I take the right hon. Gentleman’s point, but regional spatial strategies were set up to ensure that, ideally, houses were built where there was most need. Clearly, across the country overall, that need was starting to be met under the last Labour Government.
Developers are sitting on land. We have heard about the 300,000 existing permissions. What right-minded developer will build homes when nobody is able to buy them? Again, that is not due to the planning system. Instead of dealing with the critical issue of the economy, and the finance and confidence necessary to deliver the investment and pick house building up off the floor, we are having this smokescreen of a debate on planning. However, a debate has sprung up around the country, and it puts planning at the heart of the conflict between growth, the economy and the countryside. That point was very well made by my right hon. Friend the Member for Leeds Central (Hilary Benn) in his excellent speech. That is a false choice and it has unhelpfully polarised opinion.
It is important that we have clarity in the system—I do not disagree with hon. Members in different parts of the House on that issue—but this false debate is now proving to be a total distraction. The NPPF is a deeply flawed document that needs to be seriously amended, and I hope that the Minister is listening to Members in all parts of the House because the Government are committed to railroading it through.
Under Labour, the green belt was expanded. We pursued a policy of “brownfield first”. Brownfield expanded as a proportion of new build as we focused on developments and regeneration—a word that is sadly missing from both the Localism Bill and this document.
No, not at the moment.
We focused on existing communities, and that is missing from the NPPF, and we will see more building on greenfield sites.
The need to protect gardens was not dealt with clearly in the Minister’s statement, although it was the driver behind the change in the “brownfield first” presumption. It is not clear exactly how an assessment will be made of land of the least environmental value, and I think that houses and gardens in some very nice areas will fall into that category. We need clearer definitions, and I am pleased that at least he is willing to rethink the wording of brownfield provisions. I urge him to speak to the Prime Minister and insist that when he answers questions on development in the House he should make it clear that there is no threat to the green belt. The Prime Minister should answer the question that he is asked. If he is asked about the threat to green fields—not green belt—he should deal with that. I have to say that the green fields that are going to be built on are in leafy Tory shires.
The NPPF is silent on affordable housing—a point made by my right hon. Friends the Members for Leeds Central and for Greenwich and Woolwich. When is the assessment of housing need going to be made, as there is just a cursory reference to it in the NPPF, and how will the evidence of that need be collated? Again, that is far from clear.
Finally, there was a glimmer of hope or common sense on transitional arrangements, which are vital. Without a transitional period, there will be fears on the one hand of a development free-for-all while, on the other, developers have concerns about the lack of such arrangements. When the Localism Bill is enacted, regional spatial strategies will disappear, and there will be a gap before the NPPF is introduced, with further losses of planned homes on a scale of the losses that have already taken place as a result of announcements by the Secretary of State. This is an incredibly important subject for people on both sides of the debate, and I am pleased that there appears to have been some backtracking.
In the Committee that considered the Localism Bill, the Opposition were asked to legislate without sight of the NPPF. The House, on Report and on Third Reading, was asked to legislate without sight of the document, and now developers and local communities are going to be asked, some time in the future, to plan without sight of the details that they will need, either to support good-quality local development, designed to meet needs, or to protect local areas of importance. Even today, we have had another statement on the abolition of RSSs that discusses the requirement to undertake a proper environmental assessment, albeit voluntarily. It says that the Government are undertaking another consultation on the matter. How can we legislate and make decisions about things as important as the planning policy framework without seeing the outcome of those consultations?
I welcome the fact that the Government have backtracked on their proposals on yet another ill-researched policy that has been introduced in haste. Along with my colleagues, I await the revised NPPF and the debate on it, because the wording of today’s motion is far from accurate. The House has not, in my view, considered the NPPF, and we should be allowed another debate on the revised paper, and a vote.
(13 years, 1 month ago)
Commons ChamberI shall cut to the chase because other Members want to speak and many colleagues have spoken powerfully about the benefits of the NHS. I have two very specific questions regarding concerns that people in the south-west have raised with me. These issues relate to part 1 of the Bill, the role of the director of public health, and the making of complaints, as covered by new clause 1. I want to link these issues to the duty of the Secretary of State to ensure that the basis on which actions are taken—indeed, the information that is used—is in the hands of and is accessible to people in the new set-ups who need that information and can use it.
The concerns that have been raised with me relate to the movement of national health service public health staff into local authority control and the fact that the Office for National Statistics currently has a duty to release certain data only to directors of public health, who are part of the NHS. I gather that the ONS has had concerns about this and I am interested to know whether it has waived the requirement for directors of public health to sign a confidentiality and proper use statement every year, or whether it has agreed to the passing of this role into local authorities. I cannot find that in the Bill, although I must admit that I am coming to this a little late—my apologies to colleagues about that—and I would be very grateful if the Minister could tell me whether that issue has been resolved.
Secondly, the Minister will know that we carry out nuclear decommissioning in Plymouth. Is he confident that public health can be fully protected in the way that it has been in the past? I note clause 54 on radiation, but will the Minister look at how H1N1 was dealt with? The first confirmed case of swine flu was in Paignton and the response was carried out by PCT public health staff in Plymouth and Torbay. They worked together rapidly to administer antiviral drugs to nearly 500 pupils and they provided reassurance and support to extremely anxious children and parents. That response was set up within 45 minutes of the initial phone call, despite the fact that it had not been done before, and it was done without any practical help from the Health Protection Agency, which was swamped with other work. The PCT public health staff just got on with it and they did a fantastic job—no other child was infected. Indeed, they compiled a guide on how to do it all, which was passed on and was commended by the Prime Minister. There is a view that such a response will not be possible in a few years’ time, so complaints from the public—this takes us back to new clause 1—will inevitably follow. Clearly, if we get health protection wrong, we can kill people.
In order to avoid complaints on new clause 1, will the Minister say what power the director of public health, sitting within the local authority, will have to galvanise staff across organisations? Will they be the appropriate authority, or will responsibility sit elsewhere? Will they have to go through another senior officer? Who is ultimately responsible if they get it badly wrong—the local authority, the director of public health or the Secretary of State? Or is it another instance when the Government are saying, “Not me, guv” and passing the buck to the local council and the political leadership of that council? If there was a viral outbreak in various parts of the country, widely spread, would the individual local authorities be held responsible for dealing with it, coming up with solutions and coping with the outcomes, or is this a case in which the Secretary of State actually has a clear duty to take the lead?
I am extremely grateful to you for calling me, Madam Deputy Speaker, as you have a tough job this afternoon. I have to declare an interest. I rarely speak in the House on NHS organisation, particularly public health, because my wife is employed as a director of public health. Obviously, the Bill and the public health section of clause 27 will affect her significantly, and by extension those of us in her family, but I make it clear to the House that although my knowledge of her role and profession has informed amendments 1255 to 1260, which stand in my name, she had no knowledge of them or their contents before I tabled them. However, I am grateful to the Faculty of Public Health and others who have given me advice.
Public health is pretty poorly understood, not least in this Chamber at times. There is a constant tendency to confuse it with the traditional, established local authority function of environmental health, and although I have great respect for the hon. Member for Stoke-on-Trent North (Joan Walley) in many respects, I think the risk of her new clause 23 is that it extends that confusion between environmental health and public health. There are many key functions to public health, not just the vital five-a-day style health promotion and health improvement work, but a critical role in health protection, including the management of outbreaks of communicable diseases—serious diseases such as meningitis and influenza—and a key role in influencing, at the moment, NHS commissioning at local level, using population-wide data and medical analysis. That, at the moment, happens very simply and straightforwardly within the primary care trust. Under the Bill at the moment, there is no role for the director of public health within the new clinical commissioning groups, and they have to exercise that kind of influence at several removes. That point was well made by the hon. Member for Plymouth, Moor View (Alison Seabeck).
It was suggested to me at one stage by some civil servants working on the Bill that in order to make up for the gap left by the director of public health in the new clinical commissioning groups—then called consortia—they might actually want to employ someone with public health expertise to make up for the reorganisation. That does not seem to me a very good use of public money.
Some of the things that Ministers have announced are to be welcomed. I will have to skip over them briefly, but principal among them is the very good decision to make Public Health England a separate Executive agency and not part of the Department of Health. That was a key request of the faculty, and I think it is very important that it retain that status and objectivity.
I pay tribute to the Minister of State, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), for taking a great deal of time and care over the concerns that I had in this whole area, but questions remain to be addressed and my six amendments are an attempt to address three main areas.
The first area is, as the hon. Member for Plymouth, Moor View pointed out, that under this scheme directors of public health will be removed from the NHS, as will their staff. One of my amendments suggests, therefore, that they should continue to be employed by Public Health England and retain that integration within a wider public health profession. At the moment directors of public health sit within primary care trusts and it is reasonably straightforward, but within the spaghetti-like structures created by the Bill, public health responsibilities and leadership are now to be split among Public Health England, the Secretary of State, the local authorities, the national commissioning board, the health and wellbeing boards and clinical commissioning groups. The threat is not just confusion and the unclear fragmentation of public health functions, but the fragmentation of the profession itself and of the career paths, whereby people might move from one bit to another and have to leave and rejoin the NHS, and so on. That is one of the issues addressed.
The second issue is that people should be suitably qualified. The responsibility for their professional qualification and professional development should lie in the hands of Public Health England, not local authority managers, who might have no medical or professional public health training. It is an important function, so they should be senior officers. Several members of the Health Committee, including its Chair, made the important point that they should report directly to the chief executive. It has been suggested in some parts of the country that the post of director of public health could be combined with or report to other directorates in the principal local authority—for instance, the director of housing.
I wrote to the Deputy Prime Minister on the issues, and he replied:
“given the importance of these new local authority public health functions, the leadership position of the DPH in the local community and the critical health protection functions to be carried out by the DPH on behalf of the local authority, we would expect the DPH to be of chief officer status”.
I do not think that an expectation is strong enough. I have great regard for many directors of housing, but if my child had meningitis, I would not want the director of housing to be on the other end of the phone line at a critical moment.
As it is still possible for the Government to address these issues through the consultation exercise on public health that is being planned, I will not press my amendments to a vote today, but I was rather disappointed with the Minister’s response to them. Should any noble Friends be listening from the Gallery, I hope they might take up the theme of public health in another place. Public health is poorly understood and has not grabbed the headlines in the way that the 38 Degrees campaign has, but over recent years it has been quietly becoming a more and more successful, professional and increasingly medically qualified discipline in the NHS. It saves lives, and we should protect it.