£6bn NHS and Social Care Budgets in Greater Manchester Devolved to Councils and Health Bodies

The Independent is highlighting a ground-breaking plan to devolve the £6bn NHS and social care budget in Greater Manchester to the regions councils and health bodies could become the model for many parts of England.

The shake-up is expected to be announced tomorrow, would break down barriers between hospitals and care in the community to ensure a “joined-up” service for patients.

The rising elderly population has put huge pressure on hospitals, which often cannot discharge old people because of a lack of social care provided by cash-strapped local authorities hit by spending cuts.

The Greater Manchester blueprint is part of George Osborne’s vision of a “northern powerhouse” under which a directly elected mayor in Greater Manchester will enjoy new powers such as over housing and transport from 2017. It could allow the Conservatives to trump Labour’s  flagship plan to integrate health and social care.

The Chancellor’s growing partnership with the region’s Labour council leaders is embarrassing for the party’s national leadership.

Jeremy Hunt, the Health Secretary, said: “Labour talks about integration but did nothing in 13 years in power. Now this Government is doing it for real.”

A new board of health and council officials would oversee the combined budgets of NHS England, 12 GP-led clinical commissioning groups and the social care provided by 10 local authorities in Greater Manchester.

The proposed system, which could take two years to bring in, would be similar to the integrated one in Northern Ireland and the one being introduced in Scotland.

Similar offers of NHS autonomy could be made in Birmingham and Bristol, the North-east region and north London.

Richard Humphries, assistant director of the King’s Fund think-tank, said the Manchester plan was “the right direction of travel” but warned it could mean more organisational change, which he said the NHS “needs like a hole in the head”.

He  told politicians not to assume integration would save money. “You might get people out of hospital quicker because of joint working with social care, but you’re not saving any money because the next patient is ready to jump into the bed,” he said.

A sign of the potential hurdles ahead came in a critical report today by the Commons Public Accounts Committee on the trouble-hit Better Care Fund which pools hospital and social care budgets. It said the planning for the fund was “deeply flawed” and that only £55m of the £1bn savings expected by the government was realised.

The fund has now been redesigned and in the financial year starting in April £5.3bn of pooled spending is due to save £532m. But Margaret Hodge, the committee’s Labour chairman, said it was “not convinced” that emergency hospital admissions and delayed discharges could be reduced to achieve such savings.

Mr Osborne hailed the Greater Manchester scheme as “a very exciting development” but dismissed suggestions that it would undermine a national health service.

Ed Balls, the shadow Chancellor, appeared to back the deal but Andy Burnham, the shadow Health Secretary, did not, saying: “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 and freedoms.”

Grice A. Cooper C. 2015 The Independent Daily Briefing 26/02/2015 P. 4

“This scheme will cost £millions if not £billions to put in place with any appreciable gains unknown.

We have left ourselves in a “right pickle” through seeing the problems looming for years and doing nothing to address them.

Our manufacturing base was decimated through lack of investment and foresight and now we are hitting seemingly insurmountable problems with our health and social care systems for the same reasons.”

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