A healthy development in Manchester

Exciting news from Manchester today with the announcement that £6 bn of health spend is to be controlled by the combined authority.

LGiU has argued for a long time that we need to create single, place-based budgets for all public services including health.

The broad outline of public service reform is clear. We need to move from a system that is geared towards acute intervention to one that is characterised by demand management, prevention, integration of services, multi-agency working and which is co-produced with, and designed around, the needs of service users.

You simply cannot achieve that if you are always negotiating across separate funding streams that are siloed down from Whitehall departments.

When the Chancellor announced the Greater Manchester agreement back in November we wondered if he saw it as an end point, or the beginning of an ongoing devolutionary process, which is certainly how the local authorities saw it. We appear to have our answer.

We must hope now, first that this just one more step on the road towards local control of the whole £22 bn public spend in Manchester and second that we see this sort of process developing very soon in other places – including non-metropolitan regions.

It’s interesting, though not surprising, that this progress outwards devolution is being driven by the treasury with the Department for Communities and Local Government apparently absent. No doubt there are all sorts of politics behind the scenes, but it feels as though George Osborne and Greg Clark have realised that a more decentralised politics and economy are not just nice to have alongside core political objectives like growth and public service reform; they are how you achieve those objectives

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    1. Colin Rosenstiel says:

      This is great news but why are Andy Burnham and the Labour Party being so dog-in-a-manger about it? Do they really imagine that the NHS is that uniform across the country anyway?

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