English Devolution and Community Empowerment Bill

Baroness Royall of Blaisdon Excerpts

Committee stage
Wednesday 4th February 2026 Grand Committee

Moved by

[Baroness Royall of Blaisdon]

140: Schedule 20, page 225, line 22, at end insert—
“(d) take account of the statutory health duty and health inequalities strategy prepared by the strategic authority, and(e) promote community wealth building, cooperatives, mutuals and the wider social economy as mechanisms to narrow health inequalities.”Member’s explanatory statement
This ensures that local growth plans explicitly take account of the statutory health duty and the proposed Health Inequalities Strategy. It strengthens the link between economic growth and health improvement, complementing the government’s intention that devolution should support inclusive growth and stronger communities, while maintaining local flexibility.

[Baroness Royall of Blaisdon (Lab)]

My Lords, Amendment 140 would strengthen the link between economic growth and health improvement, complementing the Government’s intention for devolution to support inclusive growth in stronger communities while maintaining local flexibility.

Devolution should give local leaders the tools to make a tangible difference to the lives of their citizens. However, if poor health and widening health inequalities continue to constrain economic participation and the effectiveness of public services, and if local growth plans are not used to drive better health, devolved leaders will fail to deliver real change to their communities. I believe that this Bill is a hugely significant moment for regional governance, with its explicit expectation that devolution should support improved outcomes, including health outcomes, for communities.

In many UK regions, long-term illness is now the single largest driver of economic inactivity. This can be seen most clearly in areas of historically high deprivation. The economic impact of poor health is stark. The Health Foundation’s independent Commission for Healthier Working Lives found that

“8.2 million working-age people report a long-term health condition that limits their ability to work … Poor workforce health is estimated to cost UK employers up to £150bn a year through lost productivity, sickness absence and recruitment costs”.

I warmly welcome the Government’s ambition to address regional economic inequality. Improving health and reducing inequalities are prerequisites for economic success. However, health currently remains largely absent from most local growth strategies, although not all. In the Oxfordshire strategic plan—the plan that I know best—health inequalities are a primary focus. The plan explicitly integrates social well-being with economic growth to address the county’s stark internal disparities. It pays specific attention to the foundational economy, which is to say the sectors providing basic goods and services, such as health and education, and identifies these as providential elements on which well-being depends.

Without considering health as a core objective and precondition for growth, local growth plans are less likely to be effective in delivering long-term sustainable growth. Some places in the UK are pioneering new approaches, including the West Midlands, which has implemented the inclusive growth framework. This aims to ensure that everyone benefits from growth by focusing on all types of investment, such as public, private, capital, revenue and time, which are all given attention. However, practice is uneven and lacks a consistent understanding of impact. This amendment aims to recognise the relationship between health and local growth so that further devolution reduces rather than widens inequalities.

I recognise that the number of co-operatives and mutuals is expanding and that the Government are calling for new growth plans across the mutual sector. That is very welcome—I am a Co-operative Member of the House of Lords. My amendment therefore dovetails with the current policy. It is right that local growth plans should promote co-operatives, mutuals and community wealth building—the practice of creating an inclusive and democratically owned economy. This puts people before private equity profits and champions the kind of economic development activity that gets overlooked by industrial strategies. Instead, it focuses on the everyday economy where most people work.

In Preston, for example, community wealth building is changing lives and has been linked to an incredible 9% increase in life satisfaction and an 11% rise in median wages. This has led to a reduction in daily antidepressant prescriptions of 1.3 units per person and a drop in depression prevalence compared to similar areas of 2.4 per thousand. I am sure that the Government would agree that these results should be replicated across the whole country.

I suggest that community wealth building is the missing piece of the puzzle to unlock growth for the benefit of all citizens, everywhere. Scotland already has a community wealth building Bill passing through its Parliament and I hope that this amendment ensures that England does not fall behind. I very much hope that my noble friend the Minister will take these things into account. Economic growth will be the lifeblood of mayoral combined authorities, but their ability to achieve that growth will be diminished if health and health inequalities are not an integral part of their plans. I beg to move.

[Baroness Freeman of Steventon (CB)]

My Lords, I will introduce Amendment 141B in my name. This amendment is designed to help address perceptions that economic growth and environmental growth are in competition with each other. Tony Juniper of Natural England said it as eloquently as anyone could:

“we need to ensure that Nature and the economy are partners rather than seen as choices. That means weaving Nature recovery into the growth planning up front—the cheapest point at which to invest in Nature, and the one that also yields the biggest returns”.

In essence, this amendment calls for the Secretary of State to publish a local authority guide to constructing a win-win: best practice in growing the natural economy as part of the growth plans, and how nature-based solutions and easy mitigations to protect wildlife can help local economics.

The amendment covers a range starting with responsibilities to individual wild animals and birds under the Wildlife and Countryside Act, which was picked up by the Animal Sentience Committee as something that was slightly missing when we discussed the Planning and Infrastructure Bill. I cannot help mentioning my beloved bird-safe design of buildings as a specific example of something that might be covered. Just as a reminder to those who might have missed the fun and games on the Planning and Infrastructure Bill, buildings that are poorly designed in their use of glass and light can pose a serious threat to birds and are thought to kill around 30 million a year in the UK. Simple tweaks to the design of buildings in the planning stages can make them much safer to birds at no cost at all. But not many people know this, so guidance is necessary. Local authorities can use that guidance as they wish.

The amendment goes on to cover broader responsibilities to the environment and natural world. It would carry best practice advice on all the environmental services that can be harnessed to reduce flooding and pollution and to provide green spaces—all opportunities that can help local authorities to reach environmental as well as economic targets. So many developments that have gone badly wrong at the interface between economic and environmental growth could have been entirely turned around if, at the very outset of planning, the right expertise had been applied. It could make all the difference if a guide to best practice was a necessary part of the pack given to support local authorities. Without it, more avoidable issues might arise to the detriment of both the economics and the environment.

I completely recognise that I am not a drafter of legislation and that this amendment is very roughly worded. I anticipate that the Minister will say that the schedule already allows the Secretary of State to publish any guidance that they want, but I hope that the Government grasp this opportunity to put forward their own amendment to the Bill that commits to publishing a best practice guide that shows that they do not believe that protecting wildlife and helping nature is an opposing aim to wanting economic growth and that helps local authorities to see how both can be done together in a virtuous circle.

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[Baroness Taylor of Stevenage (Lab)]

My Lords, I echo the words of the noble Baroness, Lady Scott, that this has been a very thoughtful and interesting debate. I am grateful to all contributors and for the amendments to Schedule 20 on local growth plans.

I will start with the amendment in the name of my noble friend Baroness Royall of Blaisdon, which draws our attention to the important role of mayors in addressing health inequalities in their areas. Through Clause 44, we are introducing a new legal requirement for combined and combined county authorities to have regard to the need to improve the health of people in their areas, and to reduce health inequalities between people living in their areas. This will reinforce our ambition to ensure that health is considered in all policies and will support our health mission in England.

I add that the mayoral competencies set out in the Bill specifically include health, well-being and public service reform, so that means that that should be taken into consideration in all the work that the mayor and the strategic authority do. It is the Government’s intention that mayors should sit on ICBs, which I hope will start to address some of the issues raised by the noble Baroness, Lady Scott, and my noble friend Lady Royall about how we get that linkage between what is going on in the national health and what is going on at local level.

There are some great examples across the country of what is happening—obviously, Manchester is the best known because it has specific powers to tackle health, and I really welcome that, but in a district council like my own, we took great interest in tackling some of the key health challenges in our area to help the economy, such as tackling obesity, smoking and some of the big, long-standing mental health challenges that we faced, and we worked closely with partners in doing that. Of course, there is no better example of the contribution that local authorities can make to public health than the response of local authorities to the Covid pandemic, in those very unique circumstances, so we know it can be done.

Although I recognise that it is not explicitly stated in relation to local growth plans, I can reassure the Committee that this new duty will apply to all functions, including developing a local growth plan. Indeed, as I said, many places are already demonstrating this awareness.

I know that many of my noble friends will be very sympathetic to the benefits of co-operative and mutual models in addressing these challenges—I know they are aware of my history in the co-operative movement. I hope they will also recognise that a key principle behind local growth plans is that they must be locally owned, in line with the fundamental principles of devolution.

I recognise the community wealth-building principles so clearly articulated by my noble friend Lady Royall, and the example that she gave of Preston, which has been a leading proponent of using the power of public procurement and provision of infrastructure and services to tackle inequalities in its local area. That has been very important, and Matthew Brown and his colleagues have done a very significant piece of work on that. However, while we may commend those local examples, we must afford local growth plans the flexibility for local challenges to be addressed in response to the local context.

I hope my noble friend feels reassured that mayoral combined authorities and combined county authorities are already considering health as part of their plans, and that the new health improvement and health inequalities duty will achieve the desired effect. On that basis, I hope my noble friend feels able to withdraw her amendment.

Amendment 141B is in the name of the noble Baroness, Lady Freeman of Steventon, and I thank her for all the discussions we have had around her environmental issues, during the passage of the Planning and Infrastructure Act and recently. The amendment would provide the Secretary of State with the opportunity to set out in guidance how mayoral combined authorities should align growth measures in their local growth plan with considerations of nature, wildlife and the environment.

I want to reassure the Committee on two points. First, this is already possible. We have set out that the guidance on local growth plans can cover a range of matters. That includes the information to be included in a plan—that is to say, its content—and the ways in which the authority may have regard to the plan when exercising other functions. But the guidance is not limited to just these matters; it can cover additional matters not explicitly set out in the primary legislation. I reassure the Committee that this enables us to set out the matters included in this amendment, should that be needed.

Secondly, mayoral combined authorities and mayoral combined county authorities are already subject to several requirements linked to this amendment. This includes the recently strengthened biodiversity duty, which supports the delivery of legally binding biodiversity targets, as well as statutory duties related to air quality. Local growth plans will provide an important framework for economic growth, but they will sit alongside a range of other statutory plans, strategies and duties. Decisions that impact protected species, nature recovery and the environment will still need to consider relevant policy frameworks—for example, local nature recovery strategies, about which we had much discussion during the passage of the Planning and Infrastructure Act.

I am very grateful to my noble friend Lord Hunt for setting out so clearly how important it is to ensure that in our planning process, whether it is local growth plans or spatial planning, we aim to create that win- win for development and the environment. We made some significant steps with that in the Planning and Infrastructure Act, and I hope that local growth plans will contribute to that as well.

That said, I hope that the noble Baroness, Lady Freeman, will feel reassured that the matters in her amendment must already be considered by mayoral combined authorities and mayoral combined county authorities. I hope she will feel reassured that, should further guidance be necessary, it remains possible to set this out in the guidance on local growth plans. I therefore ask that her amendment be withdrawn.

[Baroness Royall of Blaisdon (Lab)]

My Lords, I am very grateful to my noble friend the Minister for her response, because she clearly understands the issues. I am super-grateful for all the contributions from noble Lords around the Room.

We are all absolutely in agreement that good health is a prerequisite for economic growth in our country. I realise that the Bill takes more account than ever before of the need for these new strategic authorities to act in relation to health and health inequalities. I hear all the frustrations around the Room about the fact that it has not really worked before. Manchester is working really well, and that is brilliant, but as the noble Lord, Lord Mawson, pointed out, the dots simply are not joined, either in funding or in services terms. I know that a lot of that is because of the siloed way in which each of our public services receives its money. For it to work really well, we need to have properly funded local authorities and a well-funded health service.

This is a great opportunity, and I am sure that the Bill as it stands will take us a long way. Still, if we could have a statutory health duty in the Bill, it might be a catalyst for further action; it might be a real catalyst for discussion between the Treasury, the NHS and the MHCLG. I would really like to discuss this further with my noble friend before Report. I do not know how far we will get, but this is a great opportunity to make the system work better. I do not want to give up just yet, but I do not want to make her life a complete pain. I would like to come back to this matter before Report and have a discussion with my noble friend the Minister and her team but, with that, I beg leave to withdraw the amendment.

Amendment 140 withdrawn.

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[Lord Hunt of Kings Heath (Lab)]

My Lords, Amendment 165A is in my name. It seeks to

“include wheelchair and community equipment provision in the list of ‘general health determinants’ that authorities need to have regard to as a cause of health inequality”.

My intention is to highlight to noble Lords that the provision of wheelchairs and community equipment for disabled people is, to put it bluntly, a disgrace. I urge the Government to look at the outcomes at the moment for those who depend on wheelchairs and disability equipment and, basically, to ensure that local authorities and the NHS play their part in putting things right.

As the Wheelchair Alliance has said, at the moment, there are no consistent national standards, there is no independent regulation and there are few clear paths for users seeking repairs, reporting faults or making complaints. As a result, many disabled people face long waiting times, delays in hospital discharge, loss of independence, social isolation and, tragically, avoidable deterioration in health and well-being. It is the same dismal picture with community equipment, embracing hoists, hospital beds, pressure-related mattresses, grab rails, bathing aids, harnesses and all of the other essential items that we need.

The All-Party Group for Access to Disability Equipment recently reported on the systemic crisis in this sector. Carers think that things are getting worse, and the system is inconsistent, underinvested, fragmented and lacking leadership. What is tragic is that this is easily sortable. I am convinced that, if we sorted this out, we would provide a better service at less cost, because the current system is just a complete and utter mess.

The reason why the Bill is suitable is because local authorities and integrated care boards share responsibility for community equipment. Wheelchair services and community equipment often reach the same individual; they should operate in tandem, but they are two distinct systems. In welcoming this very good clause, I would like an assurance that combined authorities, in collaboration with the NHS, will take their responsibilities in relation to wheelchair and community equipment services seriously.

The noble Baroness, Lady Scott, made an important point about the difficulties that local authorities sometimes have in working with the health service and in the release of budget. Here we have a situation where both types of authority spend money inefficiently. I am suggesting that we could provide a much better service. Either the quality will be much better or we will have consistent quality, at least; I do not think that it will cost a lot of extra money as well.

[Baroness Royall of Blaisdon (Lab)]

My Lords, my Amendment 166 would provide a clear mechanism for implementation and accountability of the proposed health duty, while maintaining local flexibility. It would require strategic authorities to produce a health inequality strategy and report on progress every five years.

In many ways, this follows the debate we had on earlier amendments. It is intended to provide a minimum standard and accountability for strategic authorities to adhere to, ensuring that they are meeting their new health duty. The requirement to report every five years was deliberately designed to be the same length of time as the proposed local growth plans will cover, to ensure that they better support one another in strengthening local economies and improving health. The amendment would also ensure that new strategic authorities will mirror existing practice in London, ensuring that health and well-being are embedded across all strategic functions.