The UK Government has announced that from April 2016, Greater Manchester’s 10 local councils, 12 Clinical Commissioning Groups and, ultimately, an elected Mayor will be given £6 billion of public money to be spent on health and social care within the region.
Greater Manchester will be the first English region to be given full control of its health and social care spending with local people having the power to decide on health and social care services that work for their region.
It is hoped that this devolution of central powers and integration of health and social services will ease the pressure on hospitals. Focus will be placed on services in the community – keeping people out of hospitals by providing care and treatment in the community where possible.
There has been much commentary and mixed views about the new proposals.
Simon Stevens, Chief Executive of NHS England, supports the integration plan. He states that now is the time for courage and for bold moves to deliver the ambitious agenda set out in his NHS Five Year Forward View. He believes that Greater Manchester now has a unique opportunity for innovation and improvement in health and wellbeing and he is optimistic that the area will continue to deliver on national care standards and the patient rights set out in the NHS Constitution.
Andy Burnham, Labour’s shadow Health Secretary, is concerned about the NHS becoming like a ‘Swiss cheese’ with some bits of the system operating differently to others. Concerns have also been raised about ensuring accountability for the large sums of public money involved. When the NHS and social care systems join, will the new joint body lead to an additional costly layer of bureaucracy?
Lord Peter Smith, chair of Greater Manchester Combined Authority, states that it will not simply be a “town hall takeover” of Greater Manchester’s NHS budget. They will be working together with the region to make joint decisions which reflect local priorities. Lord Smith states that “this is about decisions about Greater Manchester being taken in Greater Manchester in an integrated way, not being taken away from experts.”
At present, the jury is out and it may be premature to give a verdict on whether the new proposals will be a triumph or disaster for health and social care services in Greater Manchester. The King’s Fund Think Tank rightly point out that the details of the proposals, which we do not have yet, are crucial in determining this. The recommendations came about following the findings of an independent commission, set up by The King’s Fund and led by Kate Barker. The commission recommended moving to a single ring fenced budget for the NHS and social care, with a single commissioner for services.
It will be interesting to see how the plans develop over the following year ahead of the funding, power and responsibility being handed over in just over a year’s time.
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