Speeches by Beales.

“Obviously, there is a similar analogy to school provision, and there are different ways of assessing school place planning. Generally, the LEA is the local authority, and there is the planning authority too. In your experience, does that process work better in terms of identifying school places need and the formulas fo…”

“Do you have any experience of accessing section 106 and CIL specifically? Do you have any reflections on how that can be improved? We have heard evidence before about inflexibility and large amounts unspent, including specific health pots at local authority level.”

“We will come to that in more detail. What about any other grants, section 106 funding or any national capital grants? Do you or anyone else have any experience of accessing those pots?”

“That would be harder then, from what I am understanding.”

“On that point, Bill, we have had evidence before that the NHS should be involved in the planning system or built into the planning system. What does that look like and what does that lead to? It sounds like in your experience, Joe, and certainly in my experience when I was in charge of regeneration planning in Camden f…”

“You don’t think that involvement in the planning application is the solution?”

“In my area, two ICBs have merged, so 4 million people across north and central London are now in my ICB. In terms of the grip of local GP provision, and development opportunities coming from one of the 11 local authorities, has that become more challenging in the new super ICB structure?”

“That is a big risk, as part of the changes. As you say, the NHS Bill going through Parliament at the moment removes local authority representation on ICBs, and there is a move to a mayoral system. The mayor will usually have some sort of strategic planning approach across the city, but it is a very light touch, call-in…”

“What stops that happening now? If representation in the decision-making body for the health system does not matter and it is possible to do it through local working, why are we not working well together in that informal way now?”

“That’s helpful. Finally, you talked about the local authority having the ability to move in a different way. The local authority can borrow; there is the general fund and potentially the housing revenue account, although that is more constrained. The NHS faces quite different abilities to borrow and has quite rigid and…”

“Is that a floorspace guide or an actual design guide?”

“Would it tell you, “You need this amount of flexible space for admin staff”?”

“Do you think that guide is in line with the modern requirements for neighbourhood health and primary care generally?”

“For the primary care estate broadly and for neighbourhood health.”

“You talked about the need for spaces being different. Dr Hynes, you mentioned the age of the estate predating the NHS. Are there clear, up-to-date design guides for what different sorts of neighbourhood health services should look like in the 21st century? You mentioned floor space or ICB footprint, but is there a clea…”

“Beyond just clinical safety guidelines—more like design guidelines. There is a hospital 2.0 standard being developed for the new hospital programme, but is there a clear design standard for primary care?”

“That is helpful; thank you. On sources of financing, Dr Wood, you talked about trying to get a new build proposal off the ground. What was or is your experience of accessing funding streams? What funding model or streams did you look at for that proposal?”

“And private borrowing is not financially viable.”

“So it would be helpful to have the tools that would tell you, as a manager of your estate, “You have this amount of occupation and this amount of people occupying the rooms.” GPs typing up notes might not be the best use of the estate.”

“Are there any incentives for you to offer up free rooms, or spaces that could be multifunctional? The data is quite high level, but I recently visited a GP centre on a Friday and it was quite empty. I think the view was, “This is generally what happens early in the day on Friday. It gets very busy later on.” Would ther…”