularly survey the health and social care requirements for their area when considering any future development requirements.

We know that an ageing population is increasing the demand for specialist health and care services within local communities. We also know that demand for palliative and end-of-life care is rising rapidly as our population ages. In the next 25 years, the number of people aged 85 years and over in the UK will almost double. We heard some figures around the need for housing for the elderly in previous debates, so this issue covers various aspects of how we plan for the future. In areas such as mine, in Cumbria, where we have what is known as a super-ageing population, there are even more stresses on local authorities and services to provide.

Because of this ageing population, by 2045 there will be over 136,000 additional deaths per year in the UK, compared with projections for 2023. So the demand for palliative care and end-of-life services will increase, particularly due to the larger numbers of people living longer with multiple and complex health conditions. It is absolutely critical that every person at the end of their life receives the care and support they need so that they can live the end of their life in dignity.

Marie Curie has provided some very helpful information, and I thank it for its briefing on this matter. It has estimated that, if palliative care capacity does not increase in line with projected increases in mortality, as many as an additional 14,000 people may die each year without palliative care by 2030, and as many as 86,000 additional people may be in the same position by 2040. In contrast, if capacity in the palliative care system grows to reflect this ageing population, as many as 77,000 more people every year could receive the specialist palliative care they need at the end of their lives. It makes a huge difference to how people can get the support and dignity that they need, as well as support for families in that difficult time.

My Lords, the noble Baroness, Lady Hayman of Ullock, has raised a very important issue about end-of-life care and how the planning system can be encouraged to prepare for the needs that will arise in the not-too-distant future. It is an argument that we on these Benches absolutely support; I will just expand it ever so slightly by saying that whenever there is a big allocation for a housing site, local residents immediately say there will be a huge pressure on primary healthcare—GP services. Although the community infrastructure levy enables planning authorities to try to extract some funding from the levy for improvements to primary healthcare services, it is often not that possible when there are so many other big demands placed on the levy—highways infrastructure, education, outdoor play space and so on.

Often, certainly in my part of the country, where house prices and land values are lower, the levy is therefore also lower and is unable to support the development of essential provision for primary healthcare. It is an area that I guess we may want to explore when we get to discussion about the replacement of the community infrastructure levy. I thought I would raise it now, in this context, because whichever of the Front Bench team is responding may be able to give me an answer. With that, I clearly support the amendments.

My Lords, the two amendments in this group, Amendments 213A and 312I, tabled by the noble Baroness, Lady Hayman of Ullock, look to ensure, as she explained, that local planning authorities should consider the health and social care facilities needed for their area when considering future development. I am sure that we can agree that it is important to ensure that we have the right health and social care facilities in place where they are needed: that is why this is already a consideration as part of planning policy, guidance and legislation.

The National Planning Policy Framework is clear that when setting strategic policies, local planning authorities should set out an overall strategy for the pattern, scale and design quality of places, and make sufficient provision for community facilities, including for health infrastructure. The Government have set out in planning guidance how the need for health facilities, as well as other health and well-being impacts, can be considered as part of the plan-making and decision-making process. Plan-making bodies will need to discuss their emerging strategy for development at an early stage with directors of public health, NHS England, local health and well-being boards, and sustainability and transformation partnerships/integrated care systems, depending on the local context and the implications of development on health and care infrastructure. The National Planning Policy Framework must, as a matter of law, be given regard to in preparing the development plan, and is a material consideration in planning decisions.

We have also set out, in the consultation on reforms to national planning policy, that we are intending to undertake a wider review of the NPPF to support the programme of changes to the planning system, and, as part of this, we will consider updates needed to reflect the importance of better environmental and health outcomes. In addition, as part of the new infrastructure levy system, local authorities will be required to prepare an infrastructure delivery strategy. This will set out the local planning authority’s priorities for spending levy proceeds.

I do recognise fully from my time as a Health Minister the importance of palliative care in the range of NHS services, and the noble Baroness, Lady Hayman, will remember that, as part of the Health and Care Act 2022, we added palliative care services to the list of services that an integrated care board must commission, promoting a more consistent national approach and supporting commissioners in prioritising palliative and end-of-life care. NHS England has made available a number of resources, including statutory guidance and service specifications, to support commissioners in fulfilling this duty. NHS England has also made funding available to establish seven palliative and end-of-life care strategic clinical networks. These networks support commissioners in the delivery of outstanding clinical and personalised care for people in the last year of life and aim to reduce local variation. NHS England has implemented an accelerated development programme to build a community of practice and develop commissioning mentors, supported by a number of supporting guides and documents, such as the commissioning and investment framework.

I hope what I have been able to say is helpful to the Committee. I do take on board the comments made by the noble Baroness, Lady Pinnock. There is not time to have a full-scale health debate. I have a wealth of information here on what is now going on to ensure that, for example, primary care is beefed up across the country; we have set out plans to recruit 26,000 additional primary care staff, and there are special incentives to attract doctors to underdoctored areas which are already proving to be a success.

In the field of social care we have made available up to £7.5 billion in additional funding over two years, which is a historically enormous increase. On the people front, the noble Baroness may recall that in the People at the Heart of Care White Paper, we set out a 10-year vision for adult social care that includes workforce reforms and funding for hundreds of thousands of training places, which of course we all agree we need. So there is a great deal going on, and I think the levers are there at a local level as well as a national level to make sure that we are not legislating for levelling up in a vacuum, as it were, in this field.

I hope I will have persuaded the noble Baroness, Lady Hayman, that her amendment is not necessary, as these important matters are already being considered and addressed through national planning policy, associated planning guidance and indeed legislation.

My Lords, I thank the noble Baroness, Lady Pinnock, for supporting my amendments. As the Minister said, she was right to draw attention to the many competing demands on local authorities and others, which can sometimes mean that joined-up health and care services are overlooked or pushed further down the pecking order than they should be. When we reach the groupings on the infrastructure levy, I am sure that we will discuss what we feel that money could or should be spent on and I imagine that these areas will be touched on again.

I thank the Minister for his helpful response. We referred again to the National Planning Policy Framework, which will continue to come up a lot and we will continue to say how great it would be if we could actually see it. It is welcome that the intention is for this overall strategy for communities to include health facilities, but social care and palliative care services are not always adequate in every community. We need to ensure that any future planning decisions, support for local authorities and so on provide the resources required to reflect future pressures that will be put on those services with an ageing population over the next few years.

In rural areas, social care and palliative care delivery are much more complex. They are often more expensive and need extra support and care. It would be good if the Government could take that into account when continuing to design those services, particularly for people in their own homes. It needs to be looked at. Just on that point, I should have declared an interest as vice-chair of Hospice at Home West Cumbria. It plays an extraordinary role in our community and I thank it very much for what it does. I also thank the Minister for his serious, careful response and beg leave to withdraw my amendment.

Amendment 213A withdrawn.

Amendments 214 to 216 not moved.

Amendment 216A

216A: Schedule 7, page 294, line 19, at end insert— “(3A) The Secretary of State may require the local planning authority to—(a) reimburse the Secretary of State for any expenditure incurred by the Secretary of State in, or in connection with, appointing a person under subsection (3), or(b) pay any fees and expenses of a person appointed by the Secretary of State under subsection (3).”Member’s explanatory statement This amendment allows the Secretary of State to require a local planning authority to reimburse the Secretary of State for expenditure incurred in connection with appointing a person to provide observations or advice on a proposed local plan or to pay any fees and expenses of that person.

My Lords, this group is intended to make minor, technical and consequential amendments to the reforms in the Bill connected to plan making.

Amendment 216A is a minor and technical amendment to Schedule 7. It clarifies an ambiguity in relation to new Section 15CA, to be inserted into the Planning and Compulsory Purchase Act 2004 by Schedule 7 to the Bill. The amendment, which will insert new subsection (3A) into new Section 15CA, clarifies that local planning authorities may be made liable for the costs associated with observations or advice delivered by a person appointed by the Secretary of State under new Section 15CA(3), which in practice will be in relation to the proposed local gateways.

Noble Lords will note that the intention was always that, in relation to remuneration and allowances payable under new Section 15LE(2)(j) in Schedule 7, it should be possible for local planning authorities to be made liable for these costs. This amendment simply ensures clarity as to where liability for remuneration or allowances under new subsection (2)(j) may fall. The position following this amendment will broadly mirror arrangements for other relevant appointments, for example in relation to independent examination of plans and local plan commissioners appointed by the Secretary of State.

Amendments 242A, 242B, 242C, 242D, 242E, 242F, 242G and 242H set out consequential amendments required to various pieces of legislation in connection with our reforms to plan making. Through the reforms to Part 2 of the Planning and Compulsory Purchase Act 2004, as introduced by Clause 90 and Schedule 7 to the Bill, the concepts of “local development document” and “development plan document” will be replaced by

“local plan, minerals and waste plan or supplementary plan”.