This is Hansard’s record of my speech in yesterday’s Committee stage debate in the House of Lords as we began line-by-line scrutiny of the Levelling Up and Regeneration Bill. All amendments, having been debated and responded to by the relevant Minister, are by convention then withdrawn so that the government can take back the content of the debate and decide whether the text of the Bill might be amended before bringing a (hopefully) revised text at Report Stage.
My Lords, at Second Reading, I remember applauding, broadly speaking, the ambitions of the White Paper. However, I share the concerns of the right reverend Prelate the Bishop of London, who of course brings to this much more experience than I do.
I am pleased that, already, the noble Baroness, Lady Hayman, has alluded to the interconnectivity of all these different missions; they cannot be seen in silos or in isolation. For example, if you have children who are turning up at school unfed or living in poor housing, you can try teaching them what you will but it may not be very successful, and that has an impact not only on individuals but on communities and their flourishing.
I will speak to Amendment 15, tabled by the right reverend Prelate the Bishop of London, and briefly to Amendments 7, 30 and 31.
Health disparities require discrete attention in the Bill. It is not an optional extra. The Bill as it stands states the missions but does not provide mechanisms for action or accountability. How will we be able to measure whether they are effective or not? The right reverend Prelate the Bishop of London has said that, although assurances by the Minister are very welcome, they are not enough; they have to be backed up in the Bill with measurable implementation gauges.
Good health is key both to human—that is, individual—and social flourishing. As I said, we cannot separate out such things as housing, education, health, transport and so on as if we can solve one without having an impact on the other. However, there are inequalities between the regions in many of these areas. I speak from a context in the north: the whole of west Yorkshire, most of north Yorkshire—but do not tell the right reverend Primate the Archbishop of York that—a chunk of Lancashire, one slice of County Durham and a bit of south Yorkshire. The inequalities are serious. The economic squeeze, in the words of the right reverend Prelate the Bishop of London, is an incubator for inequalities, and we know the impact that inequality has across the board.
The White Paper rightly recognises the centrality of health to levelling up, but the actions by which this will be achieved could be argued to be lacking—and we certainly need long-term solutions and not quick fixes or slogans that sound good but do not lead to content. Can the Minister therefore offer assurances of the Government’s commitment to health within the levelling-up agenda in ways that can be measured and accountability upheld?
I support Amendment 30, in the name of the noble Lord, Lord Holmes of Richmond. The Government must give formal consideration to the inclusion of social prescribing. Why? Because social prescribing recognises the social determinants of health and the importance of community in improving health at every level. There are good examples already of where this is being explored, such as the National Academy for Social Prescribing, and I endorse the comments of the noble Baroness, Lady Grey-Thompson, at Second Reading in this regard. There are examples of services run by faith and community groups in London and beyond, and the pilot by the DHSC in Wolverhampton is promising. The key to all of this is the relational dynamic in the well-being of both individuals and communities. This leads me to ask how social prescribing might be used to tackle inequalities in health and well-being. I hope that the Minister will be able to respond to that.
I turn briefly to Amendments 7 and 31. The text of the missions might be important but we need evaluative measures in the Bill so that they can be measured. Otherwise, they are merely aspirational and all we can do is trust the word, however well-meaning, that is applied to it. Moreover, how can the Government be held to account on delivery? Commitment to the missions can be measured only by some process of assessment on implementation, and this needs to be in the Bill.
I conclude with the obvious statement that healthy life expectancy is surely a key measurement of our effectiveness in tackling health inequalities.
