£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.”

Diesel Cars – ‘Massive Public Health Problem’

By Jonathan Owen & Jamie Merrill – The Independent on Sunday

The drive by the previous government to encourage millions of people to opt for diesel cars in a bid to lower carbon emissions has created a ‘massive problem for public health’ the shadow environment minister, has admitted.

Ten million Britons drive diesel cars, in a trend which was encouraged by tax breaks given by George Brown when he was Chancellor of the Exchequer.

Last year more than half of all new cars were diesel. But while they emit less carbon dioxide (CO2) than their petrol counterparts, diesel cars emit more deadly pollutants – which have contributed to dangerous levels of air pollution causing the deaths of 29,000 people a year.

Air pollution from carCompared to petrol cars, diesels produce 22 times the amount of  particulate matter – a cause of cancer. And they emit up to four times more nitrogen oxides – including nitrogen dioxides, which damages lungs and blood vessels and can cause heart disease, stroke and diabetes.

Barry Gardiner, shadow environment minister, said: “there’s no question that the decision we took was the wrong decision, but, and it’s a big but, at the time we didn’t have evidence that subsequently we did have, and we had cleaner diesel engines, which we thought meant that any potential problem was a lower grade problem than the problem we were trying to solve of CO2.”

Speaking in a Dispatches documentary that will be broadcast on Channel 4 tomorrow, he claims the drive for diesel was the “right move away from those vehicles who were pushing out CO2 emissions.”

Air quality is now so poor that it is stunting the lungs of young children in parts of London, according to preliminary findings of researchers at Queen Mary University Hospital and King’s College, London.

The documentary also reveals how car drivers are exposed to higher levels of pollutants than cyclists and pedestrians. Professor Frank Kelly, Chair of of the Committee for the Medical Effects of Air Pollution, said that diesel fumes could “penetrate” car cabins with “ease”. Alan Andrews, a lawyer with environmental campaign group Client Earth, said: “People still think diesel is the green fuel… The truth is diesel is a very heavily pollutant fuel.”

In London, councils are pushing back against diesel engines, with plans in Islington and Hackney for surcharges of up to £96 on parking permits for diesel vehicles.

The car industry has reacted with dismay to the “blanket” clampdown, with one source close to Ford, which just opened a £190m diesel engine plant at Dagenham, saying it was an unfair “demonisation of diesel”.

A government spokesperson said it had invested £2bn since 2010 on “ultra-low-emission vehicles, sustainable travel and green transport schemes”.

“Not many of us can get away from passively ‘smoking car fumes’ unfortunately. We still await a clean replacement for the internal combustion engine after well over a hundred years!!”