Reports
What’s holding up housebuilding? The government’s green paper proposes to drop planning permissions for projects unlikely to be started, to use compulsory purchase orders on those that have stalled, and to work with developers to fix practical barriers to development. But “developers can only build houses as fast as they can sell them”, argue Civitas. Land prices are tied to current house prices, enforcing slow development. Demand side policies, like Help to Buy, can only reasonably support those who can afford current house prices and therefore don’t spur faster building to serve waiting customers. The surest way to increase housing supply would be to enable the public sector to do it at a large scale. The next would be to improve the absorption of new houses by the market - specifically by tweaking the conditions attached to planning permissions. Landowners would no longer have the right to sit on land indefinitely, with sites that are needed for new homes subject to compulsory purchase “at a price that does not incorporate prospective planning permission”. Could this work? In a sense, the use of land is already affecting its value - for example where infrastructure commitments are attached. Civitas
Not so fast. There’s a lot of political steam behind regaining powers on immigration from the European Union, but this may be one of the most complicated policy priorities to secure. Certainly, the UK Government can immediately implement a new regime. However, primary legislation will be needed when parliamentary time is in short supply. In administrative terms, the Institute for Government argues, “the scale of the task makes successful implementation of a new immigration regime by April 2019 unfeasible”. This is because much enforcement activity at the moment is carried out by “employers, landlords and public services”. Given that three million EU nationals already resident in the UK will be affected, and the potential for labour market and administrative disruption is significant, the Government should avoid tinkering until a new system is ready. Many want to see a simpler, less burdensome and more easily enforceable regime. To make this happen means well-planned and phased implementation, and that means freedom of movement may need to stay in place for several years after Brexit. Institute for Government
Shock absorbers. Medical wards delivering acute care in hospitals need a plan: they are treating complex conditions, in increasingly frail patients, under growing time pressures. The teams responsible are large and comprise many disciplines, spread out across the hospital. Frequent handovers between staff undermine consistency and mean mistakes are made - not from breakdowns in procedure, but from missed opportunities to provide care adding up. So what can be done at the frontline? Clinical teams are already acting as “shock absorbers” for an overstretched system. Within the NHS, they are taking the initiative to make patient records readily available, and they have been empowered to make scientifically-grounded design interventions to improve care quality - such as redesigning the emergency floor. Wider moves towards greater collaboration, however, are put at risk by a lack of esteem for junior doctors, expressed not only in declining pay and working conditions but “a more fragmented experience”. More collaborative ways of working, The King’s Fund argue, will require a move away from the craftsmanlike model of clinical work towards greater standardisation. There is a cultural shift needed, too: high performing hospitals tend to have a leadership with a visible, personal commitment to quality improvement. Making the change is everyone’s responsibility, however: “no stakeholder ought to be a bystander”. The King’s Fund
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