It’s time for a legislative requirement to address health inequalities through planning

Originally published by The Planner, 1 June 2023

Attempts to address health inequality through the NPPF and local plans falls down because they lack statutory strength, argues Emma Cooke. This needs to change – here’s how, and why

The planning system should work to improve people’s health. Right?

That’s why, back at the beginning of March, Professor Sir Michael Marmot was joined by eight other experts as he wrote to the Secretary of State, Michael Gove MP, supporting a proposed change to the Levelling Up and Regeneration Bill.

The amendment these experts wanted to see was one that would create a statutory duty to address health inequalities through the planning system. The amendment is supported by the Better Planning Coalition, of which Quality of Life Foundation is an active member.

Professor Sir Michael Marmot’s letter was clear in its reasoning; it highlighted the evidence of the links between health inequalities and our built and natural environments. It also made clear the fact that maintaining the status quo in planning is not enough if we are to really tackle the Levelling Up agenda’s missions of ‘health’ and ‘wellbeing’.

The letter stated: “The National Planning Policy Framework has for some time referred to ‘enabling healthy lifestyles’ and Planning Policy Guidance notes have for many years supported action to promote walking and cycling and ensure good access to open space. However, new developments which do not get the basics right are still getting built.”

Last month, Rachel Maclean MP, the current Minister of State for Housing and Planning, responded to Professor Marmot’s letter. In her response, the Minister explained the Government’s “preference for these important health and well-being matters to continue to be dealt with by the National Planning Policy Framework (NPPF).”

The reply states: “The NPPF sets out that planning policies and decisions should aim to achieve healthy, inclusive and safe places that enable and support healthy lifestyles,  especially where this would address identified local health and well-being needs.”

But, as members of the Better Planning Coalition – which brings together over 30 organisations who want a planning system fit for people, nature and the climate – we don’t think this is enough.

As Professor Marmot’s original letter made clear: the current system, in which the NPPF encourages planners to ‘aim to achieve healthy, inclusive and safe places that enable and support healthy lifestyles’ is simply not working. If it were working, we would no longer see new developments that entrench car-dependency or lack access to green space. In fact, our developments would provide people with everything the Quality of Life Framework describes as being essential in ensuring developments support residents’ health and wellbeing.

Furthermore, planners themselves have told the Better Planning Coalition that, while they are determined to improve the quality of the places they are building, their options are currently limited without robust regulation.

So, what should we do about it?

Well, as Professor Marmot’s letter originally explained: “Enshrining a statutory duty to address health inequalities within the planning system would ensure a consistent and embedded approach, rather than relying on guidance such as the National Planning Policy Framework or upcoming National Development Management Policies.” A legal duty would also add significant weight to local planning authority’s policies, which should mean they translate to change in real terms.

With that in mind, we and our friends in the Coalition, will continue to push for this amendment, particularly as the Levelling Up and Regeneration Bill reaches report stage shortly.

To make it easier for those making the decisions on this, with others in the Coalition, we have given considerable thought to the practical application of this statutory duty, speaking to planners to get their thoughts.

And we have come to the conclusion that implementing this proposed duty would not add too great a burden to local planning authorities, and that the benefits of such an approach would far outweigh any additional legwork needed.

This is because:

  • Much of the baseline data that would be needed to assess the potential impact of development on health inequalities is already collected within public health teams – it’s just not always being used effectively within the planning system
  • Many planning policy documents already address health and wellbeing, they just don’t have the extra weight that a legislative requirement would give them (nor are they applied consistently across the country)
  • Many planning and public health professionals support this proposed legal duty

We know that planning teams are significantly under-resourced, and we assume (or hope) that this issue will be tackled very soon. However, while local planning authorities would need some capacity to analyse the information required by such a legal duty, the responsibility for showing that proposed developments meet the health and wellbeing objective would be shared with the developer.

The legal duty would help to identify the specific health-related requirements and determinants of health that developers would be expected to address. As such, it would help to translate health and wellbeing policy (which so many local planning authorities already make provisions for) into delivery on the ground.

With all this in mind, we call again on the Government to reconsider the amendment to create a statutory duty for the planning system to address health inequalities. If we really do want to tackle the missions of ‘health’ and ‘wellbeing’ it is the right thing to do.