Baroness Royall of Blaisdon (Lab)

My Lords, I am pleased to follow the noble Lord, Lord Bichard. I agree with so much that he said—but I shall speak to Amendment 196, which would introduce a duty on local public service partners such as NHS bodies, the police and fire authorities to co-operate with strategic authorities and principal councils. I am particularly concerned about inequalities. I was very proud to co-found and co-chair the Oxfordshire Inclusive Economy Partnership, which works closely with businesses, charities, higher education establishments and local councils, including in relation to inequality and health. Oxfordshire is now a Marmot place—and I know that the Greater Manchester Combined Authority is considered to be a Marmot city region. I hope that new strategic authorities will follow. As noble Lords are aware, health inequalities are pronounced within as well as between regions, with huge life expectancy gaps between and within local authorities, including those operating within the same strategic authority. For example, within the East Midlands Combined County Authority, the gap is 5.2 years. The gap is enormous within cities; we all know that in London the gap is between 17 and 19 years. But, shockingly, in counties such as Oxfordshire there is a life expectancy gap of at least 10 years. Addressing these health inequalities requires action at regional level, where leaders have the power to shape economic growth, create healthy places and, consequently, reduce the inequalities. The Bill already contains several important levers to do this, which is welcome, with the duty to improve health and reduce health inequalities in Clause 44; the requirement for strategic authorities to produce local growth plans in Clause 39 and Schedule 20; and the inclusion of health, well-being and public service reform in the areas of competence for commissioners. However, I believe that this amendment is necessary, because we know, and evidence demonstrates, that health improvement and a reduction in health inequalities requires joined-up policies and actions across public services. My amendment would ensure reciprocal engagement in local decision-making, service planning and policy implementation, strengthening whole-area collaboration across public services. It would also be the catalyst for places to use the powers that they already have to build local partnerships. The duty would also embed in statute best practice around co-operation, which already exists at neighbourhood, local and regional level. It would set out clearer expectations on different parts of the system, such as integrated care boards and local authorities, to collaborate on improving health. The amendment is light touch, practical and evidence-based, with the support of many organisations that work on health and reducing health inequalities. It would not add unnecessary bureaucracy or require new spending commitments, but it would make a profound difference to policy-making and action in areas of our country and in the new bodies that are about to be created. I beg to move.