Long Covid

Debate between Guy Opperman and Steve Baker

Thursday 24th February 2022 Commons Chamber

[The Parliamentary Under-Secretary of State for Work and Pensions (Guy Opperman)]

The Russian invasion of Ukraine colours everything we talk about today, and I wish to put on record my support for what has been said by all political parties. I am sure I speak for all colleagues on both Front and Back Benches when I say that we stand with the people of a sovereign and independent Ukraine. We are a legitimate democracy, which means that we can debate things. We can have a discussion in a way that other countries, such as Russia, cannot do. I congratulate the hon. Member for North East Fife (Wendy Chamberlain) on securing this important debate on an important issue. As she knows, the Minister for Disabled People, Work and Health, who would normally respond to this debate, cannot be with us tonight because of personal reasons. She apologises for that, and I am here to respond to the best of my ability on all matters on behalf of the Government.

The Government recognise the impact of long covid on individuals and their families. We are committed to working across the Government to ensure that appropriate provision and support is available to those suffering from the condition of covid. The hon. Lady is right to say that we have been through the worst pandemic since the Spanish flu of 1919, and all Governments around the world are playing catch-up in an attempt to understand, appreciate and deal with the consequences of this terrible disease. It is also a chance for us in this House to put on record our thanks to the pharmaceutical companies, everyone behind the vaccine taskforce, the NHS, the public and private sectors, and the volunteers behind the vaccine roll-out.

We cannot discuss covid without raising the specific issue that it is in everybody’s interests to get the jab. I have done everything possible, including videos with my dog, Zola, to encourage vaccine take-up, and it is very much in our interests to have a continuation of that take-up. Sadly, however, a significant proportion of the population have still not had the jab, and we urge them to go forward and do that.

[Mr Steve Baker]

One thing I notice when I look at the vaccination map brilliantly provided by the Government is that the areas of Wycombe with the highest ethnic minority populations are the least vaccinated. Will the Minister take this opportunity, if he can, to tell us a bit more about what the Government are doing to help those people?

[Guy Opperman]

A great deal is being done; I will write to my hon. Friend and set it out in copious detail. The most important thing is that thought leaders, whether voted for or not—they range from Members of Parliament to religious leaders and community leaders—make the case in their communities that people need to get the jab, because the way out of this and back to normal life and living with covid is clearly to embrace the vaccine. There is much more that I could touch on, but that is the main point.

Specific guidance was set out in the detailed “COVID-19 Response: Living with COVID-19” document put forward by the Prime Minister. The hon. Lady said that there was no reference in the Prime Minister’s statement to long covid. That is not the case for the document—I refer her in particular to paragraphs 87 and 118—but this is clearly a work in progress. I will come to the specifics in a bit more detail. We remain committed to ensuring that everybody can access the health and support that they need. We are doing what we can to ensure that care pathways are available and clearly signposted so that people who need extra help receive it.

The hon. Lady rightly mentioned that she is a Scottish MP and that this is a devolved system. I will therefore briefly touch on the health approach before turning to benefits. The Department of Health and Social Care has invested over £50 million in dedicated research to improve the diagnosis and treatment of long covid. In addition, NHS England and NHS Improvement have invested £224 million to provide care for people with long covid, including £90 million in 2022-23. There are 90 long covid assessment services across England, including 14 specialist paediatric hubs that have been established to support adults, children and young people with long covid and to direct them into appropriate care pathways.

The Government recognise that while England has adopted a clinic-based service model, no one single approach is likely to fit all areas and circumstances, and it is right and proper that each part of the UK can adopt a service model for long covid that most effectively responds to its patients’ needs. That recognises that—this goes to the hon. Lady’s point—everyone experiences long covid differently and that health services are organised differently depending on where they are located.

In Scotland, I understand, NHS boards are developing pathways between primary and secondary care according to local services and the needs of their respective populations, with a focus on providing care and support that is as close to home as possible. In Northern Ireland, assessment services have been established featuring multidisciplinary assessment and support in primary and secondary care settings. Similarly, in Wales, a recovery programme has been established whereby the majority of people accessing services will do so directly via their GP practice and, following assessment, people may be supported by a range of healthcare professionals depending on their individual needs.

I turn to benefit entitlement. It is vital that the existing benefit system provides inclusive, accessible and sustainable support to all people with health conditions that impact on their ability to work and participate fully in society. That includes, obviously, people with long covid. However, the benefit system is set up to consider the impact that a health condition has on an individual’s ability to work and carry out day-to-day activities. In the case of long covid, there would be an assessment of a person’s needs in the same way as for other conditions, by understanding its impact on their day-to-day activities.

Claimants can apply for benefits on the basis of their symptoms and the impact that those symptoms are having on them. The hon. Lady rightly outlined that there are a multitude of different symptoms, which goes to my point that the NHS in the UK and particularly in England—I cannot speak in detail for the Scottish NHS—is making great efforts to better understand diagnosis and treatment. Clearly, however, the main symptoms would be pain, fatigue, breathlessness and some things that are akin in many ways to ME and other illnesses. Clearly, how those symptoms fluctuate is particularly relevant to long covid and the ability to function on an ongoing basis.

Assessments for health and disability benefits take those matters into consideration. Our healthcare professionals are trained to explore and evaluate those factors. Overall, there are three ways in which we assess a claimant’s needs. First, irrespective of a person’s income or whether they are in or out of work, we can assess mobility or care needs through the disability living allowance, the personal independence payment and the attendance allowance. For the current financial year 2021-22, PIP alone will provide around 2 million people of working age with £12.2 billion of support.

Secondly, we can also look at a person’s capability for work to understand if, owing to the impacts of a health condition, they might have difficulty finding and keeping a job. We assess that through the work capability assessment, which provides access to the employment and support allowance and the additional health-related element of universal credit. Anybody who is unable to work can claim those benefits. New-style ESA provides support to those with sufficient national insurance contributions, and universal credit provides support for those without contributions. Overall, in 2021—I accept that it is an ongoing process—we are supporting over three-quarters of a million people on the universal credit health journey and spend over £17 billion a year on working-age benefits or incapacity.

That brings me to the third type of need that we must address, which is financial need, whereby the system of universal credit looks at a household’s situation in and out of work, and provides support according to that household’s financial needs. For those out of work, it is also the main gateway to access Jobcentre Plus support to help them get back into work.

The hon. Lady referred to industrial injuries. I cannot speak to the specifics for Scotland, but the Department for Work and Pensions is responsible for the industrial injuries scheme, which compensates for injuries arising from an industrial accident or a disease contracted as a result of a person’s occupation. The Industrial Injuries Advisory Council advises the Secretary of State for Work and Pensions regarding industrial injuries disablement benefit, and is considering available scientific and epidemiological evidence on long covid. IIAC does not specifically apply in Scotland. It is important to add that any changes to the scheme can be recommended only where there is sufficiently robust evidence. However, it is reviewing the available evidence on an ongoing basis to inform on whether long covid can and should be prescribed as an occupational disease for the purposes of industrial injuries disablement benefit. The House will be updated as that work progresses.

In addition, work is being done on occupational health support. The hon. Lady will be aware that in July 2021 we published the response to the “Health is Everyone’s Business” consultation—if she is not, she should look at it—which specifically sets out the measures the Government are taking to help employers better navigate the work and health system. They include improved access to occupational health, particularly for employees of smaller employers and self-employed people who are least likely to have access; testing a new occupational health financial incentive; and stimulating the development of innovative quality services while addressing workforce capacity constraints.

In addition, there is clearly a situation in respect of data on long covid. I am aware of the figures from the Office for National Statistics which the hon. Lady cites, but they are not necessarily a reflection of what the NHS is seeing. The nature of that particular report would disagree with, for example, the NHS England activity data. I will read out some of the figures, as they are published. Information is published on activity and demographic characteristics of patients referred to a post-covid assessment clinic in England. For the period 22 November 2021 to 19 December 2021, there were 5,539 referrals to NHS post-covid assessment services, 458 fewer than in previous weeks. Of those, 4,946 were accepted as clinically appropriate for assessment. There were 4,750 initial specialist appointments assessments, which were completed together with 8,695 follow-up appointments. Those figures are the highest reported since publication of that data commenced.

A whole host of further long covid research is being done through the National Institute for Health Research and UK Research and Innovation, which invested some £50 million in research to better understand long covid and to treat it. My strong advice to the hon. Lady is that she sits down with Health Department colleagues from Scotland and this country with a view to getting the details on that. I cannot give more information about that tonight given the limited time that I have.

Clearly, however, a lot of work is being done. There is £8.4 million being spent on the post-hospitalisation covid-19 study at the University of Leicester, and £18 million of funding has been given to four research studies to better understand and address the long-term effects of covid-19 on physical and mental health. The studies will examine the causes, consequences and treatment of what is known as long covid. Similarly, a further £19 million has been given to 15 research studies to accelerate the development of new ways to diagnose and treat long covid as well as to consider how to configure services to provide the absolute best healthcare. It is clear that this is a work in progress. This is a journey. It is important that the hon. Lady raises these points and we debate them, and that we all understand that the journey is not complete.

In conclusion, the Government recognise that long covid can have a significant impact on individuals and their families. We are committed to working across Government to ensure that people suffering from this terrible condition can access the appropriate provision and support. The initial £50 million investment in research to improve the diagnosis and treatment will help us to understand the condition and its impact more fully. That, alongside investment in expanding care and assessment facilities for patients, shows that the Government recognise the condition and are acting.

In addition, the Department for Work and Pensions provides a great deal of financial support in the ways that I have outlined, which enables those affected by the pandemic to access the help that they need. We will carefully monitor and consider the advice of the Industrial Injuries Advisory Council regarding long covid. We remain committed to this support. We continue to review our approach and to ensure that there is ongoing support, and I thank the hon. Lady for the points that she has raised tonight.

Question put and agreed to.

Charter for Budget Responsibility

Debate between Guy Opperman and Steve Baker

Tuesday 13th January 2015 Commons Chamber

[Guy Opperman]

Absolutely nothing whatever. My hon. Friend and I are leading lights in the all-party apprenticeships group, which has seen fantastic work. I should probably make a declaration that I am the first MP to hire, train and then retain an apprentice as an office manager—not as an MP, I hasten to add—because she was doing a fantastic job.

On what the Opposition intend to do, we have to address the deficit. The Chancellor eloquently put it that the Leader of the Opposition is practising Basil Fawlty politics by not mentioning the deficit at every opportunity. We also have to look at fiscal consolidation. We all heard what the shadow Chancellor said today, but what did the Leader of the Opposition say only on Sunday on “The Andrew Marr Show”? He said that

“if we…cut our way to getting rid of this deficit, it won’t work”.

So there goes fiscal tightening in any way whatever. To the clarification put to him that

“that requires a £30 billion fiscal tightening”,

he replied, “I don’t accept that.” Whatever the Opposition say today, the reality will always be that the Labour party will introduce greater taxes and greater borrowing, and greater difficulties for our children.

On attempts to address the deficit, other Members have made the point, including my right hon. and learned Friend the Member for Rushcliffe (Mr Clarke), that raising the tax rate to 50% will not increase the tax take by any margin and will actually decrease investment. On the minimum wage, tax credits from the coalition have already addressed that in a very successful form and we intend to raise it. I heard on the BBC “Daily Politics” today the hon. Member for Nottingham East (Chris Leslie) proposing that his plan for addressing the deficit was an increase in gun licences. That may be laudable, I do not know, and I am sure he has fiscally costed this matter in great detail, but if that is his plan to address the entirety of the deficit, we really are in more trouble than we thought.

We were indeed fortunate to hear from the hon. Member for Rochester and Strood (Mark Reckless). It is always a pleasure to comment on his speech. I will not cast aspersions on his honour, but I will attack his memory and grasp of economics. He supported the coalition as we did the tough work from 2010.

[Steve Baker]

Will my hon. Friend give way?

[Guy Opperman]

I will not. I am so sorry, but I have zero time. The hon. Gentleman supported us then, but he does not support us now.

Local Plans (Public Consent)

Debate between Guy Opperman and Steve Baker

Wednesday 9th July 2014 Westminster Hall

[Steve Baker (Wycombe) (Con)]

It is a delight to see you in the Chair, Mr Betts, for a debate on a subject in which I know you have a particularly keen interest. I must say that there is no tumbleweed today; looking around me, I can see that my Conservative colleagues have a clear interest in this subject as well. I will try to give the short version of my speech. I had planned lengthy remarks, but if I was to say everything I have in mind I would consume my colleagues’ time.

I begin by outlining two key problems. First, land for development is extremely scarce in Wycombe, and there is real public anger at the prospect of building on all of High Wycombe’s reserve sites, which would further burden the inadequate infrastructure, especially our roads. Secondly, there is an obvious, acute need for more homes, especially those that people, particularly young people and families, can afford. In some cases there is a real sense of despair; I am thinking particularly of one working father I talked to with a family of four who will not only struggle to buy a home locally but might find himself facing the prospect of a Bank of England cap on the mortgage he would need.

There is a real problem of despair among those who do not own homes, and there is also a clear need for public consent. We need to find a way forward because the current approach is failing for three key reasons. First, collaborative democracy is inherently unlikely ever to meet policy makers’ aspirations. Secondly, a duty to co-operate is not the right way to co-ordinate decision making and works against localism. Thirdly, the crux of the matter is that the current system leaves individuals and families facing the imposition of costs without adequate recompense. I am going to say something about each of those points.

I rather regret that I cannot put a map in Hansard, but I will try to describe the problem in High Wycombe. It is surrounded by an area of outstanding natural beauty, apart from where the M40 emerges to the south-east, where it is green belt. That creates enormous pressure on development land—indeed, the district, which is larger than my constituency, is 71% AONB. There are four reserved sites in Wycombe: Abbey Barn north, Abbey Barn south, the Gomm valley and Terriers Farm, all of which are highly prized by local residents and would be served by roads that are already heavily used. We are short of school places and our hospital is already falling short of public expectations, having lost services; it is no surprise that the public have concerns.

Among all that, I have been very impressed by the commitment of Wycombe district councillors to represent their electorate and mine, as well as by the cool-headed professionalism of the planning officers. They are operating a system that they have been given, with all its complexities, uncertainties and, crucially, areas of discretion. They are determined to be constructive and certainly not to abdicate control to the Planning Inspectorate and developers, which is how they perceive things. They have explained clearly that, under their current proposals, most of the Gomm valley and Abbey Barn north in particular would remain undeveloped. Nevertheless, people remain concerned.

Turning to the results of a quality assurance survey about the local plan, I observe that of the 3,800 survey packs sent out, only 550 people replied. That tells me that non-participation remains a crucial problem. Nevertheless, about a third of people had seen the council’s leaflet on the local plan and read some of it, and 71% felt that new homes were needed locally. Aside from talking to local families, I have experience of talking to residents’ groups and finding out just how irate they are about the notion of their lives bearing specific costs without adequate compensation—and, it turns out, without adequate opportunity to participate.

The Government’s approach is an implementation of the collaborative approach to planning described in the Conservative party’s Green Paper, “Open Source Planning”, which was available online to download before the election—I did so and read it. Another thing I would observe about non-participation is that, given that the Green Paper very much explains what the Government have been doing, it is surprising that there has been so much controversy about the presumption of sustainable development—it was clearly articulated that a Conservative-led Government would implement that. It says something about non-participation in democracy that even the most interested campaign groups nationally appear not to have read the Green Paper.

I challenge the notion of open source consent. Without going off on too much of a tangent, as a software engineer who has participated in open source software projects, I observe that open source software is entirely voluntary—if someone does not wish to use it, they can do something else—and the incentives to participate are strong. In contrast, the land use planning system involves coercion and imposed costs, and there is no exit from it. The whole open source metaphor has been flawed.

The Green Paper said:

“Our conception of local planning is rooted in civic engagement and collaborative democracy as the means of reconciling economic development with quality of life. Planning issues drive members of the public to become engaged in local political campaigning and decision-making. Communities should be given the greatest possible opportunity to have their say and the greatest possible degree of local control. If we get this right, the planning system can play a major role in decentralising power and strengthening society—bringing communities together, as they formulate a shared vision of sustainable development. And, if we enable communities to find their own ways of overcoming the tensions between development and conservation, local people can become proponents rather than opponents of appropriate economic growth.”

We can see how that approach fed into our manifesto, the “Invitation to Join the Government of Britain”, and then into the national planning policy framework, but I want to argue that it has failed. I am very sorrowful that it has, but I would like to explain why by describing some local experience.

The residents of Daws Hill have strong incentives to participate in local neighbourhood planning. The Daws Hill site is bracketed by RAF Daws Hill to the east and Wycombe sports centre to the west. The sports centre is going through a major redevelopment, and more housing will be built on RAF Daws Hill because it is a brownfield site. The residents formed a neighbourhood forum and set out in good faith to participate in the system that the Government had set out. However, the council ruled that neither of the two developments of interest to residents could be considered by the neighbourhood forum. There was a judicial review and an appeal, and the council was found to have acted properly within the law.

The chairman of the neighbourhood forum said:

“Having encouraged participation in local development through the formation of a neighbourhood forum, as set out in the Localism Act, the forum now finds that the local planning authority has the discretion to restrict its area, it appears, for whatever reason it chooses.

“In our opinion, this makes a nonsense of the legislation, which is supposed to be there to encourage participation.

“It's not surprising we feel aggrieved at the outcome of the legal process. We are struggling to see any advantage in participating in local affairs.”

I am dismayed that that happened, because I stood on a platform of radical decentralisation of power, which I very much expected we would deliver. People have wasted their time, money and energy—the outcome has been everything that open source planning was not supposed to be.

Elsewhere in High Wycombe, people are not participating to any great extent. Across the district there were about 1,700 responses to the local consultation; I have about 75,000 electors. In the rather unfortunate jargon of public policy theory, people are “rationally ignorant”— it is just not worth the effort of participating in these matters because they are complex and tedious. The process of information gathering, discussion and decision often produces unacceptable results that people are forced to accept. That is the problem with public choice factors. In reality, the public either have too few incentives to get involved or have found that in practice the system excludes them from the involvement that they want: the power to avoid having costs imposed on them.

Another active local group, Penn and Tylers Green residents society, which is most concerned about the Gomm valley, provided this eviscerating judgment on the national planning policy framework:

“The NPPF seems to us to be a disingenuous mixture of high-sounding intent and contradictory assertion. It identifies planning as aiming to achieve ‘sustainable development’, a term which, because it defies succinct interpretation, has come to mean popularly, ‘the importance of building houses’.”

Notwithstanding the Government’s honourable intent, we now have council, not community, power. Land use planning remains a complex and specialist subject, so Wycombe’s local plan was produced by planning officers, not residents bravely taking control of their own lives. Planning regulations remain so complex that specialist expertise is required even to work out whether a proposal is permitted development, about which I will talk more in a few moments.

It also turns out that the process of electing councillors every four years does not persuade people to accept the costs imposed on them by the plans and decisions of officials. The process followed is certainly lawful but it cannot be said to be democratic, given that the electors do not have the opportunity to discard the plan if they do not like it. I suggest that we see, by harsh experience and by reading the Green Paper, that the NPPF and collaborative democracy in planning have turned out to be an opportunity to comply enthusiastically with the goals set by authority, which is, I am afraid, the freedom to obey.

Regarding the duty to co-operate, if collaborative planning has not worked at the local level, what of collaboration among planning authorities? Whenever decision making is decentralised, a problem of co-ordination arises. The duty to co-operate was bound to bring different plans into conflict, and such conflicts were bound to be difficult to resolve.

I understand from planning officers that the burden of co-operation is now simultaneously slowing down delivery, as authorities communicate with the constellation of organisations indicated in the NPPF, and making planning less accountable to local people. How is public consent for a local plan to be obtained when it is bound to be the product of an opaque process of collaboration between many individuals working for many official bodies?

I understand that moves are now afoot to ask local enterprise partnerships to co-ordinate local planning authorities. When the chief executive of our LEP told me that a particular problem was that there were now so many economic plans that people could not reconcile them, I asked him, light-heartedly, “Are you saying that what we need is a strongman, with the power, authority and vision to resolve the plans and impose the solution on everyone?” He said yes, but of course I was parodying Hayek’s “The Road to Serfdom”; it seems that, once again, life imitates literature, if not art.

[Guy Opperman (Hexham) (Con)]

I will certainly not be quoting Hayek back to my hon. Friend. I congratulate him on securing this debate. Does he share my concern, however, that there is a lack of joined-up thinking among neighbouring councils? For example, Northumberland and Newcastle councils act differently in relation to the green belt on their border. Does he agree that that sort of problem needs the overarching view that he is so enthusiastically endorsing?

[Steve Baker]

I do. One of the problems is that the valuation of things such as the green belt is subjective—different people will have different opinions about different pieces of land. Some green belts are not especially high in quality. Around Wycombe, as I have said, most of it is AONB, but it is probably true that some of what is just green belt is not especially high in quality. Where it is poor in quality, people will value it differently. When elected representatives are involved at a local level, it is not surprising that they are unable to agree a valuation of land.

That is the point I want to make. When it comes to co-ordinating plans among decentralised decision makers, only the price system can promise to reconcile those differences, through voluntary and mutual adjustment. It is precisely because only the price system can co-ordinate human action that economic planning by authority always falls short of people’s ambitions for it.

I turn to what I propose the Government should do. In the short term at least, we must inevitably continue to attempt to make planning by authority in land use function without doing too much harm. I therefore ask the Government to take three short-term actions.

First, the Government should take the time to deliver a genuine simplification of the existing rules, so that complexity does not undermine public trust in the system. For example, I understand that permitted development can now be farcical in practice. I looked at the website, and to me it seems that some of it can be simple. In practice, however, people find it so difficult to decide whether something is permitted development, and are so afraid of the consequences of being fined if they get it wrong, that, in practice, they often end up applying to the planners for a certificate confirming that permission for the development is not required. That is absurd. A solution has been put to me. It essentially involves abolishing permitted development and making things simple: if there were no response within an eight-week period, the development would be allowed to go ahead.

Secondly, the Government should ensure that the duty to co-operate is not allowed to produce a creeping reinstatement of unaccountable, unelected regional government through the LEPs. I endorse everything that the Conservative party has said about regional government; I do not want to see it reinstated through LEPs.

The Government should narrow the range of bodies among whom co-operation is required and state clearly that local planning authorities must resolve differences among themselves without adjudication by authorities of broader scope—notwithstanding the wise comments of my hon. Friend the Member for Hexham (Guy Opperman). If necessary, the test on the duty to co-operate should be relaxed to avoid reinstating the failed concept of regional government.

Finally, I ask the Minister to confirm the view he set out in his letter of 3 March 2014 to Sir Michael Pitt, chief executive of the Planning Inspectorate, regarding inspectors’ reports on local plans. The Minister says, in the letter:

“The special role of Green Belt is also recognised in the framing of the presumption in favour of sustainable development, which sets out that authorities should meet objectively assessed needs unless specific policies in the Framework indicate development should be restricted. Crucially, Green Belt is identified as one such policy.”

What I understand from that is that authorities are not required to consume green-belt or other protected land to meet those objectively assessed needs. That is critical for a place such as High Wycombe; although the housing need is clear, it is also clear that the place is surrounded by AONB. I am looking for the Minister to confirm that that is his view.

I turn to reserve sites and one of the difficulties of the NPPF. The reserve sites are all in close proximity to the communities they serve, special to the adjacent communities and local in character. Under the NPPF, they could be designated as local green space and managed as for the green belt. Will the Minister confirm that that could be done, in which case local councillors and planners would have the discretion to decide whether to do so, to protect those areas? After scrutinising the documents and considering the sites, which I know well enough, I am absolutely sure that that is the case. It would mean that we have local power, at least at council level, over those sites.

In the longer term, the crux of the matter is that the development of land imposes costs on other people. The fundamental reason why local plans are failing to attract public consent is that compensation for such so-called “externalities”, as the literature puts it, is provided to councils as the embodiment of community, not to the people affected. People simply have inadequate reason to consent and every reason to object. What is necessary to achieve public consent in land use decisions is what economists call “internalising the externalities”—that is, making developers cover the costs that they impose on others when they wish to proceed.

In the long term, it cannot be right to leave young people and working families facing a housing market with too few homes whose prices are too high. It is perfectly plain that more homes must be built, and built at reasonable prices with widespread public consent. There is extensive literature on how to deliver such a system through common-law property rights and market mechanisms. For example, “Liberating the Land” by the Institute of Economic Affairs provides a good survey. Its ideas include: covenant protections and deed restrictions, combined with affordable land use tribunals; tradable development rights; strengthening the law on nuisance; and various restraints from economic forces. National protection in law could be retained for AONBs, green belts and places of historic value.

I do not doubt that such a system would have its own difficulties, but it would offer a promise of a way forward, in which people had genuine power to say no and every incentive to say yes. We must abandon command-and-control economic planning in land use, and instead find ways to meet the laudable goals of the present system in a way that is realistic about public participation, incentives and the efficiency and effectiveness of bureaucratic processes. We certainly must not continue to preach market capitalism, only to practise socialism in land use before blaming inevitable failure on the market.

There is a clear way forward. In the short term, planning inspectors should accept local plans that meet the aims of the NPPF by protecting designated land, even if that means not building the full quantities of homes identified as being objectively needed. This is necessary to establish public confidence in the democratic legitimacy of the system. In the longer term, policy should give real power to the public, which means the power to say no, combined with proper incentives to say yes, including due compensation, without the public having to acquiesce to costs imposed by other people, including the long-term costs of losing beautiful, highly valued land.

Democracy is government by consent. Only when the public do not face costs without compensation will our system of land use control meet that aspiration.