English Devolution and Community Empowerment Bill

Baroness Royall of Blaisdon Excerpts

Thursday 26th March 2026 Lords Chamber

[Baroness Scott of Bybrook (Con)]

My Lords, my Amendment 132 is on the general health determinants listed under Clause 44. Under that clause, combined authorities must have regard to improving the health of people in their area. Our amendments would expand the current list of general health determinants to include the availability, as opposed to just the standards, of housing. In addition,

“matters of personal behaviour or lifestyle”

as referenced in the Bill are specified to include “physical activity and diet”.

On housing, standards are crucial of course, but housing availability should also be considered as it affects housing insecurity and homelessness. On physical activity and diet, it should be clear to all noble Lords that these are major health determinants. This is common knowledge: dietary patterns are a key determinants of chronic disease, and physical activity is a major factor for preventable disease. In 2023, evidence from the Sport and Recreation Alliance showed that the UK was ranked 11th out of 15 comparable European nations for the levels of physical activity that were undertaken, and that we were the third-highest spender on healthcare costs caused by inactivity. Updating the general health determinants in this Bill would inform fthe health determinants referenced in Amendments 133 and 134 from the noble Baroness, Lady Royall of Blaisdon.

Evidently, there is scope in this Bill to see what more can be done to make our country healthier, based on common sense. I look forward to the Minister’s response to this very short and very simple amendment.

[Baroness Royall of Blaisdon (Lab)]

My Lords, I will speak to my Amendments 133 and 134. As we are aware, the UK’s health is fraying and unequal, with increasing numbers of people unable to work owing to poor health. Compared with other high-income countries, the UK now has one the lowest life expectancies and is among those with deepest health inequalities. This has avoidable and negative consequences for individuals, public services and the economy.

Addressing these inequalities requires action at regional level, where leaders have the powers to shape economic growth, create healthy places and reduce inequalities. This Bill provides a timely opportunity to embed health and health equity at the heart of devolved decision-making, and I warmly welcome Clause 44, which is a crucial lever for improving health and reducing health inequalities.

In Committee, I tabled amendments to strengthen this duty and the proposed local growth plans to ensure that all strategic authorities act consistently to improve health, reduce health inequalities and consider health while growing their local economies. My noble friend the Minister responded that she believes the duty as drafted

“will apply to all functions, including developing a local growth plan”.—[Official Report, 4/2/26; col. GC 613.]

However, the Government have not yet provided any detail on how this duty should be fulfilled or how strategic authorities will be held accountable for this. Without this detail, there is a real risk that inequalities will be worsened, with some strategic authorities taking significant action to improve health and others seeing the duty as a tick-box exercise.

To ensure that the duty is as successful as we and the Government want it to be, I have tabled amendments which would require the Government to report to Parliament on the implementation of the duty. I am grateful to the noble Lords, Lord Hunt of Kings Heath, Lord Bassam of Brighton and Lord Bichard, for their support.

The Government previously said that they will monitor the health duty, with Miatta Fahnbulleh, the Minister for Devolution, Faith and Communities, saying that

“we will continue to monitor how the new duty beds in and its impact across the country, so we can ensure that the intent is aligned with practice and delivery”.—[Official Report, Commons, English Devolution and Community Empowerment Bill Committee, 21/10/25; col. 358.]

These amendments would formalise the Government’s commitment, providing a mechanism to identify whether further support, guidance, resources or requirements are needed in the future. It would also provide a mechanism to support shared learning across strategic authorities.

The amendments focus on implementation and process rather than outcomes, given the time it takes to see shifts in health inequalities. Information could be collected with a light-touch approach of returns from strategic authorities covering actions taken, strategies produced, partnerships formed, et cetera, and desk research by civil servants. Without these amendments, there is a risk that the new health duty remains well intentioned but inconsistently applied across regions and will therefore fail to have any real impact on reducing health inequalities. This would be a significant missed opportunity to reverse worrying health trends. If the amendments are not acceptable, I hope that the Government will agree to guarantee strong guidance on this issue to ensure that the duty is properly implemented across all regions.

[Baroness Freeman of Steventon (CB)]

My Lords, I support these amendments. I spoke to Amendment 132 in Committee. I will not repeat what I said then, but I just want to say that the Minister said in Committee that the reason why the Government want to stick with their own wording on Clause 44—a clause that we all support very strongly—was that they did not want to be too prescriptive regarding what areas should be looking at as health determinants. However, if we do not reflect what is known about the determinants of health, we will not be able to set down what we need to measure to evaluate the success of Clause 44, which is so important and which the noble Baroness, Lady Royall, spoke about in connection with her amendments. I therefore urge the Government to look very carefully at these amendments to see whether some adjustments can be made that would make Clause 44 as strong as we all want it to be.