Levelling-up and Regeneration Bill

Baroness Lister of Burtersett Excerpts

2nd reading
Tuesday 17th January 2023 Lords Chamber

[Baroness Lister of Burtersett (Lab)]

My Lords, I will focus on levelling up, even though it forms but a fraction of this leviathan of a Bill. If the Bill and the wider levelling-up agenda are to meet their objectives of

“giving everyone the opportunity to flourish … living longer and more fulfilling lives … benefitting from sustained rises in living standards and well-being … and … realising the potential of … every person across the UK”,

to quote the White Paper, they have to be about people as well as places, as my noble friend Lady Anderson said in her inspiring maiden speech. The White Paper acknowledges the point made by my noble friend Lord Whitty that

“disparities are often larger within towns, counties or regions than between them”,

and the former Lords Minister stated:

“It is very clear that the levelling-up mission involves levelling up both within and between communities”.—[Official Report, 19/5/22; col. 558.]


However, they—I do not count my noble friend here—failed to draw the obvious conclusion that a geographical lens is not in itself sufficient. Then when a Conservative Back-Bencher in the Commons argued that

“levelling up applies to need not geography”,

the Secretary of State did respond, “Yes, absolutely”, and that:

“It is critically important that we … address poverty wherever we find it”.—[Official Report, Commons, 2/2/22; col. 339.]


The fact is that many people in poverty are not to be found in the poorest areas.

Despite Mr Gove’s admission, nowhere does the levelling-up agenda directly address poverty. Last year, the then Prime Minister, who championed levelling up, was asked in the Liaison Committee on 30 March:

“Do you believe it is possible to level up the country without reducing the number of children living in poverty?”


“No,” he replied. He was then asked how many times child poverty was mentioned in the levelling up White Paper. When he was told it was “none”, he responded that it is a “purely formal accident”.

If it was an accident, how come that accident is now being repeated? Specifically, could the Minister please explain why a mission to reduce the level of child poverty has not been added to the list of missions in the White Paper? A Written Answer to a Question from the right reverend Prelate the Bishop of Durham on whether a reduction in child poverty in every local authority across the UK is

“an intended outcome of the levelling up agenda”

stated that reducing child poverty

“is a central part of this vision”

and referred to the White Paper’s missions. But if it is a central part of the vision, why is it not explicit in the missions?

I hope to argue in Committee that there should be such a mission with regard not just to the number and proportion of children in poverty but to the depth of that poverty, because more and more children are being pushed further and further below the poverty line, in part because of the Government’s own social security policies. Action for Children has argued that tackling child poverty is key to levelling up and that this calls for a new child poverty strategy and review of how the social security system could be best used to lift children out of poverty and give them the opportunity to thrive.

Action for Children also makes the more general point that levelling up can only succeed if this includes levelling up for children. Only one of the missions relates specifically to children, and it does so in a way that frames children purely as future “becomings” through their educational outcomes, while ignoring them as beings whose childhood in the here and now matters—a bias criticised by the British Academy programme on reframing childhood that I chaired. Even from the narrow and, I accept, important perspective of educational results, there is no recognition of how those results can be affected by child poverty and hunger, and of the role that expanding free school lunches and breakfasts could play in supporting this mission.

In arguing for levelling up to focus on people as well as places, I am not suggesting that place does not matter. Indeed, it probably matters most to those who are least mobile geographically and has a significant impact on their well-being. I thus welcomed the Government’s eventual agreement to include community wealth funds in the recent consultation on the use of dormant assets, not least because proposals for such funds place great emphasis on the participation of local communities, including the most marginalised, in deciding their use. Is the Minister in a position to update us on the outcome of that consultation?

In conclusion, in the Commons Second Reading debate, the then Minister for Housing heralded the Bill as

“a major milestone in our journey towards building a stronger, fairer and more united country.”—[Official Report, Commons, 8/6/22, col. 914.]

But it cannot represent such a milestone without explicitly committing the Government to pursuing a child poverty strategy.

Levelling-up and Regeneration Bill

Baroness Lister of Burtersett Excerpts

Committee stage
Monday 20th February 2023 Lords Chamber

[Baroness Pinnock (LD)]

My Lords, we have a lot of scrutiny of this Bill before us. Before we start, I want to explore what is meant by levelling up, and whether there is a broad agreement as to its definition and purpose. My amendment proposes to remove the words “levelling up”, as the content of the Bill fails to live up to the aspiration as described in the levelling-up White Paper.

Here is one definition. The purpose of levelling up is,

“to break that link between geography and destiny so that it makes good business sense for the private sector to invest in areas that have, for too long, felt left behind ... A vision for the future that will see public spending on R&D increased in every part of the country; transport connectivity reaching London-like levels within and between all our towns and cities; faster broadband in every community; life expectancies rising; violent crime falling; schools improving; and private sector investment unleashed.”

That is the former Prime Minister’s explanation, set out in the foreword to the levelling-up White Paper.

Does levelling up refer to this? The White Paper says:

“There are stark geographical inequalities between and within our cities, towns and villages … It is about unleashing opportunity, prosperity and pride in places where, for too long, it has been held back.”


These words were those of the Secretary of State for Levelling Up, Housing and Communities, and Andy Haldane, formerly of the Bank of England, in a further foreword to the White Paper.

The executive summary of the White Paper spells out the purpose very clearly:

“This requires us to end the geographical inequality which is such a striking feature of the UK … This programme has to be broad, deep and long-term. It has to be rooted in evidence demonstrating that a mix of factors is needed to transform places and boost local growth: strong innovation and a climate conducive to private sector investment, better skills, improved transport systems, greater access to culture, stronger pride in place, deeper trust, greater safety and more resilient institutions.”


Therefore, throughout the White Paper, on which presumably the Bill is based, there is a clear focus on geographical disparities and inequalities. These inequalities, it is argued, harm the whole of the country, not only for the lost opportunities of lower incomes and skills but because the consequence is lower growth, which has a negative pull on the country as a whole.

The levelling-up fund is, I assume, a precursor to a wider strategy. If so, it is instructive to analyse which areas have been granted funds in the first two rounds. If levelling up was to be laser-like in addressing the worst of the geographic inequalities, levelling-up grants would be targeted at those parts of the country deemed to be suffering the greatest inequalities as defined by the White Paper. Yet, as the House of Commons Library has shown, those areas categorised by the Government as priority 1 for grant funding had just 59% of the total funding available. Over £1 billion from the levelling-up fund was allocated to areas not deemed in greatest need; those were in priority 2 and even priority 3 areas.

That is not levelling up as defined by the White Paper; it is spreading the government funding jam way too thinly. Of course there will be, within every area, pockets of deprivation. Empowering and enabling local councils to tackle smaller areas of deprivation is probably the most effective way to do so. The levelling-up White Paper, however, is setting out a strategy, not for tackling individual poverty or small areas of deprivation but for finding solutions to economically underperforming places. Will the Minister clarify whether levelling up is to tackle individual poverty or to narrow the gaps as proposed by the metrics in the annexe to the White Paper?

The White Paper—it is a good read—also states:

“The UK has larger geographical differences than many other developed countries on multiple measures, including productivity, pay, educational attainment and health … While London and much of the South East have benefited economically, former industrial centres and many coastal communities have suffered. This has left deep and lasting scars in many of these places, damaging skills, jobs, innovation, pride in place, health and wellbeing.”


In chapter 1 of the White Paper the analysis is most clearly stated:

“The UK’s spatial disparities are also among the largest across advanced economies on a number of measures, including productivity and income per head … When assessed across 28 different measures—using different spatial units of analysis, different measures of prosperity and different indices of inequality—the UK has been found to be one of the most spatially unequal countries among the OECD.”


The Bill offers an opportunity to fulfil the aspirations set out in the White Paper. Currently, it fails to do so. The missions and capitals described in the White Paper must be part of this Bill. The Bill should then establish the legislation to enable those missions to be enacted. It fails to do so.

This is a complex Bill addressing, in part, one element of the White Paper missions, that of wider local devolution. It also has a detailed section on planning reform which may—or may not—add to a mission to narrow spatial gaps. Yet measures to enable the big strategy of levelling up are simply not there. Levelling up is a slogan seeking some substance. For the sake of millions of people, the substance and the financial commitment are desperately needed. I beg to move.

[Baroness Lister of Burtersett (Lab)]

My Lords, I thank the noble Baroness, Lady Pinnock, for tabling this amendment because it gives us the opportunity to pinpoint the tension at the heart of the levelling-up agenda. As the impact assessment reminds us, the problem it claims to address concerns unequal shares and opportunities, and levelling up

“is a mission to challenge, and change, that unfairness.”

It means

“giving everyone the opportunity to flourish”

and to have

“longer and more fulfilling lives”,

together with

“sustained rises in living standards and well-being”

for people everywhere. In fact, this is a statement about people, not places, as reflected in some of the missions. Yet the impact assessment states that achieving the aims of levelling up

“requires us to end the geographical inequality which is such a striking feature of the UK.”

The Minister’s levelling-up letter explains that the missions are necessarily spatial—but why are they purely spatial and geographical when inequalities of income and wealth between individuals are also striking features of the UK? A report published by the Social Market Foundation, called Beyond Levelling Up and written by a former senior adviser to recent Conservative Chancellors, argues that this approach to levelling up

“avoids the question of whether we think the gap between rich and poor is acceptable, and whether we are comfortable with the current levels of income and wealth accruing to the richest in society.”

I will leave those in poverty until a later amendment. To make matters worse, ONS data shows that inequality has worsened since he wrote the report, and it is worse still if we use alternative measures on inequality.

I ask the Minister if she thinks the gap between rich and poor is acceptable. How does she think that the levelling-up agenda’s ambitions can be achieved without addressing that gap between rich and poor?

[Lord Shipley (LD)]

My Lords, I declare, for Committee stage as a whole, that I am a vice-president of the Local Government Association and a vice-president of the National Energy Action advisory board.

I thank my noble friend Lady Pinnock for raising this issue; it is very important that we have a shared understanding of what we mean by levelling up. For me, I think it is the second option she gave, which is narrowing the gap. If we were to compare ourselves with Germany, we would find that there is a constitutional requirement in Germany for the 16 Länder to support each other, and the outcomes are assessed in terms of how well off the Länder are and using the many criteria we will be debating later today—there are so many criteria you can use. However, it is important that we understand the Government’s precise objectives with the Bill.

--- Later in debate ---

Moved by

[Baroness Lister of Burtersett]

4: Clause 1, page 1, line 14, at end insert—
“(2A) The levelling-up missions must include a mission to reduce the numbers and proportion of children in absolute poverty, relative poverty and deep poverty in each local authority and across the United Kingdom.”Member's explanatory statement
This would ensure that the levelling-up missions included a mission to reduce child poverty.

[Baroness Lister of Burtersett (Lab)]

My Lords, I rise to speak to Amendment 4 in my name and those of the right reverend Prelate the Bishop of Durham and the noble Baronesses, Lady D’Souza and Lady Stroud, whose support I am grateful for, although they could not speak today. The purpose is to ensure there is a levelling-up mission to reduce levels of absolute, relative and deep child poverty in each local authority and across the UK.

On Second Reading, I quoted the response of the Levelling-up Secretary to a Conservative Back-Bencher who had argued that levelling up applies to need, not geography. “Yes, absolutely,” said Mr Gove:

“It is critically important that we … address poverty wherever we find it”.—[Official Report, Commons, 2/2/22; col. 339.


The former Prime Minister Mr Johnson was asked by the Liaison Committee:

“Can you level up the country without reducing the number of children living in poverty?”


He replied, “No.” When he was told that child poverty was not mentioned once in the levelling-up White Paper, he assured the committee that this was a “purely formal accident”. So, while I appreciate the detailed letters sent by the Minister following Second Reading, it was disappointing that nowhere could I find an answer to the question I had posed—

“could the Minister please explain why a mission to reduce the level of child poverty has not been added to the list of missions in the White Paper?”—[Official Report, 17/1/23; col.1766.]

given that its omission was apparently an accident. Indeed, I could not find any mention of child poverty at all in her levelling-up letter. Is that another accident?

Part of my argument on Second Reading was that levelling up has to be about people as well as places if it is to meet its objectives, including giving everyone the opportunity to flourish. Indeed, although the existing missions are framed in terms of inequalities between areas, ultimately, many of them concern people rather than the places in which they live, and earlier, the Minister acknowledged that levelling up is about people and places.

However, apart from the education mission, children are conspicuous by their absence. Yet, to quote Action for Children,

“Levelling up can only succeed if this includes levelling up for children.”


Levelling up for children has to address the child poverty that blights our society, with nearly 4 million children in poverty, or getting on for three in 10, projected by the Resolution Foundation to rise to its highest rate since 1998-99 by 2027-28. Moreover, half of children in families with three or more children are projected to be in poverty by that year. A glimpse of what this means is provided in an open letter from participants in the participatory Changing Realities project:

“Our children are hungry. Schools report ‘short concentration’ and ‘unmanageable moods’. They have lost their childhood ... we are sick with anxiety, drowning in financial doom.”


The report in which this is reproduced, prepared by the APPG Child of the North just last month, noted:

“We know that poverty is the central driver of inequalities between children, leading to worse physical and mental health, poorer educational attainment and life chances and alarming … gaps in life expectancy”.


This underlines the importance of tackling child poverty through existing missions on education, health and well-being. Gaps in healthy life expectancy cannot be closed without tackling child poverty. As the BMA has warned, “poverty kills”. In a recent BMJ interview, the President of the Royal College of Paediatrics and Child Health observed that social deprivation is a far bigger problem for children’s health than it was five to 10 years ago. She warns that poverty

“essentially eats away at what we believe the kinds of key components of a healthy childhood are”

and that this is going to have a generational impact. She calls for long-term thinking and, in the absence of government action, the college is encouraging paediatricians to lobby politicians on their commitment to reduce child poverty and health inequalities. Indeed, the royal college has briefed in support of this amendment, presenting evidence that child poverty is a key driver of health inequalities.

As a recent open letter to the Prime Minister from leading public health bodies and others—signed by many Peers, including myself—makes clear, the impact of child poverty and food insecurity on health has knock-on effects on education and achievement levels in schools. The educational mission looks to level up the numbers of primary schoolchildren achieving the expected standard in reading, writing and maths. Yet there is no acknowledgement of how poverty prevents many children reaching their potential with, as the public health letter spells out, implications for the provision of free school meals and breakfasts.

While I have stressed the importance of the levelling-up agenda explicitly addressing inequalities between people as well as places, as I argued earlier and the Minister accepted, the case for a child poverty mission stands, even if one accepts the Minister’s assertion, in her levelling-up letter, that the missions are “necessarily spatial”. The amendment is thus deliberately framed so as to include a spatial as well as a national, aggregate dimension. The evidence provided in the APPG Child of the North report, and also by Action for Children, shows clearly the spatial dimension to child poverty. According to Action for Children, 60 out of 152 local authorities have child poverty rates above the average. The APPG report underlines how the risk of child poverty is consistently higher in the north than in the rest of the country. However, it should also be noted that, after taking account of housing costs, research by my university, Loughborough, for End Child Poverty found that some of the highest child poverty rates are to be found in London authorities. So, in order to level up all these areas, wherever they are, we need an explicit child poverty mission that addresses both the extent and depth of child poverty.

The Minister’s letter explains that the levelling-up missions aim

“to anchor ambition and provide clarity over the objectives of public policy for the next decade”

and that they will be varied only

“following careful review of all missions”.

Yet we are constantly told that the Government are committed to reducing child poverty, and earlier the Minister said that levelling up is about bridging the gap between rich and poor. So, I ask again: why is there not a child poverty mission which would underpin and complement the existing missions and help to bridge that gap? Such a mission is important, both because children experience childhood only once and because poverty in childhood can have longer-term effects on their education, health and general well-being and their ability to flourish and realise their potential. Thus, this is urgent. Children cannot wait for a review of existing missions some years hence.

If the Minister cannot accept the amendment, will she at least agree to take it away and consider the addition of a child poverty mission to the existing list? If not, we can only conclude that the Government do not care sufficiently about child poverty or children to include them in their levelling-up strategy. I beg to move.

--- Later in debate ---

[Baroness Scott of Bybrook (Con)]

I will read Hansard, then write to her and put a copy in the Library.

[Baroness Lister of Burtersett (Lab)]

My Lords, this debate has shown the importance of some of the gaps in the Government’s levelling-up mission. It also shows how social and environmental justice are intertwined in terms of child poverty, the environment and disability, as we have talked about. They gel together well as a set of amendments.

I am very grateful to noble Lords who spoke in support of Amendment 4. Some powerful speeches have enriched the case for adding a child poverty mission to the list of missions. I am very grateful to the noble Lord, Lord Young of Cookham, who looked for a way through without an extra mission but looking at how the current missions could be adapted. It was very disappointing that the Minister rather rejected that olive branch—that way out or way through—and has not even agreed to take it away and consider it as an option.

I thank the Minister for engaging with the issues raised, but, needless to say, I found her response very disappointing. I think she said that the Government accept that child poverty is an issue that we must keep an eye on, manage and act on—but where is the Government’s child poverty strategy? There is none. It is simply not good enough to say that it is all about getting parents into paid work, without even acknowledging the growth of in-work poverty and the number of children in families who have someone in paid work and yet are in real, serious poverty.

The Minister said that she did not want to have targets that would just take people above the poverty line. That is one of the reasons why the amendment talked about deep poverty, not simply getting those just below the line over it. It is a shame that the noble Baroness, Lady Stroud, could not be here, because her Social Metrics Commission has done a lot to draw attention to the increasingly serious issue of the depths of poverty. We now have organisations such as the Joseph Rowntree Foundation talking about destitution. In our modern-day society, this is really not something to be complacent about.

The Minister said, “we are not complacent”, but she then went on to repeat all the wonderful things that the Government are doing, none of which is reducing child poverty—they may be managing it but are not reducing it. It is irrelevant to this amendment to say that we are doing this and that, because those things are not serving to reduce the level of child poverty. I am afraid that, for me, that smacks of complacency.

I do not want to keep people from their dinner. The Minister said that she hoped that we would be reassured by what we had heard and withdraw the amendment. I will of course withdraw, but do not take that as me being in any way reassured. I am not. We will have to consider whether we want to come back on Report with an amendment on child poverty. But, for now, I beg leave to withdraw.

Amendment 4 withdrawn.

Levelling-up and Regeneration Bill

Baroness Lister of Burtersett Excerpts

Report stage
Tuesday 11th July 2023 Lords Chamber

Moved by

[Baroness Lister of Burtersett]

4: Clause 1, page 2, line 3, at end insert—
“(2A) The levelling-up missions must include a mission to reduce the proportion of children of all ages living in poverty in all its dimensions.”Member's explanatory statement
This would include in the levelling-up missions a mission to reduce child poverty based on the UK Government’s domestic commitment to meet the universal UN Sustainable Development Goal 1.2: by 2030 to ‘reduce at least by a half the proportion of…children of all ages living in poverty in all its dimensions’.

[Baroness Lister of Burtersett (Lab)]

My Lords, I rise to move Amendment 4, which is supported by the right reverend Prelate the Bishop of Durham and the noble Baronesses, Lady Stroud and Lady D’Souza, to whom I am very grateful, even though they could not all be in their places. I also give my support to Amendment 7 in particular. I am also grateful to Action For Children, and Paul Wright of Children’s Alliance, for their support.

The amendment would add a child poverty mission to the existing list of levelling-up missions, but it does so in a very different way to that put forward in Committee. I will explain that in a moment but first, I will give a very brief recap of the case. The latest official figures show that over 4 million—nearly a third—of all children are living in poverty. There is an even higher proportion among some minority ethnic communities and a growing problem of deep poverty, as demonstrated by the Social Metrics Commission, chaired by the noble Baroness, Lady Stroud.

While poverty rates vary regionally, Tower Hamlets stands out as the local authority with the highest rate—nearly 50%, according to my colleagues in the Centre for Research in Social Policy at Loughborough University. They used government data, which also show that children are more likely than the overall population to be in low-income households, so it is perhaps not surprising that the Trussell Trust has found that nearly half of all households experiencing hunger include children —a significantly disproportionate number. This is among the latest in a flood of reports I have received, since we debated the issue in Committee, documenting the hardship experienced by children in low-income families.

As I pointed out in Committee, both the Levelling-Up Secretary and the former Prime Minister who introduced the levelling-up strategy have acknowledged that it has to address poverty, in particular child poverty. That child poverty was not mentioned in the White Paper was, according to Mr Johnson, an accident, but the accident has not been rectified. Indeed, the opportunity to do so in Committee was rejected, despite strong support for a child poverty mission throughout the House. Moreover, it was disappointing that the suggestion of the noble Lord, Lord Young of Cookham, that poverty might be written into the existing missions was simply ignored. Mission 2, on opportunities, would, I suggest, be the obvious place to do so.

The Minister’s rejection of the previous amendment in Committee appeared to be based on three propositions. The first was that such a strategy was unnecessary in light of the usual list of what the Government are already doing, together with an example of local authority action to support child poverty reduction at local level. Listing various initiatives does not constitute a strategy. While the anti-poverty strategies pursued by some local authorities are indeed inspiring, it was clear from a recent event organised by Greater Manchester Poverty Action that, despite the good work they are doing, what local authorities are able to achieve is hampered by the lack of a national anti-poverty strategy.

Secondly, on the much-repeated mantra that paid work is the best route out of poverty, it is certainly an important route, but for all too many it represents a cul-de-sac if it simply means in-work poverty. It is not an argument against a wider interdepartmental strategy.

Thirdly, there is the Government’s aversion to income-based targets. I do not accept the Minister’s argument, nor do most academics or charities working in the area, but I shall spare noble Lords a debate on this. Instead, in a spirit of compromise, I have redrafted the amendment to address her concerns so that it now refers to

“poverty in all its dimensions”.

This phrase is taken from the UN sustainable development goal 1.2, which commits all signatories to work to

“reduce at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions”

by 2030.

Noble Lords who are not familiar with the sustainable development goals might think that this is an odd commitment to include in domestic policy but, as was made clear in a 2019 Written Statement from the Department for International Development, these goals apply to all people in all countries, including here in the UK. The amendment is in fact much less prescriptive than the goal itself but, given that the UK Government are committed to meeting the sustainable development goals and the then Secretary of State acknowledged that

“there is more work to do if we are to meet the ambitious targets by 2030”,

I hope the Government accept that this amendment would help them to do so. They might not like targets, but I am afraid that they are committed to the SDG target.

In Committee, the Minister accepted that child poverty is an issue that needs to be acted on. I am grateful to her for meeting me and the right reverend Prelate last week to propose a welcome, albeit small, concession by way of introducing child poverty statistics into the levelling-up metrics, which I shall leave her to spell out. But again, that alone does not constitute a stratagem. The Westminster Government remain the only Government in the UK without any kind of child poverty strategy, despite the 2021 recommendation for such a strategy from the Select Committee on Work and Pensions.

In conclusion, I would like to quote from a short film shown recently in Westminster by the Food Foundation, focused on Melissa, a mother from Solihull who is struggling to make ends meet. Speaking of families in poverty generally, and of politicians, she said:

“They”—


the politicians

“know we’re here, but they don’t see us”.

The inclusion of a child poverty mission in the levelling-up strategy would be a tangible way for the Government to say, “We do see you and we are serious when we say we are committed to eradicating child poverty”. I beg to move.

[Baroness Finlay of Llandaff (CB)]

I declare an interest in that I am vice-president of Marie Curie and co-chair of the Bevan Commission on health in Wales. I shall speak principally to Amendment 7 in this group, which is based on the previous amendment in Committee from the right reverend Prelate the Bishop of London, who is also a signatory to this amendment.

The levelling up White Paper, the precursor to the Bill, published in February 2022, identified that:

“One of the gravest inequalities faced by our most disadvantaged communities is poor health”.


Yet health disparities are not explicitly specified in the Bill and the health disparities White Paper has been scrapped, hence this amendment. In Committee the Minister stated that the Government are committed to working with the devolved Governments to reduce geographical disparities across the whole UK and to share evidence and lessons from across the country, learning what works and what does not. Today we have already heard the Minister re-emphasise this in summing up on previous amendments.

Levelling-up missions must address inequalities right across the life course, from cradle to grave. Tackling health inequalities is essential to improving the nation’s economic health as well as people’s well-being. Inequalities in life expectancy are the result of poor health literacy and those broad social determinants of chronic illness and poor health. The Bill purports to reduce geographic disparities using a range of mechanisms. There are marked regional differences in health outcomes across the nation; within and between regions, disparities are increasing.

The largest decreases in healthy life expectancy were seen in the most deprived 10% of neighbourhoods in the north-east. Between 2017 and 2019, healthy life expectancy at birth for women in the north-east of England was 59 years, 6.9 years less than for women in the south-east; for men, life expectancy was 5.9 years shorter. Alarmingly, ONS data showed that healthy life expectancy was around 19 years shorter in the most deprived compared with the least deprived areas of the nation. In these deprived areas, people had a more than threefold risk of dying from an avoidable cause. Before the pandemic, health inequalities were estimated to cost the UK £31 billion to £33 billion each year in lost productivity, £20 billion to £32 billion in lost tax revenue and higher benefit payments, and almost a fifth—£4.8 billion—of the total NHS budget.

The pandemic sharply exposed the real impact of health inequalities through excess mortality in some population groups, and exposed a number of related socioeconomic factors and regional conditions that exist across the life course. Poor housing, inadequate diet, including maternal malnutrition, and adverse childhood experiences have long-term consequences, including crises in adult life, greater need for NHS and social care support and poorer employment prospects. Living on a low income is a source of stress, and emerging neurological evidence suggests that this affects the way people make health-affecting choices, ranging from food to activity.

Poor-quality and overcrowded housing is associated with increased risk of cardiovascular and respiratory diseases, depression and anxiety. Access to good-quality green space improves physical and mental health and lessens obesity. Deprived inner-city areas have far less good-quality green space and higher atmospheric pollution. Unemployment is associated with lower healthy life expectancy and poorer physical and mental health, for unemployed individuals and their households. In 2019-20, employment rates in the least deprived decile were 81.5%, compared with 68.4% in the most deprived decile. Such unemployment damages the nation’s economy.

These health inequalities, starting in childhood, persist right through to the end of life, when social disadvantage is often exacerbated by regional disparities, leaving palliative care needs unmet, particularly for those 90,000 people who die in poverty and deprivation, and those in rural areas where a quarter of the population are aged over 65, unlike younger urban populations. In the UK, those living in poverty, particularly in the most deprived areas, are more likely to die in hospital than in the community and have more emergency hospital admissions in the final months of life. When they leave bereaved children, these young people have worse long-term outcomes in mental health, employability and so on.

The Bill could break the cycle for many if it truly focuses on the population rather than being diverted by commercial short-termism. This is not about taking away from some to give to others: levelling up must address overall well-being and health inequalities across the life course for us to be an economically stronger nation. Without this as a common thread and a foundation for all missions, attempts to level up will fail. I hope that I will get overwhelming reassurance from the Minister today, because otherwise I will be really tempted to test the opinion of the House on this important issue.

--- Later in debate ---

I hope that the assurances and explanations I have given on these matters have reassured the noble Baroness, Lady Lister of Burtersett, that she feels able not to press her amendment, and that others in the group are not moved.

[Baroness Lister of Burtersett (Lab)]

My Lords, I thank all noble Lords who have spoken. They have strengthened the argument very much and really underlined that it is not possible to level up without explicitly addressing child poverty. I am grateful to the Minister for engaging with the arguments and, at I said earlier, meeting me and the right reverend Prelate, and I acknowledge that we have made some progress with the inclusion in the metrics of the child poverty statistics. I point out that we have those statistics only thanks to the right reverend Prelate, because the Government wanted to do away with them—but thanks to him, in whichever dreadful Bill it was I cannot remember now, we saved them, and I am very glad that they are now proving useful to the Government.

But simply having the metrics without a clear, explicit statement in the missions themselves is not sufficient. It does not meet the arguments that have been put by a number of noble Lords why addressing child poverty should be, as I think somebody said, a foundational mission to the levelling-up strategy. So, much as I am grateful to the Minister for moving since Committee by including the metrics, I am afraid it does not go far enough. It does not meet the arguments put by every noble Lord who has spoken. Therefore, I wish to test the opinion of the House.

Levelling-up and Regeneration Bill

Baroness Lister of Burtersett Excerpts

Consideration of Commons amendments
Monday 23rd October 2023 Lords Chamber

Finally, I turn to Motion W, on access to banking facilities for communities. We are very clear that closures of bank branches are commercial decisions for banks, and we do not believe that a blanket requirement on the Secretary of State to engage with local authorities to produce strategies to inhibit this would be effective or proportionate. Instead, His Majesty’s Treasury will continue to support the rollout of alternative services, such as banking hubs, which will ensure that communities across the country have access to the facilities they need. On this basis, I hope your Lordships will agree that Amendment 199 in the name of the noble Baroness, Lady Hayman of Ullock, is not needed. I beg to move.

[Baroness Lister of Burtersett (Lab)]

My Lords, I will speak to my Motion B1, under which Amendments 4C and 4D would amend government amendments 4A and 4B in lieu. I am grateful to the Government for going part of the way in meeting the concerns raised in the original amendments, which were supported by your Lordships’ House. The purpose of those amendments was to introduce levelling-up missions to address child poverty and health disparities throughout the life course. The latter was moved by the noble Baroness, Lady Finlay, who is unable to be here today, but we have agreed the amendments that I am proposing. Both amendments received strong support on Report, including from the right reverend Prelate the Bishop of Durham, who regrets that he cannot be in his place today.

I am grateful, too, to the noble Earl the Minister for the helpful meeting we had last week. I am only sorry that the noble Lady Baroness, Lady Scott, is still unable to be with us, and I send her my best wishes. I am, though, disappointed that the Government did not accept the compromise that we proposed—I emphasise that it was a compromise. This compromise no longer pushes for specific missions and it accepts the government amendments in lieu, but would add to them the words

“including child poverty, and health disparities throughout the life course”.

I think they are still necessary—indeed, essential.

In the Commons and today, Ministers have acknowledged that child poverty and health disparities are

“essential factors when deciding missions”.—[Official Report, Commons, 17/10/23; col. 182.]

The Government’s argument against our original amendments is that missions may need to evolve over time, so their details should not appear explicitly in the Bill. But does anyone in government really believe that child poverty and health inequalities will not continue to be essential factors in any levelling-up strategies for the foreseeable future?

Just this weekend, the president of the Royal College of Paediatrics and Child Health emphasised the importance of long-term action on child poverty and health inequalities in the context of the climate emergency. Earlier, the early years healthy development review and the Marmot review into health equity underlined the need for a long-term focus with regard to these issues. This amendment would help ensure such a focus, without introducing the kind of inflexibility that the Government are so frightened of.

Given the time constraints, I will not repeat the arguments we made on Report. Child poverty and health disparities are a terrible blot on our society. Child poverty damages childhood itself and children’s life chances. Health disparities diminish life chances and physical and mental well-being at every point of our lives from before the cradle to the grave. The reference to life expectancy is only one element of health disparities; it is not the whole story by any means. Action on both fronts should be seen as an economic and social investment in the future of our society and as key to any levelling-up missions.

Acceptance of our amendment by the Government would constitute recognition of the importance of child poverty and health disparities throughout the life course and help ensure that, whatever the future levelling-up missions, they take account of these essential factors in levelling up our country and improving the life chances of all its members. Unless the Government are willing, even at the last minute to accept this compromise—and I hope I can persuade the Minister to accept it—I give notice that I wish to test the opinion of the House at the appropriate time.

[Baroness D'Souza (CB)]

My Lords, I too speak to Amendments 4C and 4D in the name of the noble Baroness, Lady Lister. We are essentially discussing four non-contentious words: “throughout the life course”. The Government have gone out of their way to address most of the concerns expressed about the welfare of children, for which everyone is extremely grateful. However, it is puzzling why these four words continue to be resisted. We know that health disparities begin in pregnancy, even before birth, as the noble Baroness said, and continue until advanced old age. Surely any levelling-up Bill has to acknowledge that continuous investment at every stage will result in a healthier and more productive society. The Government argue that this is implicit in the Bill, but why not make it explicit in the Bill? I honestly fail to understand this reluctance on the part of the Government and, should the noble Baroness, Lady Lister, decide to press her Motion to a vote, I will follow her into the Lobby.

--- Later in debate ---

Moved by

[Baroness Lister of Burtersett]

At end “, and do propose Amendment 4C as an amendment to Commons Amendment 4A, and Amendment 4D as an amendment to Commons Amendment 4B—

4C: At end insert “, including child poverty, and health disparities throughout the life course.”

4D: At end insert “, including child poverty, and health disparities throughout the life course.””

[Baroness Lister of Burtersett (Lab)]

I beg to move Motion B1 because I am afraid that I am not satisfied by the Minister’s response. What policy? There is no child poverty policy. The health inequalities White Paper was abandoned. We need to focus on these issues. The Government have said that these are essential elements of levelling up, so I wish to test the opinion of the House.