Healthcare devolution: we all have a part to play

Last week saw a major step forward in the push for decisions to be made locally.

At the start of the week the news broke that plans to devolve decisions over healthcare in the region were imminent. And then on Friday came the ground-breaking announcement of plans to bring together health and social care budgets worth £6 billion.

This puts local people firmly in control of future health and care services that suit the region.

I am clear decisions made about services which effect people should be made by, or as close to that community as possible, and have democratic accountability.

We must now use the next 12 months during the ‘transitional stage’ to involve local people, health professionals and ALL councillors in the changes that will follow.

In many respects the changes all get obsessed about (governance) but most people don’t give much attention to them, they just want it to work. When they need social care or health treatment they rightly expect the system to work.

But there are too many stories of people falling through the gaps between services, departments and the complex number of organisations. Any sense that the NHS is ‘one’ today is very far from reality. It’s complicated and while in some cases that might be for good reason, for the public they just want a system that puts them first.

We all have our own ambitions for this and together with my own desire to see services formed around people, not institutions. I also want to see an equal relationship between the government, the public, NHS staff and other public services.

Success for me would be to see the hardworking employees who provide in home care for mainly older people treated with the same respect as those caring in hospitals. Decent wages and terms and conditions will mean they can be held by members of the public in the same respect and admiration as NHS staff (quite rightly) have earned.

Here’s what the deal says:

The deal sees NHS England, 12 NHS Clinical Commissioning Groups, 15 NHS providers and the 10 local authorities, including Oldham, agreeing a framework for health and social care – with plans for joint decision-making on integrated care to support physical, mental and social wellbeing.

This is an early step on the road for the devolution of decisions and budgets to regional level and it is welcome. By devolving power away from the distant Whitehall civil servants to locally accountable councillors and health and social care professionals we believe we can create a better and more efficient way to deliver services that are arranged around people, not institutional silos. Health and Social Care has some of our best and highly-regarded frontline workers and they, like us, recognise there are gaps in the current system which can only be resolved through true integration.

We need to balance this opportunity though. It is all too easy to get carried away into building more layers of bureaucracy and slowing down a system that is already under pressure to the point of breaking. It is also vital that we don’t rush into expensive reorganisations and restructures – that would be a big mistake.

We need to go into this with our eyes and ears open. We need to listen to the public and ensure that their needs and voices are part of the ongoing discussions. We also need to keep our eyes open as leaders and make sure we have the full picture so we can make vital decisions on a crucial part of people’s care – now and in the future.

There is a lot to be said for ‘better together’ and here in Greater Manchester we can be proud of what we have achieved by working together.  We have one of the best tram systems in Europe and many leading institutions such as the BBC and the Imperial War Museum have chosen to locate here.

We must be clear, however, about the major challenges still facing us.

As a conurbation our local economy under-performs compared to similar areas in the rest of Europe. We actually receive more from central government than we currently raise in taxes and too many of those who could contribute to our success choose to make their futures elsewhere.

The ongoing discussion about an elected mayor and devolution for Greater Manchester needs to be firmly focused on addressing these key concerns – and how we can help create prosperity locally.

The Combined Authority working in real partnership will have a budget of billions of pounds. It cannot be a talking shop and it has to be clearly very accountable to the public.

The real opportunity is that locally we can begin to exert more control over the billions spent in Greater Manchester by unaccountable national quangos and ensure that our housing and employment programmes can meet real local needs.

The public aren’t calling for more politicians – there’s no public appetite for that – and it’s absolutely right that we’re incorporating the existing Police and Crime Commissioner role, saving money and avoiding duplication.

With a £50 billion economy and a population of 2.7 million, Greater Manchester has led the national debate on political devolution from Westminster.

There was a tipping point on the devolution debate. A point where the assumption was in favour of devolution over Whitehall control was accepted as the norm. I believe with this announcement we’ve seen the tipping out.

And if the assumption is devolution we now need to look at other areas where Whitehall has failed to reform services. I’ll put a marker down for the Department for Work and Pensions right now.

Our task now is to take the people with us and create a city region leadership that can contribute to our economic success and a brighter future for all our residents.

More information about last week’s announcement can be viewed online at the Greater Manchester Combined Authority website at:

Thanks for listening,



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