There are calls for housing developers to provide upgraded health care facilities. Under planning law and policy in Scotland, that is not a straight-forward process.
Link to the development
The common thread running through current law and policy in Scotland is that a housing development can only be expected to contribute towards the cost of infrastructure where there is a direct link between the development and the need for the infrastructure.
Although it might seem obvious that a substantial housing development creates a need for health care facilities, it can be difficult to prove that.
In a recent appeal, the Scottish Government reporter rejected the planning authority's approach of using payments of £1,000 per residential unit towards an extension of a GP practice. That approach did not meet the policy tests for a variety of reasons:
Pre-existing need: planning policy makes it clear that new developments cannot be asked to resolve existing deficiencies in infrastructure provision. The reporter concluded there was a considerable pre-existing need for new health facilities. The planning authority had failed to examine the degree to which the deficit was pre-existing.
Other developments: the reporter also criticised the planning authority for failing to consider what other developments would benefit from the extension and might be expected to contribute to it.
Cost: the £1,000 per unit tariff did not take account of the actual cost of the extension or what may be a fair distribution of costs across the developments that benefit.
Type of facility: the extension to the GP practice is an interim measure. The reporter criticised the planning authority for not assessing how long the interim provision may be required and whether it is actually worth making interim provision.
This appeal decision illustrates that very detailed evidence may be needed to justify requiring a developer to pay financial contributions towards the provision of healthcare facilities. Similar experience with education infrastructure suggests that appropriate methodologies will evolve.
Funding of treatment
Planning law also indicates that developers cannot be asked to pay for funding of medical treatment. A recent English court decision drew a distinction between capital and operational funding: additional demand arising from new residents might justify seeking a financial contribution for new medical facilities, but an applicant for planning permission cannot lawfully be required to contribute to funding of treatment within the NHS.
Better information about the need and cost of medical and other facilities might be available through the infrastructure first approach, which is supported by the new National Planning Framework 4. This approach is aimed at understanding infrastructure needs early in the development planning process as part of an evidence based approach.
The Planning (Scotland) Act 2019 gives the Scottish Ministers power to establish an infrastructure levy to be used to fund infrastructure projects, including medical facilities. The introduction of the levy would remove the need to show the link between the development and the need for the infrastructure. However, it might be more difficult to coordinate the phasing of the development with the provision of the infrastructure.