King’s Speech

Lord Mawson Excerpts

Wednesday 20th May 2026 Lords Chamber

[Lord Mawson (CB)]

My Lords, in response to the gracious Speech, I want to focus on health. This Government’s policy to move more services out of hospitals and into local communities is the right direction of travel. However, NHS England’s neighbourhood health centre guidance deserves a clear-eyed response. After three decades working across primary care, grass-roots community regeneration and social enterprise, my colleagues and I at the Bromley by Bow Centre find ourselves holding two different views at the same time: real optimism about what this programme could become, and deep frustration about the journey and destination described in the current road map.

The Bromley by Bow Centre has been working in this space for 42 years. We built the first integrated working model of what we think the Government are proposing. We are now responsible for 55,000 patients on four sites in east London, and have grown, with our public and private sector partners, a national social business working on place-making projects across the country. I declare my interest. We have focused on practice in the micro because we know that the clues to the macro lie there.

The neighbourhood health centre programme signals a genuine institutional commitment to moving healthcare closer to communities. The ambition to create 250 centres by 2034, the multi-disciplinary model and the acknowledgement that health cannot be delivered by clinicians alone all point in the right direction. At its best, the NHC framework is an invitation. The problem is that it is written in the language of compliance, rather than liberation, and is simply not radical enough.

There is an implied acknowledgment that good health is driven principally by social factors, but there is an underpinning assumption that a successful NHC will be defined by how it more efficiently organises multidisciplinary teams in a single building, rather than how it might meaningfully pass the ownership of health resources into the hands of local communities. What the guidance gets right is the recognition that health is produced in communities, not just delivered by clinicians. The neighbourhood health centre framework could, if NHS England has the courage to allow it, become the vehicle through which a generation of community entrepreneurs—many of them GPs—finally get the platform, the estate and the institutional backing they have always lacked.

The Bromley by Bow Centre was an early example of what becomes possible when you refuse to draw hard boundaries between health, community, enterprise, the arts, green space and human connection. We were not unusual in our instinct; we were unusual in having the space and partners to act on it. NHCs could give many more organisations this same opportunity.

However, the case for flexibility is not simply ideological. We have known for decades that 80% of health outcomes are driven by social determinants. A programme that creates impressive buildings, staffed by excellent clinicians and allied professionals, but fails to address these upstream factors will make a marginal difference at best. The problem is that the guidance is shaped overwhelmingly by a statutory NHS-centric worldview.

The illustrative design briefs for new neighbourhood health centres capture this problem precisely: rooms with narrow purposes, square boxes, places for professionals who drink coffee, but no art-making spaces, no messy spaces and not a curved wall in sight, in buildings that one health colleague described as “prisons”. The consequence of this type of top-down thinking is a dominant multidisciplinary clinical model, with social factors treated as peripheral rather than foundational. These will be places to go for appointments, not places you belong to.

The omissions in the guidance are as telling. The creative arts are entirely absent, despite a substantial evidence base for their foundational and consistent role in good health outcomes. Social enterprise and business are also missing, despite some of the most innovative health-generating work in the UK being done in this space. On community ownership of assets, the words point to local power, but the structures point to central control. Green space and horticulture are a remarkable omission, given the evidence on their broad therapeutic and transformative value—ask the RHS. On funding for non-clinical services, social prescribing is promoted while its funding base is eroded and the resourcing of the non-statutory services that it refers into are being decimated.

Perhaps it is not too late. NHS England has a choice: it can insist on fidelity to the template and create 250 well-resourced and shiny MDT polyclinics that improve access to statutory services, or it can explicitly invite and resource flexible interpretation.

The modern health world is everybody’s business; it is no longer the private domain of the NHS and its clinicians. Such a model is totally financially unsustainable. The challenge for this Government is whether they will create a health landscape based on last-century thinking or a modern, entrepreneurial culture in which everybody plays their part. This is the big opportunity to truly join up government systems on the ground. Let us hope we do not miss it.

Automated and Electric Vehicles Bill

Lord Mawson Excerpts

Committee: 2nd sitting (Hansard - continued): House of Lords
Thursday 17th May 2018 Lords Chamber

[Lord Borwick]

My Lords, I shall speak to Amendment 65. It was painfully obvious when dedicated spaces were introduced for disabled drivers that those spaces should be nearest to the supermarket. Yet, unfortunately, this had to be spelt out in regulation. Sometimes, things that are blindingly obvious to noble Lords escape the attention of other people.

I fear that the same may be true of electric rapid charging points, which is why I proposed my amendment. If the Minister can assure me that the department already has this power I will be happy to withdraw it, but if, as I fear, it does not, the Minister should accept the amendment. It is always possible that the noble Lord, Lord Campbell-Savours, is entirely correct and we shall see entire fields full of rapid charging spots, so the location does not matter so much. But until that stage—and particularly at the beginning—the location of rapid charging points relative to other amenities could be important.

[Lord Mawson (CB)]

Listening to the debate I find it really interesting, but I certainly would not claim to be an expert. I can easily imagine circumstances in which we end up with many diverse charging points across the country, and not enough people buying cars to use them. I have seen many examples in other areas of government doing things and pushing forward proposals, but with disconnects on the ground.

Having a 17 year-old, one thing that I have discovered recently is the cost of insurance for that age group. We need some joined-up thinking in that respect. We live in a rural area and my son has quite an old petrol car, but the insurance for him is £1,857—a great deal of money. If we are to get the next generation of young people buying electric cars and helping us to move this agenda forward, we may need some joined-up thinking between that amount of money being invested in insurance companies and the need to trigger more purchases of electric cars, with incentives to that generation to own a better, cleaner car, which would work for them and also begin to trigger the economy. I suspect that there are opportunities in all this, amid the problems that the younger generation face—but we need more joined-up thinking to ensure that we do not have lots of power points that are not used.

[Lord Tunnicliffe]

My Lords, I shall speak briefly to Amendment 66, in my name. It would provide exemptions for operators with limited forecourt space who could not accommodate public charging points without an expansion of land, and ensure that retailers and operators did not incur disproportionate costs for complying with regulations. The general thrust of the Bill is to make more charging points available, but we must ensure that there are no unreasonable unintended consequences. I do not think the wording of the amendment is particularly good, but I would like the Minister to consider that general approach. There are a lot of powers in the Bill, and if we are not careful we may find some pockets of unreasonableness.

Infrastructure Bill [HL]

Lord Mawson Excerpts

Wednesday 5th November 2014 Lords Chamber

[Lord McKenzie of Luton (Lab)]

My Lords, I am very happy to support my noble friend Lady Whitaker’s amendment and to support those other noble Lords who have spoken in favour of it. Like the noble Lord, Lord Jenkin, I am a great admirer of the way in which my noble friend Lady Whitaker has persistently championed the cause of good design and always the enlightened approach to planning.

As I understand it, the change in wording that is proposed is quite modest, but its impact could be quite profound. The 2008 Act, rather than stating that,

“the Secretary of State must … have regard to the desirability of … achieving good design”,

would state that “the Secretary of State must have regard to achieving good design”. The former, as my noble friend said, suggests that good design is somehow optional. The amendment would make sure that it was not. I hope that the Government are able to accept this small but important amendment.

[Lord Mawson (CB)]

My Lords, I, too, support the amendment. When I arrived in the East End of London 30 years ago this year, I was very conscious of the poor quality of design of large infrastructure. As you spent time in one of the most challenging housing estates, you saw the effect of some of that on ordinary people’s lives. At the Bromley by Bow Centre, we began to challenge that logic of poor-quality design. When we built the first integrated health centre in Britain, we did so from hand-made bricks—like those used at that time at Glyndebourne opera house. There followed a beautiful cloister facing a park and bringing together health, education and enterprise in what is now a rather beautiful environment, in the middle of a housing estate, that has affected many things around it.

I have noticed over the years how people are the environments that we live, work and play in. If you create certain sorts of environment, you get certain sorts of human behaviour. In our park on the housing estate, we do not have any cameras; local people have taken a lot of ownership of it. We have probably one of the few wooden playgrounds that are not burnt every night. If you put numbers around all that, you see that the value of it to people and the Exchequer is considerable. We are following similar principles in the Olympic Park—where I am a director and sit on the planning committee—and trying to ensure that we do not repeat the tacky stuff that has gone on before but build a very beautiful environment that begins to have a major catalytic effect on the quality of design that is starting to happen in the lower Lea Valley. It is interesting to watch how local people and others, and children running through the beautiful fountains, respond to all that. If one looks at the quality of what is being built and the lack of graffiti and other things, one gets a sense of how these things affect human life and their financial implications.

Yes, I suspect that it is difficult to measure in numbers terms; it is difficult to know which box you tick; but my 30 years of experience suggests that quality of design has a massive impact. I suggest that we ignore it at our peril.

[Lord Ahmad of Wimbledon]

My Lords, I, too, acknowledge the work that the noble Baroness has done in this respect. I agree with what she said about good design being necessary. While she acknowledged the steps that the Government have taken in this regard—for which I thank her—she cited Oliver Twist and said that she might be perceived as being churlish in asking for more. I would never accuse the noble Baroness of being churlish. I recall that the response to Oliver Twist asking for more was, “Do you want more?”. That will certainly not be my response at this juncture, but I wish to set out the Government’s position. I also thank other noble Lords, including my noble friend Lord Jenkin, for their contributions.

I should stress from the outset that the Government are committed to tackling issues such as climate change and the mitigation of, and adaptation to, the impacts of such change, as well as good design for new developments. Where I suspect we will differ is on the extent to which this amendment would bring any discernible change if an infrastructure project was brought forward for consent under the Planning Act.

Part 2 of the Planning Act sets out the legislative requirements where a Secretary of State brings forward a national policy statement. National policy statements form the prime basis for deciding whether a project should be granted development consent. Given this very important role, such statements, as noble Lords will know, are scrutinised by Parliament and subject to public consultation before being finalised. This process of scrutiny provides the most appropriate means of ensuring that matters such as design and climate change are appropriately covered in a national policy statement.

All national policy statements that have been prepared to date have taken into account the issues set out in Section 10 of the Planning Act. Parliament has been given the opportunity to help shape these before they were finalised. That process of scrutiny will continue when new policy statements come forward and existing ones are reviewed. The final version of the policy statement on national networks will be designated soon and the next policy frameworks to be produced will be after the Davies commission has reported in 2015. I therefore suggest to the noble Baroness that the best place in which to seek the changes and improvements that she proposes is in the wording of national policy statements when they are subject to parliamentary scrutiny before they are designated. With those assurances and the clarity that I have provided, I trust that the noble Baroness will be minded to withdraw her amendment.