Greater Manchester to get control of £6bn of health spending

[wendy]

without democratic safeguards, say critics

Sir Richard Leese, leader of Manchester city council, said a provisional deal had been struck between NHS England and the 10 clinical commissioning groups in Greater Manchester.

Helen Pidd, northern editor Rajeev Syal and Patrick Wintour political editor

Wednesday 25 February 2015 12.21 GMT Last modified on Wednesday 25 February 2015 16.22 GMT



Greater Manchester is to become the first English region to be entrusted with spending its own £6bn health and social care budget, cementing its status as the UK’s second city.

Sir Richard Leese, the leader of Manchester city council, said a provisional deal had been struck between NHS England and the 10 clinical commissioning groups in Greater Manchester to devolve health and social care spending powers to the region.

From April 2016, a new umbrella body in Greater Manchester will have control over public health, social care, GP services, mental health, and acute and community care, Leese said. Currently those services were run separately – and often inefficiently – by the clinical commissioning groups (CCGs), NHS England and the local authority, he said.

“Instead of it all being commissioned by a mishmash of bodies, it will be commissioned in a joined-up, coherent way. There’s 40 years of evidence proving that the integration of health and social care can vastly improve early intervention, preventing patients from becoming patients, and decreasing unnecessary and expensive admissions to hospital.”

Leese noted that while similar agreements already existed in Scotland and Northern Ireland, Boris Johnson, the mayor of London, had no control over health and social care.

“London doesn’t have the structures in place to do this,” he said.

Labour’s Andy Burnham reacted cautiously to the plans, saying he was in favour in principle of greater integration of health and social care, but he said he was wary of anything that might lead to a two tier service.

It is understood that the plans were due to be published on Wednesday, but were postponed partly due to pushback by Manchester city council.
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Burnham said he was not sure if he supported the localisation of the National Health Service.

“For me, this has to be a solution that works for everywhere or that could be offered to everywhere,” he said.

“Because if you’re going to stick to the idea of a National Health Service you can’t have a Swiss-cheese NHS where some bits of the system are operating to different rules or have different powers or freedoms. So I am a bit worried by what I’m hearing. Because it does point to further breakup of the idea of a National Health Service.”

But Jeremy Hunt, the health secretary, said the new care model for Manchester would be the first step in an “exciting process”.

Writing on Twitter, Hunt added: “Labour talk about integration but did nothing in 13 yrs – now this govt is doing it for real, perhaps some grudging support?

David Cameron hailed the nascent NHS deal in Manchester an “important breakthrough”. He claimed Burnham had known about the plans, adding: “Eight Labour authorities have been talking to us and working with us to make it a reality.”

He said this example of co-operation was a contrast with Burnham’s attempt to weaponise the NHS across the dispatch box.

John Leech, the Liberal Democrat Manchester MP, said: “I believe that decisions are best made locally, and today’s £6bn health budget announcement is great news, and further proof that this government has delivered to Greater Manchester on extra local powers”

The plans were greeted with dismay by Lisa Nandy, the Labour MP for Wigan and a frontbench spokeswoman, said the plans were being introduced without any of the necessary democratic safeguards. She is among many who fear that the the government’s insistence on introducing an elected mayor for Greater Manchester in return for devolution could concentrate too much power and money in one office.

In November, the Greater Manchester Combined Authority agreed to hold elections for a mayor in 2017 as part of its groundbreaking devolution agreement. Nandy said: “It’s astonishing that control of the NHS will be handed over to an appointed mayor without any thought given to democratic involvement or public scrutiny. It shows complete contempt for the people of Greater Manchester.”

But Leese, leader of the council since 1996, has continually insisted that the elected mayor would be kept in check by the leaders of Greater Manchester’s 10 local authorities. He said the health deal would eventually help Greater Manchester to bridge the £5bn gap between the £22bn it currently received from the Treasury and the £17bn it put back in tax revenues.

He said the NHS was not being abolished in Greater Manchester and that the deal was all part of the devolution agreement signed by the chancellor, George Osborne, and Greater Manchester’s 12 leaders last November.

Leese added that the deal was due to be announced on Friday and that the fine details were still being hammered out. The news was released “prematurely” via a leak to the Manchester Evening News, he said.

The local paper said it had received a draft internal document that suggested that the move would include powers over the workforce, regulation, information-sharing and NHS buildings – as well as the cash itself.

After news leaked out on Tuesday night, even close observers were surprised. Mike O’Connor, national head of projects at the law firm Addleshaw Goddard, which provides legal advice to the Greater Manchester combined authority, said: “It’s astonishing that this has come so quickly. It shows how much faith George Osborne and others have in the Greater Manchester city region’s administration.”

O’Connor said the deal should improve the competing (and expensive) interventions from Whitehall, which currently had to deal with those issues in Greater Manchester that straddle health and social care. For example, the troubled families programme, which tackled the myriad problems of some of the most difficult and disadvantaged families in the region.

“Right now you might have five or six different interventions for each family in a week and there’s no co-ordination,” he said. “Sometimes you’d have no one turn up, other days there would be a queue out of the door. The idea is that you can do more for less if you coordinate provision more carefully.”

O’Connor said he expected Whitehall jobs to be transferred to Greater Manchester to administer the £6bn budget: “There has to be a growing administration for the Greater Manchester city region and an equal an opposite reduction in Whitehall staff. There has to be a skills transfer to the north in order for this to work.”
Last year, Addleshaw Goddard co-commissioned a report into devolution called DevoManc, which said Greater Manchester should be entrusted with its entire £22bn annual budget. The provocative report, written by the thinktank Respublica, argued that this would allow local decision-makers to eliminate inefficiencies and spend the money where it was most needed, eventually leading to the region becoming a net giver to the Treasury rather than a net taker.

“After DevoManc I remember colleagues in London were saying: ‘Yeah yeah yeah, I’ll believe that when I see it.’ Six months later, look what’s happened,” said O’Connor.
http://www.theguardian.com/society/2015 ... h-spending

[wendy]

Will these changes effect you? Please let us know how it goes.

[annie]

Out trust is East Lancs, so will not be affected

[wendy]

what about Honey?