One of the biggest news stories of recent weeks has been the challenges faced by the NHS. Many readers will be aware of the issues faced by hospitals as they struggle to meet demand from patients. However, you may not be aware that healthcare also represents one of the biggest challenges faced by local government, and that property must be a vital part of the solution.
That may sound surprising to some. And on the one hand it is true that responsibility for the NHS lies with central government.
However, on the other hand, public health directly affects almost every aspect of civic life, from the local economy to educational performance.
As a result, healthcare provision must be central to placemaking and regeneration. Even if councils don’t control what happens inside hospitals, through effective planning and integrated service delivery they can have a hugely positive impact on public health.
Firstly, it is worth reflecting on the importance of delivering high-quality public health systems.
For individuals, local data shows that incidences of asthma, diabetes and other non-communicable diseases reflect the quality of healthcare in each area. Poor local health services mean kids are more likely to have to take days off school and adults are more likely to miss work.
In aggregate over time, poor public health provision drags down life outcomes like school performance, access to employment and income.
Furthermore, the impact on individuals has a knock-on effect on business. Poor health, sick days and caring responsibilities drag down productivity, eroding an area’s attractiveness for investment.
The final link in this chain is government. On the one hand, poorly planned public health systems waste public money as councils miss out on potential cost and efficiency savings. On the other, if poor public health discourages private investment, local authorities will forego a potential boost to local economies and tax revenues.
This is a significant issue now, but it is a challenge that is only set to grow as society ages.
It is a truism that being in the catchment area of a good school increases the appeal of an area to new residents. An ageing society means that what has long been the case for education is becoming true of healthcare; the quality of health services will increasingly be a factor in where people choose to live.
So how can property and planning help address the issue?
Firstly, while the NHS is under central control, it is just one part of the healthcare system. Social care is a local council responsibility, while GP surgeries operate as independent businesses. It is these other pillars of the system that can be effectively shaped through local incentives and planning initiatives.
Some parts of Birmingham serve as a clear example. In some parts of the city, single-doctor GP surgeries predominate. Their small and limited range of facilities makes obtaining appointments harder. This results in patients going straight to A&E, increasing pressure on local hospitals. The predominance of solo GPs also results in purpose-built community facilities not being fully utilised, resulting in inefficiencies and wasted business rates.
But public services are like businesses; they can benefit from the economies of scale and network effects that come from clustering together. Effective planning and placemaking should aim to facilitate this.
In Birmingham, I am keen to help incentivise poorly-located health facilities to move by working with developers to offer purpose-built facilities near new transport link hubs, especially along the Midland Metro extension. Where possible, we also aim to facilitate wrap-around services such as health links back to schools, access to social care and connections with mental health or Jobcentres.
As a result, we would hope to deliver both a better experience and improved health outcomes for patients. This approach should help ease the pressure on hospitals by ensuring more effective early intervention. We also anticipate significant efficiency and revenue benefits to the public purse from more integrated service delivery.
Most of all, however, we expect that improved health services will be another catalyst in making Birmingham a more attractive place to live, work and invest.
As debate rages about how best to manage internal pressures within the NHS, local governments should be conscious of the positive influence they can have from the outside. The benefits of a more joined-up approach to healthcare will be felt in hospitals, health systems and across whole communities.
Waheed Nazir is director of planning and regeneration at Birmingham City Council
