Developer contributions (section 106 payments) secured as part of planning permissions for new developments have provided significant funding for the new healthcare infrastructure needed to support growth.
A key change now taking place in the planning system is the phased introduction of the Community Infrastructure Levy (CIL for short). This involves changing from an up-front negotiation of developer contributions (section 106 payments) on a site by site basis around a planning application to one where, when CIL is implemented, health professionals (including CCGs) will need to make the case to the local planning authority (LPA) for investment and release of appropriate funds. There is likely to be significant competition for CIL funding, and the prioritsation and allocation of funding is a matter for the charging authority.
“Local planning authorities should work with other authorities and providers to… assess the quality and capacity of infrastructure for transport, water supply, wastewater… health, social care, education, flood risk and coastal change management, and its ability to meet forecast demands.”
CIL is a development tariff (charged per square metre of net additional increase in floorspace) that can be charged on new developments to contribute funds towards a list of local infrastructure projects (known as a Regulation 123 list). CIL charges and items on a CIL list need to be justified by local evidence, which could include the identification of specific healthcare infrastructure needs resulting from planned growth, such as GP surgeries or hospitals. The list could also include contributions to wider infrastructure that could improve health or reduce health inequalities, such as green infrastructure or cycle paths.
It is not compulsory for LPAs to prepare a CIL charging system. In the absence of CIL not being adopted by a council then Section 106 planning obligations remain the primary means to ensure that developments pay for the infrastructure that supports them. Section 106 planning obligations require developers to make a financial or in-kind contribution to mitigate on-site impacts from new development. However from April 2015, Section 106 policies will be scaled back to on-site contributions, regardless of whether or not an LPA has a CIL in place. Moreover, LPAs will only be able to pool and use up to five Section 106 planning obligations for a particular infrastructure requirement.
It is critical that public health practitioners provide costed evidence of infrastructure needs and gaps when planners prepare a CIL Regulation 123 list, and that this is aligned with the local authority’s infrastructure planning process and local plan-making, and takes into account the scale of planned new development. This collaboration is particularly important in two-tier areas where the county is responsible for strategic infrastructure such as health, education and transport and the districts are responsible for planning.
Two key tools for addressing the health service implications of development are highlighted below.