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Greater Manchester to get control of its entire £6bn NHS budget

Councils in Greater Manchester are to take control of the region’s entire £6bn health and social care budget, as NHS powers are passed down from government under the latest wave of devolution for the area.  

Manchester City Council confirmed that the 10 local authorities, 12 clinical commissioning groups and 14 NHS partners in the area have struck a preliminary deal with NHS England and the government on a "groundbreaking agreement for health and social care".

The agreement has been negotiated between local officials and the chancellor, George Osborne, who described it as “a really exciting development”.

"This is what the NHS wants to see as part of its own future,” he said.

"And it's also about giving people in Manchester greater control over their own affairs in that city, which is central to our vision of the "northern powerhouse"- so it's a very exciting development."

Sir Richard Lease, leader of Manchester City Council, told the Guardian that the deal will allow services to be commissioned in a more coherent way.

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.”

However, Richard Humphries, assistant director of the King's Fund think tank, said the move could represent a “poisoned chalice”. He told BBC Radio 4’s Today programme that the deal “is on the nuclear end of the spectrum and raises all sorts of questions and risks”.

“Depending on the detail – and the detail is really crucial and we don't have that yet – you could either see this as a triumph for local democracy or creating real risks of yet another reorganisation of the NHS when it's barely recovered from the last one,” he said.

“If the plan is to give the money to local government, the words 'chalice' and 'poisoned' perhaps spring to mind.”

The deal represents a quarter of the region’s public spending budget and is set to go into effect from April 2016. It will ultimately see the new mayor of the conurbation assume control of how budgets are allocated for public health, social care, GP services, mental health and acute and community care.

Additionally the deal will include powers over the workforce, regulation, information sharing and NHS buildings.

As part of the deal a new health and wellbeing board for all of Greater Manchester is to be appointed to run from April, with control of the budget to be handed down the following year, according to a memorandum of understanding with the Treasury.

The new board will work closely with existing CCGs and the council to commission services. It is hoped that the deal will be a big step in integrating health and social care services, which will in turn ease pressure on hospitals and help to improve home care services for patients who need it.

The speed of the deal has surprised many local officials, with one source telling the Manchester Evening News the decision had been unexpectedly quick.

He said: “Devolution is a ball that’s rolling and cannot be stopped. But the speed and the timing of it has come as a surprise.”

Cllr Mike Connolly, Labour leader of Bury Council, told the BBC: "Those decisions need to be made in Greater Manchester and not Westminster, and I welcome any form of devolution to the city region.

"We are all agreed, certainly in the Labour Party, that health and social care must be integrated because it's about providing that primary care – and it can only be good for healthcare across Greater Manchester."

This is the latest and most significant step in the devolution agenda for Greater Manchester. A number of powers devolved to the Greater Manchester Combined Authority in November 2014 worth roughly £1bn including control over some transport, planning, housing and policing budgets in exchange for a new metro mayor by 2017.

(Image source: Joe Mott)

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