English Devolution and Community Empowerment Bill

Debate between Baroness Freeman of Steventon and Baroness Royall of Blaisdon

Report stage
Thursday 26th March 2026 Lords Chamber

[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.

English Devolution and Community Empowerment Bill

Debate between Baroness Freeman of Steventon and Baroness Royall of Blaisdon

Committee stage
Wednesday 4th February 2026 Grand Committee

[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.