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Chamber and committees

Health, Social Care and Sport Committee (Virtual)

Meeting date: Tuesday, January 25, 2022

Agenda: Decision on Taking Business in Private, Health and Wellbeing of Children and Young People, National Planning Framework 4


National Planning Framework 4

The Convener

Welcome back. Our third item is an evidence session on the national planning framework 4. I welcome to the committee Irene Beautyman, who is place and wellbeing partnership lead at the Improvement Service; Dr Matt Lowther, who is head of communities and local partners at Public Health Scotland; and Professor Jamie Pearce, who is professor of health geography at the school of geosciences at University of Edinburgh.

One strand of the NPF4 strategy in which we are interested is liveable places and how those will be designed for the benefit of health and wellbeing. What do we know about spaces and liveable places? Do we have enough information on what those will look like and on what we should be striving for? Will any aspects of the framework have a particular impact on our nation’s health and wellbeing?

Irene Beautyman (Improvement Service)

Thank you for the opportunity to speak today. The issue of liveable places is high up the strategy, which is to be welcomed. The link into public health and keeping us healthy almost joins together the two ambitions of planning to manage land and using buildings in the long-term public interest. That public interest sits within public health, which gives us the evidence and research that tell us what we need to be doing in places and what every place needs for it to be more liveable. That includes using places in a more preventative manner to keep people well, enable them to thrive and deal with other inequalities that Scotland faces.

In my role, I have been doing a lot of work on linking together what the Improvement Service does to help councils and planning authorities to deliver such places with all the evidence that sits in public health about the things that we need to get right.

We have spent a number of years pulling together a set of place and wellbeing outcomes. At the beginning of January, we submitted that as part of our input to the Local Government, Housing and Planning Committee’s call for views on NPF4. That sets out what every place needs for everyone in them to thrive. There are different themes, which give a lot more clarity than I can see in the draft framework on how we move around; on our access to space, including open space and streets; on our access to facilities, amenities, affordable homes and work; and on our ability to take part in society, feel safe and have a sense of belonging.

All those aspects are about behaviour change. They give someone stepping out their front door the opportunity not only to lead a more active life that will help their physical and mental wellbeing, but to change the decisions that they can make that impact on whether they live in poverty, whether they feel socially isolated or whether they feel supported by their community when they hit trauma or any issue in their life. We look at our ageing population, which is an important aspect, too. There are evidenced links, which we have submitted along with the set of place and wellbeing outcomes.

I have been hearing comments about how, overall, the framework lacks clarity. Clarity is needed to help us to hit the ground running. The document will be used by development management for big decisions that will be made as soon as the framework is taken on board. We could really hit the ground running and help to deliver places that address all our current crises around climate, inequalities—including health inequalities—Covid recovery and so on.

There needs to be more clarity, and we need to be clear that we need all the policies to be used. We want to avoid a debate across 32 councils, with some councils saying that they are using only 10 and others saying that they are using only four. All sectors need to have clarity and confidence in the framework.


The Convener

You have hit on the fact that the policy sits at council level and relates to local development plans. We are just about to have council elections, and people who have not been councillors before might come into those roles. Is there a need for them to have a degree of training on the goals of NPF4 and how the decisions that they make need to dovetail with those?

Irene Beautyman

Absolutely. There definitely is a need for training, because the national planning framework has a new set of outcomes for planning to deliver that have not been there before. We now have outcomes for health and wellbeing, and we need to deliver not just on housing and growth but for our ageing population and on biodiversity and the climate. We need to do that together; we should not be off in silos delivering on one aspect of how a place contributes to addressing the climate crisis. It cannot be a healthy town versus a climate-based town; we have to combine those.

The skills to be able to understand that link and add a level of scrutiny when officers and councils move things forward have been highlighted this week. I have seen a lot about one of our councils approving an out-of-town retail centre at a time when we need to think about car-oriented development and how we change the hierarchy. We need officers and councillors to buy into that and understand it so that they can truly represent the needs of all people in our society. They need to understand how decisions that are made about an out-of-town development have an impact on people who live in the town but have no access to a car.

Dr Matt Lowther (Public Health Scotland)

Public Health Scotland welcomes NPF4 and the focus on public health. It is probably the first time that the planning framework has had such a focus on health—it is writ large throughout the document, which is really good to see from a public health perspective. We have recognised for quite a while the impact that good-quality places can have on long-term health outcomes, but it is really welcome to see that formally recognised and embedded in such an important document.

You specifically asked about the liveable places policy, convener. That is where the majority of the health stuff sits, but health could be woven through other elements of the framework. Sustainable places, productive places and distinctive places will all ultimately have an impact on health.

You asked about the components of a neighbourhood or place that affect health. There are lots of those. When we talk about place, we use a fairly broad definition of it in relation to health. We might touch on the place standard, which has 14 different themes. All of those themes are place based and have evidence behind them that shows the impact on health. I will pick out a few.

We know how our neighbourhoods are designed. They are where people live, work and play. How they are designed can have significant impacts on health. It can improve the way in which people interact socially, improve levels of physical activity, reduce air quality and improve access to services, for instance.

Another key element is housing, which can impact on health through a raft of different mechanisms. Perhaps we will talk about housing later.

Place policy can also have a significant impact on our local food environment. Our lifestyle is affected by our access to good-quality food and to alcohol and other substances that could harm our health. We have lots of good-quality evidence on access to good-quality natural and sustainable places—I am sure that Professor Pearce will touch on that. We know that just being in contact with nature and having access to it is good for our mental and physical health.

Another key element that is important to health from a place perspective is transportation—how we move around and access services and how we increase our levels of physical activity through active travel and transport.

There is a variety of mechanisms. Overall, we welcome the focus on health in the policy.

That is really helpful.

Professor Jamie Pearce (University of Edinburgh)

Good morning. It is worth reminding ourselves of some of the public health challenges in Scotland and connecting those to the discussion. The committee will be aware that we have some of the most significant public health challenges in western Europe. If we think about what some of those challenges are, we would probably identify mental health, alcohol, tobacco use, drug use, lower life expectancy and greater health inequalities, both socially and spatially.

A range of processes explain that and the things that we can do. The planning system is integral to that. As the other witnesses have said, we very much welcome the focus on the planning system and the significant opportunities that it offers us to improve the health of everyone in Scotland, not least by reducing inequalities, which is an important part of the approach.

As Matt Lowther said, many elements in the NPF documentation offer welcome steps that can benefit the health of people in Scotland. Access to, and the quality of, green spaces is a good example. We know that green spaces are beneficial for health throughout someone’s full life, from birth through to older age. In particular, we know that formative experiences of green space have a lifelong impact. There are some really welcome things in the document.

As a public health researcher who is interested in the connections between health and place, I argue that there is quite a piecemeal approach to thinking about those connections. Some aspects are represented really well and some are largely overlooked. One of my take-home messages is that there is an opportunity to think holistically about the key public health challenges in Scotland. What are some of the underlying aspects of the planning system that are integral to addressing those challenges? How can we bring those things together to make a large-scale impact in improving public health in Scotland?

It would be remiss of me not to pick up on what you said about aspects being overlooked. Are you able to articulate what those are?

Professor Pearce

Yes. It is useful for us to look at the food system, for example. We know that obesity is one of the big challenges. It is important to address the proliferation of highly saturated food in our communities and to improve access to high-quality food, and that work is starting to come through.

We know that other commodities are really bad for our health. Alcohol and tobacco are two of the remaining big health challenges in Scotland. For example, one in five deaths in Scotland is attributed to tobacco. However, the availability of tobacco and alcohol is not represented in the document. An important part of the planning system is making sure that we support our communities to have the healthy lifestyles that we all aspire to. That is one example of the opportunities to make a significant difference.

That is helpful. The next questions will dig into the place of health in the framework.

Emma Harper

Good morning. You have talked a bit about what the national planning framework contains with regard to aspirations for supporting health and wellbeing. Does the framework give enough priority to health and wellbeing in relation to planning decisions? I am not sure who would like to answer that.

Professor Pearce, we will go to you first.

Professor Pearce

That is a key point. You will not be surprised to hear me say that, although the climate and net zero-carbon priorities are important, I would like the opportunities for improving public health in Scotland to be given a high priority, too.

Elements of health are peppered throughout the document, but I think that Scotland would benefit from health being given a high-level strategic priority in relation to planning. That is how we will ensure that all Scots have access to a healthy environment in a way that will support their health and wellbeing and reduce inequalities.

I would like health to be given a high priority, and for that to be evident throughout the document.

Do any other witnesses want to come in? I neglected to mention that, if anyone wants to speak but has not been addressed by a committee member, they can type an R in the chat box.

Irene Beautyman

The question about specifically addressing the issue of health and wellbeing is a good one. As Jamie Pearce said, health is peppered throughout the document, but it says that the actual planning policy for Scotland is guided by principles around climate and nature. That emphasis surprised me, because I feel that it must also be guided by what is happening with regard to health inequality, which Jamie Pearce referred to, and poverty, as well as by climate, nature and all the other outcomes that it is being asked to deliver on.

There is a policy on health and wellbeing, but it is dealt with at a fairly high level and does not get into the meat of the issue. That part of the document moves quickly to a discussion of health and social care facilities, which are only one small part of how we are addressing health.

There is almost a need for a further policy that is akin to the policy that Wales has, which asks people to think about the long-term impact of all our decisions on our ability to prevent the persistent problems that we face in our country. Those problems include climate change, but they also include poverty, health and other inequalities. The places that we create can have a huge impact on those issues. That sort of overarching policy might be missing. Although having climate and nature as guiding principles is laudable, public health is missing from the approach.

Dr Lowther

One of the six outcomes for the national planning framework is about public health, which is to be welcomed. Obviously, the framework is a fairly high-level document that is meant to set the tone. However, with the sort of issues that we are concerned with, the devil is always in the detail, and we know that guidance is being developed that will get into the detail of how the policies will play out.

The key question that we need to ask ourselves—this might be the test—is, if a local planner wants to refuse development on the basis of health, will this suite of documents allow them to do that? We know that, in the past, that has not been the case.

I know that there is a requirement, as part of local development plans, to conduct a health impact assessment, which is to be welcomed, and I know that major developments will be subject to health impact assessments—again, that is to be welcomed. However, the framework does not say much about the ability to approve or reject applications specifically on the basis of health. It would be helpful to have more detail on that. It would be good if it were clear what the mechanism would be for making a decision in a situation in which a local planning department or a local public health team had concerns about a development’s impact on health.


Emma Harper

I have a brief supplementary question for Irene Beautyman or Matt Lowther. Is it sufficiently clear which developments generate significant health effects? I am thinking about how someone’s mental health and wellbeing can be impacted by living next to derelict buildings or vacant or abandoned land. There is research that says that abandoned buildings and shops can make us feel unsafe and that run-down environments contribute to anxiety and low mood.

If we are trying to support planning to help mental health, should we be trying to expedite planning to deal with the derelict and vacant buildings that affect mental health? There are many such buildings across the region that I represent, from Stranraer to Dunbar, such as the George hotel in Stranraer’s town centre. Do we need to ensure that developments generate significant health and wellbeing effects, and also deal with the issue of derelict buildings?

I am not sure who wants to come in on that question. Jamie Pearce might be a good person to talk about that.

Professor Pearce

I support what you are saying. There is evidence from research, including research in Scotland, that derelict and brownfield sites have detrimental health impacts. It has also been shown clearly in Scotland that crime and perceptions of crime are also closely linked to mental health. The issue that you raise is a nice example of the way in which the planning system can focus closely on those issues through a public health lens to ensure that development needs also meet health needs. The framework must support that.

Irene Beautyman

I agree with you and Jamie Pearce about the effect of vacant and derelict land on mental health. I would also go so far as to say that most developments of a substantial size have the potential to have a negative impact on mental health or physical health. There is an opportunity to ensure that that is considered in general terms and with regard to different age groups, especially our ageing population.

I am thinking about issues such as out-of-centre housing developments—housing is a big aspect of what the NPF is being asked to deliver on. If we continue to build low-density housing estates on the edge of town, where it is difficult to access services without a car, we are building in inherent physical and mental health problems, particularly as people in that area start to age, but also in terms of social isolation, because people in such developments will not be walking around their areas and building community cohesion.

I would say that the impact of all large developments on physical and mental health needs to be thought about.

Dr Lowther

It is a good question. I agree with Irene Beautyman and Jamie Pearce that all developments have the potential to impact on health.

I want to make a point about the definition of a major development as opposed to a local development. A lot of the focus, particularly in relation to health impact assessments, is on major and national developments. However, we know that the majority of developments are local ones, which I think are those with fewer than 50 homes. I would argue that such developments are really significant, and there are literally hundreds of them across Scotland. They definitely have the potential to impact on health but, as I understand it, the policy focuses only on the major and national developments.

Again, there seems to be a bit of a gap there. As I said before, the devil is always in the detail with these issues.

Thank you. We move to questions from David Torrance.

Good morning. In relation to local living, do you expect 20-minute neighbourhoods to have a significant positive impact on health and wellbeing? If so, in what ways?

Dr Lowther

In a word, yes. I welcome the concept of 20-minute neighbourhoods. Over the past couple of years, with our experience of Covid, the power of living locally has been evident. As we were saying earlier, having good-quality access to good-quality local services is important to our health and wellbeing and our communities. Anything that can increase our levels of physical activity and social interaction, which is what 20-minute neighbourhoods can do, is important for our health.

Obviously, there are issues and questions around how many of our communities can become 20-minute neighbourhoods, but the underlying principle of creating much better local access to good-quality key services that people need every day is good and is welcome from a health perspective.

Irene Beautyman

I think that 20-minute neighbourhoods are one of the most noticeably impactful ways of realising the benefits of living locally that we have had for quite some time, so I welcome the idea.

We can look across the world to see what elements other people think it important to include in their 20-minute neighbourhoods. Given that the NPF enables us to assess large applications, we have an opportunity to pin down those elements now. Unfortunately, I have already seen many communications about developments that claim to be 20-minute neighbourhoods because they have put in cycleways and have one local shop, but we are talking about more than that.

If we do not pin down what we require in our 20-minute neighbourhoods, we risk developing a planning system that ends up with local government—which is already not sufficiently resourced to deal with its duties and responsibilities—and people in other sectors having endless debates about what we mean by a 20-minute neighbourhood. The NPF expresses support for 20-minute neighbourhoods but does not say exactly what we mean when we talk about them. We need to talk about other aspects, such as density of housing, people feeling that they have some influence over the place outside their front door and so on. The concept of 20-minute neighbourhoods is about more than active travel.

We could spend a lot of time debating that and taking up a lot of time that planning officers do not have with inquiries and discussions of cost, but it would be better to pin it down now. That is why our set of place and wellbeing outcomes that we have considered and tested includes the sort of wording that could pin down exactly what a 20-minute neighbourhood needs to be. If we pin it down now, everyone in Scotland can start from the same place, and there will be a consistent and comprehensive approach, which will give a lot of confidence to all sectors that participate in the planning system.

Are you happy to leave it there, David, or do you have another question?

I have a small supplementary. How will the benefits of 20-minute neighbourhoods be realised in remote and rural areas? How can we ensure that those benefits are achieved? I put that question to Matt Lowther.

Irene Beautyman also wants to come in on that, but we will go to Dr Lowther first.

Dr Lowther

Again, that is a good question. For me, the issue is about how we improve our services in those communities so that we can ensure that people can access the daily services that they need. That is why I am so drawn to the concept. It is about trying to improve access to good-quality services for everyone.

We must be realistic and pragmatic. People in some of our rural communities will not be able to walk to all our services within 20 minutes. We should not get too hung up on the 20-minute aspect. For me, the issue is about improving the quality of access to key local services. That is what we should aspire to.

Irene Beautyman

It is a very good question, given how much of Scotland is rural. Whether someone lives in a house on its own in the countryside or in a hamlet of 17 houses, they will relate to their nearest settlement and say that they live outside it. We must ensure that, when people get to their nearest settlement, that place delivers as much as possible for them, so that they do not have to go on to another settlement 50 or 100 miles away to meet their daily needs.

It is accepted that not everyone can have 20-minute living on their doorstep, but in rural areas, local settlements should be treated as 20-minute hubs and we should think of them like that. We should not think of them as places that can spread and sprawl out because they are in the countryside. They are the 20-minute neighbourhood hubs of the future for their areas. We should build at an appropriate density and should look to provide all the aspects of a 20-minute neighbourhood within those hubs. People can choose to live within them or outwith them, but when they get to those hubs, they should be able to park the car that they needed to use to get there and to access everything that they need in the same way that someone who lived in a more urban environment would do.

There is a big opportunity to think about how we develop rural towns and to address rural depopulation, which is one of the asks in the national planning framework.

Sandesh Gulhane will dig more deeply into issues for rural areas.

Sandesh Gulhane

When a housing development is greenlit, an assessment is carried out of the impact that it will have on schools, but there is no assessment of whether primary care will be able to cope. We know that there is a historical lack of staff in rural areas and that the lack of homes and transport infrastructure makes it less likely that those areas will attract staff. Should the framework include an assessment of a minimum requirement for the health and care services that should be provided alongside new developments? I have a supplementary question that I will ask later.

Professor Pearce

Communities need a range of services for people to be able to live healthy and fulfilling lives, and the provision of primary healthcare services is part of that.

The good intention of the national planning framework would be to look holistically across all needs. That comes back to the previous question. In rural communities, those needs might look—[Inaudible.]

We appear to have lost Professor Pearce. While we try to get him back, I will bring in Dr Lowther.

Dr Lowther

The quality of services and the access to them could be picked up through health inequalities impact assessments or health impact assessments. When an LDP is being formed, the HIA can be used to consider how planned developments might have an impact on health. That includes an assessment of access to services such as health and social care services. I hope that that would be picked up and taken into account when an HIA is provided as part of an LDP.

Irene Beautyman

The framework mentions that the provision of health and social care facilities should be looked at. It could say a little more about the need for closer relationships with health and social care partnerships in order to ensure that there is provision. I know that that happens in some Scottish councils, although there are fewer better-formed connections in others. In my 28 years as a town planner, I saw a variety of approaches as to whether that was bottomed out before the growth of a particular area was considered.

There could be something in the framework about ensuring that such evidence is looked at, while working more closely and building relationships with the health and social care partnerships to establish where there is capacity and where there is a need for a matching up of provision for areas that are growing.


I see that Professor Pearce is back.

In that case, if you want to ask your supplementary question, I will invite Professor Pearce to respond first. He can round off his earlier points and then address your supplementary, if that is okay.

Absolutely. Irene Beautyman was talking a little bit about this. Can we really use planning as a tool to improve health services, especially in our rural areas?

Let us go back to Professor Pearce. We heard most of what you were saying earlier, but your sound dropped off at the end. It is good that you have been able to rejoin us.

Professor Pearce

Yes—I am sorry. I am not sure when I got cut off, but I was making the case for a holistic approach to health services.

In rural areas, on the point about 20-minute—[Inaudible.]—that more as a principle and a metaphor. I think that we should be applying that to our health services, too. What are the services that we need? How do we make sure that they are as accessible as possible to those communities? The spatial planning framework helps us to do that, as it makes us think about what we need reasonable access to in our communities, and I am sure that it will be a helpful step towards that.

Irene Beautyman

I think that we can use planning in that way. What we have just been discussing around 20-minute neighbourhoods and local living means that, in considering existing areas and any future new areas, we ensure that access is provided for people’s daily and weekly needs—not hospitals and so on, but access to health services that can be planned in. That requires closer links with health and social care partnerships.

There is frequently a breakdown in sending a local development plan off to the director of public health and the health and social care partnership once the plan has been prepared. However, so many councils are doing great work: they are talking to them up front, planning around what is already there and taking that into account. The emphasis on local living and local facilities can only support that as we move forward.

Dr Lowther

Territorial health boards are key agencies, and they are required to be consulted in relation to local development plans. As Irene Beautyman said, it is a matter of ensuring that that relationship is strong right at the beginning so that, when we produce our local development plans, we do it in the light of the health and social care needs of the population right at the beginning. For me, it is a case of ensuring that those connections are strong right at the beginning of the process.

Let us now move on to talk about health inequalities.

Sue Webber

I would be interested to hear your comments about the 20-minute neighbourhood being about more than active travel. How, in your mind, does national planning framework 4 account for the needs and experiences of disabled people? The 39km or 40km of segregated cycle lanes that have been put down in Edinburgh under the premise of spaces for people have caused a lot of concern for disabled people and those with mobility issues. What can be done to build more inclusive settlements?

That is a great question. Let us go to Dr Lowther first.

Dr Lowther

Yes—it is a great question. Again, I guess the devil is in the detail. When we are starting to write the guidance that sits alongside NPF4 and describes how it will be implemented, we know that it needs to be clear about how developments can be produced in a way that is truly accessible for all our communities. At the moment, the document does not say a huge amount about that, so it could potentially be strengthened in that area.

You also mentioned inequalities. There is an opportunity for the planning system to have real impact on health inequalities. We might touch on that later in the session, but I think that the guidance that sits alongside NPF4 is going to be critical for getting that right and making sure that it is truly accessible.

Sue Webber

Where I struggle a bit, Dr Lowther—although maybe the next contributor can address this—is that all the documents go from walking to wheeling. An awful lot happens before someone who walks ends up in a wheelchair. I really struggle with that. It does not seem to allow for those who are striving to walk and want to get out. Do you understand where my approach and my thoughts are?

Dr Lowther

Yes—absolutely; that is what I was trying to say. We need to be clear about that in the guidance. For me, it raises the need for health inequality impact assessments and not just health impact assessments, because that is the whole idea behind a health inequality impact assessment. There are tools and guidance that allow us to do that. We can look very specifically at these sorts of policies and think about how they will impact on all our communities. I would particularly push for health inequality impact assessments as well as health impact assessments, because I think that they will pick up those sorts of things.

Thank you.

Irene Beautyman

This issue is precisely why I can be known to rant a bit about use of the term “20-minute neighbourhoods” and going on and on about 20 minutes. It is about different population groups. It is about people walking and travelling through their urban and rural places at different paces, and we need to take account of that.

The place and wellbeing outcomes that we have input into the process so far were very clear that we have to see that through the lens of all our different population groups, including taking into account different abilities for mobility and for how people can move. That issue also touches on what Matt Lowther was saying about other groups in our population and considering how we deliver places with an eye on all those different aspects of a population. We really need to be talking about local living, because it is not about some arbitrary number of minutes, although that has captured the attention.

Where we have used those place and wellbeing outcomes to assess a place and how it is moving forward, we have looked at them through the lens of not just the national outcomes and the place and wellbeing outcomes but all the different population groups, including those with changing mobility, particularly because of our ageing population.

We need more on that. I would certainly like to see it now, so that planning authorities can hit the ground running when they assess this and get that change to happen.

Sue Webber

I have one more question, which is on an issue that Irene Beautyman also alluded to. One of the stated aims of the national planning framework is to increase the density of settlements. However, through the pandemic we have come to understand the value of green spaces in our urban areas. How will the need to support active travel and public transport be balanced with protecting our green spaces, which might be the spaces that are used to create active travel routes?

Perhaps that can go to Professor Pearce.

We will go to Irene Beautyman first, with her planner hat on.

Irene Beautyman

Density is very important, but there does not have to be a huge increase in density. We are not talking about going up to high density levels; we are just talking about pulling away from the large detached villa sprawl that we tend to see around most of our towns in Scotland, which does not enable us to live more densely so that we walk more and support our local shops. A certain number of households and size of population is needed to do that. If we want people to use local shops, things have to be a little bit closer together.

That is about having a mix of housing types—terraces, colonies, flats—and making more use of lower ground-floor flats for our ageing population. Many great places in our cities—I am in Edinburgh just now—have a mix of large villas, tenements, colonies and semi-detached houses. We need to achieve more of that mix while still providing access to open space, which is crucial; any development should not come at the cost of that.

There is a cost to always building individual blocks that will not necessarily meet the needs of our ageing population in the future. When we rely on the private sector, we find that it tends to take the approach that makes the most profit for shareholders. That is its business model, which is fine, but it does not enable us to create the greatest places.

We need both things that you mention—we simply need a change in the uniform spread that we currently tend to see.

We move to questions on conflicting interests from Gillian Mackay.

Gillian Mackay

Do the witnesses recognise that some of the Scottish Government’s aims and ambitions that the framework highlights conflict? For example, how does the action to support the whisky industry in order to provide sources of local employment line up with the public health aim to reduce alcohol consumption? That equally applies with regard to other areas that we have spoken about today, such as road building, and their impact on public health. Do you feel that public health should be prioritised over some of those other aims?

Dr Lowther

That is a very difficult question to answer. We know that economic investment is incredibly important and provides public health outcomes. It is difficult to provide a definitive response. From my perspective, I am responsible for creating the right places, and part of that is about creating economic investment, which is important. We also need to ensure that all our decisions are based on the evidence and the science, so that we can model how certain actions could potentially impact on public health.

We need to take a proper evidence-based approach to such decisions. As I said, they are difficult decisions, because we know that economies are so important for local public health outcomes. I apologise if I did not answer the question definitively, but there is no simple response.

That is great—thank you.


We seem to have lost the convener. Perhaps the deputy convener can take over.

The Deputy Convener (Paul O’Kane)

I think that we are coming to my questions anyway, which is neatly timed. I will kick off this section, in which we are looking at national developments.

There are 18 national developments in NPF4, which seems like quite a lot. These things can often become quite cumbersome, and I am keen to understand what impacts those 18 developments will have on health and wellbeing.

Dr Lowther

As part of the process for developing NPF4, we undertook an evidence assessment that looked at the potential of those national developments and how they impact on health. We concluded that, from a public health perspective, all the developments have the potential to impact on public health. It is difficult to answer the question on the number of developments. I have looked only at the individual developments. I am fairly comfortable and positive about what they say about health impacts.


The Deputy Convener

I cannot see anyone else wanting to come in on that question at this stage, so I will move along. In national developments, should the impact on health and wellbeing be given equal consideration to, for example, the impact on the climate and the climate emergency? We know that there is a huge focus on that at the moment.

Irene Beautyman

On the impact of the national developments, the policy and the strategy, in every case we need to be considering the impact on both climate and health and achieving that triple win that we keep talking about. When we look to do something that is focusing on climate—the NPF is clear that its primary guiding principle is around climate impact—we must ensure that that will not have unintended negative consequences on health. We can achieve both. It is more important that we work in collaboration to ensure that we are delivering all those things, and it should not be a question of prioritising one over the other. We can do both if we give ourselves a little bit of time to collaborate and talk through what we need to achieve in both areas and how we can do that.

Professor Pearce

I firmly agree with what Irene Beautyman has just said. I would add that applying a public health perspective to the 18 national developments raises the question of how those were chosen. It comes back to the supplementary point that you just made, deputy convener, about ensuring that health is a key principle. If health was a key principle in the selection of those 18 national developments, it would be good to know how those decisions were arrived at. I am being slightly sceptical here, but maybe health was not a key principle in deciding on those.

I go back to the conversation that we had at the start of the meeting about ensuring that health is up there as a key strategic driver. We must think through the benefits in relation to health and wellbeing and inequalities in a forensic way and target them throughout each of the national developments.

The convener is in the process of rebooting her computer, so I will continue to chair the meeting. We move to questions from Stephanie Callaghan on outcomes.

Stephanie Callaghan

Earlier, Irene Beautyman mentioned the work done by the Improvement Service and Public Health Scotland on spatial planning health and wellbeing outcomes. How can the proposed outcomes be embedded in the framework so that they are used consistently?

Irene Beautyman

We already have a set of policies in part 3 of the national planning framework, and the place and wellbeing outcomes provide a lot more clarity than the current set of wordings. Policy 6 talks about the design quality of a place, which is crucial. We could be using the place and wellbeing outcomes wording itself to give much more clarity on the consistent, comprehensive things that we need to be considering in order to ensure that everyone is singing from the same hymn sheet, rather than debating those over time. They can be embedded in that policy.

At the moment, the wording includes things such as “a sense of joy” and a feeling of “playfulness”, which are not phrases that planning officers who are determining major applications for change in areas can actually use. They need wording that can enable them to make decisions confidently. That needs to be backed up with evidence about inequalities, including health inequalities, in an area. They need confidence from the wording that is established in the national planning framework.

My recollection is that, when we began the process, the national planning framework was to take a lot of the burden off local development plans by putting in place a national policy for Scotland that could then be used to produce slimmer and more agile local development plans, which would speed things up and move them on. I do not think that the level of clarity that is currently in the national planning framework allows for that to happen—certainly, that is what I am hearing from others across the board. It would be beneficial to use the outcomes wording as a strong example of what we could be doing, and then consider whether it needs to be augmented in regard to the specific interventions that are required to deliver on the place and wellbeing outcomes. Every local development plan across Scotland has some of those elements, but not consistently so.

We support planning officers across Scotland, as well as heads of planning, with the planning skills series. The planning officers have told me that, frequently, they do not have the confidence to apply the outcomes, which goes back to what Dr Lowther said earlier. They do not feel that they have the teeth to confidently say to a developer, “Look, you’re not providing a good density, with good-quality open space and all the elements that we need to create a successful place, so we will turn you down.” If councils can build a reputation of taking that approach, they can eventually make a turn in the type of application that comes to them. However, that takes time, which is what concerns me. We need to get going now, and embedding that wording and quality would enable us to do so.

Stephanie Callaghan

That is helpful, thank you. I should say that I am a councillor at South Lanarkshire Council. I am no longer on the planning committee, but I was previously. Deputy convener, is it okay if I follow up with another short question?

The convener is now with us again. I have had my five minutes of fame, so I will pass back to her.

Thank you. Stephanie, before you ask your question, Dr Lowther and Professor Pearce wanted to come in on your initial question.

Dr Lowther

I will add to what Irene Beautyman has just described. The health and wellbeing outcomes allow us to clearly describe what a healthy, sustainable place looks like in its totality. However, I do not think that that is clear in any of the documentation that has been produced. The health and wellbeing outcomes are clear: if you want to create a healthy and sustainable place, there are 14 things that that place needs to achieve. The outcomes are very clear in that respect.

There is an opportunity to embed those place and wellbeing outcomes in the guidance on LDPs that is being produced and consulted on at the moment. Potentially, the outcomes could be listed in one of the annexes, so that local planners, developers and others who are involved in the planning system can properly understand what a healthy sustainable place looks like.

Professor Pearce

It is important that the outcomes are tied to the ways in which the planning framework can affect health, with concrete pathways. For example, obesity might be one that is identified. It is important that we think about the pathways, one of which might be improving access to nutritious food, as well as the health outcome, which might be reducing obesity levels among school-age children—that would be an obvious example.

It is important to think about the steps and stages through which the planning system can affect the outcomes, as well as the strength of evidence connecting the two, to ensure that it is informing whatever the outcomes are.

Stephanie Callaghan

That is great; thanks to you all for your responses.

I do not know whether you saw the session with the first panel, but Dr Booth and Jacqueline Lynn stressed the need for infrastructure to allow women and young girls to get active and feel safe in the community. Has that issue been adequately addressed, or should there be more focus on it?

Irene Beautyman

That comes back to what I was saying earlier about mobility. When we are looking at any major proposal for change, we need to run it through the lens of different population groups. That is why those groups are listed at the bottom of the place and wellbeing outcomes. One is women and another is young people. We know that open spaces need a different set of requirements if we are going to get young girls in particular to take part, because they have a different set of asks from that place. We need to consider that.

We also need to consider comments that are made in the policies about equalities. The policies say that we need to talk to communities in an appropriate and—I cannot remember the other word—manner. We need to ensure that we talk to all parts of communities or to our community planning colleagues who are aware of all parts of communities and their needs as well. That is an important aspect of the approach.

It comes back to Katherine Trebeck’s wellbeing economy measure of using the ability of 12-year-old girls to cycle to school as a way of monitoring a country’s success rather than it being purely about gross domestic product. That is crucial.

I promised that, if we had time at the end, I would allow Emma Harper to come back in for her very targeted and brief supplementary question.

Emma Harper

Thanks very much for indulging me, convener. My question is for Dr Matt Lowther. He mentioned the place standard and described the 14 questions in the framework that aim to let communities, public agencies and voluntary groups find aspects of the place to target health, wellbeing and quality of life. How do we know that people are aware of the place standard tool and are using it? Yesterday, I called Dumfries and Galloway Council planning department. It was not aware of the tool but was certainly going to look into it. How do we ensure that such tools, which can support better planning for public health, are available and used?

Dr Lowther

That surprises me, because we know that every local authority is using the place standard tool. We have a national alliance that brings together people who use it. We have representatives in each local authority area with whom we engage about the tool. It has been used hundreds of times across Scotland. We have an accessible website. We have had international recognition for the tool and it is used in dozens of other countries.

That is not to say that we can rest on our laurels. Of course, we will always need to do more. If there is something specific that you think we need to do to get the message out about the tool, or if people think that it is not getting out, we can look at that. However, I am surprised at what you say, because we have a national alliance and we have contact with all our local authorities, which are all using the tool.

That is good to hear. It was only one person I spoke to, so it might be worth my following it up more widely as well.

The Convener

I thank our three witnesses for their time. It was an interesting discussion and has given us a lot to think about. That is the end of the evidence session.

At our next meeting, on 1 February, the committee will take evidence from the Scottish Government as part of our inquiry into the health and wellbeing of children and young people. We will also take evidence on two common frameworks.

That completes the public part of our meeting.

11:58 Meeting continued in private until 12:31.