UK Parliament / Open data

Health and Care Bill

My Lords, I too was very happy to sign this amendment. I will speak only to it. I congratulate the noble Baroness, Lady Cumberlege, on her very moving speech, and the noble Lord, Lord Mawson, on a very comprehensive speech. I will be brief. In view of the logic of everything that I have heard in debates on previous amendments this afternoon, this amendment is even more important than I thought. When the Committee is discussing how to make the ICBs as effective, powerful, salient and comprehensive as possible for the people that they are bound to serve, all these factors must be taken into consideration, but the power of place itself and the opportunity that the ICB creates to make this manifest, just as the noble Lord, Lord Mawson, has made manifest in Bow, is a unique and highly innovative opportunity, and one which may not come again.

What the noble Lord proposes is extremely modest. It is to give just one person from the partnership voting power. However, it is essential, and it is in the spirit and the logic of what place-based partnerships are intended to do. It means that on the ICB there will be people who can bring nearsight, access and reach into the community to the decisions of the ICBs. They can help to inform those decisions, to bring that knowledge and sensitivity of the lives that people live, what they are faced with, and their specific choices. They are one of the most optimistic partnerships and ideas that we have had in this House for some years.

I have spoken many times in this House on the power of place, what it can achieve and how it affects people’s lives, particularly their health. The noble Lord, Lord Clement-Jones, and I published quite a useful report on building better places when we were on the same committee a few years ago. We diagnosed the relationship between good design, good buildings, good environments and good health. Maybe it is time to get that back off the shelf.

What is also useful is that the partnership principle is alive and well and is generating good practice. There is increasing evidence that it works and that there is an increasing exchange of ideas and skills, and we are learning all the time about what is possible. There is nothing to be said against this.

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The expertise that the partnership can offer to the ICB may come from different partners. I am particularly interested, for example, in the role that housing providers could have, and I am sure the noble Lord, Lord Best, will speak to this in his amendment. They will bring a perspective from the point of view of the tenant, and the diseases of poverty in poor housing, which the board will need to hear, and act on.

Equally, there could be a role for mental health providers who know why young people cannot access mental health support. They know where the bottlenecks are, and what is needed. The partnership will choose for itself who will represent it, who has the most effective

voice and who knows the place, as has been said this afternoon. But the essential criterion is that they know what will be delivered best.

I hope noble Lords will indulge me for a moment as I share a bit of history, because this has a very long history. In 1889, Charles Booth in his maps in Life and Labour of the People in London literally mapped disease against places and housing conditions—the stews of London—in a graphic illustration of where the worst concentrations of poverty were. In so doing, he redefined both health and poverty. Significantly, the first evidence came from the school boards and the local policemen: real partners in place. He certainly understood that you could not reduce inequalities or promote good health unless you had decent housing, fresh air and a decent wage. The geography of poverty has not changed that much—it is still the geography of disease and premature death—and the prescription has not changed at all. This amendment is an opportunity to put that into immediate and direct practice.

I hope that the Minister does not need much persuasion on this. It is a very simple and a very necessary amendment, and he would certainly have the support of the Committee in entertaining it.

About this proceeding contribution

Reference

817 cc1579-1580 

Session

2021-22

Chamber / Committee

House of Lords chamber
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