Levelling-up and Regeneration Bill

Lord Lansley Excerpts

Committee stage
Wednesday 22nd February 2023 Lords Chamber

I just emphasise that housing is not just a desperately urgent social need but part of the mix of creating thriving multigenerational communities across the UK. Tackling housing supply and putting it front and centre of any housing mission is part of making this vision a concrete reality, and I really hope that the housing mission goes beyond mere platitudes and says, “Build more houses now!”

[Lord Lansley (Con)]

My Lords, I am very glad to follow the noble Baroness, Lady Fox of Buckley, who has given us a very persuasive insight into a subject that I know we shall return to. I look forward to her contributing to further debates on the housing supply issue when we get to those parts of the Bill—perhaps in a fortnight’s time. We will have had a chance to take on board her excellent arguments.

I do not want to repeat what I said on Monday; I shall just precis it to this extent. I do not think we should put the missions in the Bill; we should have a process in the Bill that permits this House and the other place to consider the missions and metrics in detail every time the Government publish a statement. We can do that either by way of what I suggest in Amendment 25, which would give the two Houses the opportunity to debate such a statement; or the Government might at some point say that they should be published in draft and be the subject of debates by the two Houses. We are having that kind of debate today; it is exactly the kind of debate we ought to have every time there is such a statement or one is to be renewed, but at the moment, the Government simply lay it, publish it and that is it. That is not good enough.

I want to talk about two missions. I was not planning to say much about the first, but I was prompted by the amendment from the right reverend Prelate the Bishop of London, so ably introduced by the noble Lord, Lord Best. I feel that we have been here before. My noble friend Lord Howe and I have definitely been here before. We published and introduced—he will have done it in this House—the Healthy Lives, Healthy People White Paper of November 2010, which followed and reflected into policy at the time Sir Michael Marmot’s Fair Society, Healthy Lives work, which we and the previous Government supported prior to the White Paper.

We are talking about a very difficult mission to define. We are talking about reducing inequalities in society, because the inequalities in society are the source of the inequalities in health outcomes. Let us at least look at how we can tackle the many things that are the social determinants of health and try to capture them in something like, for example, disability-free life expectancy. The Government have used healthy life expectancy, which I think is the same thing. We know that it is poor in this country, and we know of the lack of public health support—notwithstanding that we had a shift a decade ago to support for local governance in public health, which I think has actually been proven to be a good thing, but which has not been funded in the way that local government and the health service would have wished it. We had a very good and helpful debate on that when the noble Lord, Lord Addington, who is in his place, had his Private Member’s Bill, but I will not repeat all that now.

When one looks at the metrics intended to support the Government’s mission, it is very curious. Yes, we need a tobacco control plan, although I do not know quite what the Government’s tobacco control plan now is. Yes, we must reduce the prevalence of obesity, but I do not now know precisely what the Government’s obesity strategy is. But as far as the reduction of prevalence or impacts of diseases are concerned, only cancer is mentioned. I am with the noble Lord, Lord Stevens of Birmingham, here; I thought that in the NHS we had escaped from trying to elevate certain diseases to the point where they were regarded as more important than others. Certainly, when we talk about parity of esteem between mental and physical health, surely we must have parity of esteem between cardiovascular health and cancer diagnosis. Why do we regard one as more important than the other? There are metrics that could help us; the NHS outcomes framework was first established in about 2011 and is a work in progress, but is absolutely instrumental. It should be the basis, not the Government having a mission which picks one or two things out of the outcomes framework and regards them as important when others are not.

When I was Secretary of State, over a decade ago, we had, over time, been improving life expectancy in this country on average by one month in every year. That means that if you want to improve life expectancy by a year, on average it is likely to take you 12 years. Where does “five years” come from? Things have actually got worse, not better, since a decade ago—particularly since 2017, on the data. Based on what I remembered, it would take us 60 years to improve our healthy life expectancy by five years. The Health Foundation last March, after the missions White Paper was published, produced its own data. It believed that on the previous data it would take 75 years, but it had run it with the most recent data on life expectancy and healthy life expectancy since 2017, and the figure was 192 years. If we are to have a debate about the missions and metrics, let us get down into whether the metrics are reasonable. If they are not, they should be revised, because if we are going to be standing here in 2030—I hope we all are; disability-free life expectancy in the Lords is pretty good—we want to have achieved these missions. We do not want to have excuses for why we did not—for example, because the metric was not a reasonable one in the first place, or the Government have abandoned it.

I want to mention one other thing; at Second Reading, quite well on in the debate, the role of the private sector was mentioned. I just want to come back to mission 1 and this issue of the economy, because I am not quite sure why measuring pay is there. It is a measure of relative economic well-being, but targeting pay is not the answer. Targeting employment is a good answer; if people are in employment, pay will differ in different parts of the country because the cost of living and the economic structures differ significantly. Let us improve the economic structures, reduce the economic disparities and improve the economic growth in the less advantaged parts of this country, and the pay will come with them.

--- Later in debate ---

[Baroness Scott of Bybrook (Con)]

I would like to go back on that specific issue because we would need to work with the Department of Health and Social Care and get its agreement. We are quite early in the establishment of the unit in order to do that, but I will take back that issue and come back to the noble Lord.

[Lord Lansley (Con)]

I am sorry to interrupt my noble friend. I am coming back to a point that she raised a moment ago on the Levelling Up Advisory Council, which I mentioned on Monday but did not at that time get an answer on whether it had met, what it discussed, what it said and to whom. I now discover that on 14 February a Minister in the department wrote to Clive Betts, the Select Committee chair, to say that the council had met several times, had met Ministers and was engaging in a research programme. It was interesting, because the letter said that the council had

“engaged in discussions on levelling up policy with stakeholders externally, including members attending an event with Carsten Schneider … Minister of State for East Germany and Equivalent Living Conditions, hosted by the German Embassy”.

Might the council engage at all with Parliament? We are told that the council has been around for a year, but I have had no engagement—no one from the council has come anywhere near me to suggest that it might talk to us about the levelling-up missions.

[Baroness Scott of Bybrook (Con)]

I do not know, but the council is already in train and working. On the fact that it has not come to Parliament, I will ask what the remit has been for the past year. It may have been a remit just to get together on some early work, but I will get an answer to my noble friend on that.