Some recent events in Kent illustrate a disconnect between planning for new housing development and providing essential health services to a rapidly expanding local population.
In Whitfield Dover, a new medical facility is to be built to help cope with a massive housing expansion in the area......
The proposed medical centre provides for about 15,000 patients and includes nine consulting rooms, two counselling rooms, two treatment rooms, a dispensary and multi-purpose rooms. This will accommodate a growing population expected to fill the 6,000+ homes that are planned in the Whitfield Urban Expansion, of which roughly 2,000 have been granted planning permission.
Despite objections to the application from locals fearing light and noise pollution for nearby homes, and responding to others who voiced support for the project because of the expected rise in population, District planning officers recommend approval of the scheme. Great news, but local campaigners are concerned that NHS staffing challenges will constrain the delivery of the facility.
The Westgate and Garlinge Acton Group said that the discussion leading to the Council’s approval failed to mention how the new surgery will be staffed. “There is a shortage of GPs and the surgeries we have already can’t recruit any” they argued.
Citing the recently published NHS Workforce Plan, they pointed out
“The lack of GPs has been highlighted as a critical ongoing issue. But planning permission only requires that a monetary contribution via S106 be made. Lack of trained people to fill empty buildings is never part of the assessment.”
Provision for a GP surgery was one of the planning promises made when Trenport won permission for its 1,000-home development at Peters Village in 2006.
Hundreds of homes have already been built, but although the property developer has delivered on other promises, such as the construction of a new bridge over the River Medway, a community centre and more recently the opening of a Co-op store on the estate, the GP surgery has not been provided.
According to Trenport,
"There is no agreement with the NHS to buy the land and no offer has ever been received from the NHS for the land…it has been reserved by Trenport for the medical centre and we are currently in discussions with the NHS about its construction and delivery”.
The company added
"We recognise the importance of the medical centre for local communities, and a Section 106 financial contribution has been agreed with the NHS, which will fund its delivery. This money will be paid by Trenport to the NHS to fund the construction and delivery of the medical centre."
The circumstances in Kent illustrate the complexity and confusion of integrating health provision with local planning, and is likely to be replicated across the country as local plans and housing targets are pursued in the absence of a robust framework for aligning the two.
When the NHS reorganised into Integrated Care Systems with a mandate to establish stronger links with local community groups, we saw this as an opportunity for the NHS to work closely with local planners to anticipate demand for healthcare services and to align the provision accordingly. But it’s been a slow process.
Michael Wood, of the NHS Confederation, believes that the NHS must take regeneration seriously. “Regeneration projects shape our population and are happening all the time. We should grab these opportunities and bring our integrated care strategies to the table from the start – and our involvement would be welcomed”, he says in a recent blog. He adds:
“As citizens we tend to keep a close eye on local developments; whether they be a new commercial opening on the high street, a change to our favourite bus route or plans for a major housing estate down the road. I have often found it strange then that as people working in healthcare, we don’t seem to be as curious … there will be hundreds, if not thousands, of regeneration schemes underway across the country that will change the populations we serve and the places we serve in – how many are the NHS actively trying to understand, shape and benefit from?”
On top of fundamental workforce and funding challenges, NHS bodies face numerous challenges in “understanding, shaping and benefiting from” local regeneration schemes. A key one is the lack of a common framework for meaningful dialogue between landowner, developer, local council, NHS and local community. Is it time to revisit the Health Impact Assessment and redesign it as a platform for these conversations among local stakeholders?
Doing nothing comes at significant cost to our local communities, public health and health equity. Without a framework for dialogue about the health impacts of urban development, we can expect to see worsening alignment of health provision in areas undergoing regeneration, more anger and frustration amongst locals and more shifting of blame between stakeholders.
Listen to Locals
April 6, 2023