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Osborne offers all major cities control over health budget

England’s major cities will be invited to control their own health budgets as chancellor George Osborne today confirmed he would be extending his Manchester devolution offer nationwide.

Giving his first speech since the election, Mr Osborne said to England’s cities that ‘it is time for you to take control of your own affairs’ and confirmed that the new model of city government would be central to the new Government’s first Queen’s Speech.

Rather than a national devolution scheme cities will have to approach the Treasury to negotiate the extent of budgetary control they will be given, and offer is only open to cities who first instate an elected mayor.

Speaking in Manchester today, Mr Osborne said: ‘Here’s the deal: We will hand power from the centre to cities to give you greater control over your local transport, housing, skills and healthcare.

‘And we’ll give the levers you need to grow your local economy and make sure local people keep the rewards.’

He added that the city must have a mayor in place to be accountable for budgets, which will not initially extend to tax raising power, saying: ‘I will not impose this model on anyone. But nor will I settle for less. London has a mayor. Greater Manchester has agreed to have a mayor as part of our Northern Powerhouse - and this new law will make that happen.’

As previously reported, Greater Manchester is primed to be the first city to take control of health, with local authorities commissioning services, including general practice, alongside CCGs. But London local authorities have been equally vocal in calling for devolution of health responsibility to address what London Assembly health spokesperson Dr Onkar Sahota called London’s ‘unique’ health needs.

The Greater Manchester deal will see all £6bn of NHS England’s current responsibilities passing over to local government and one of the first priorities will be expanding existing GP seven day working schemes.

An NHS England spokesperson said: ‘While we’ve been clear that the arrangements that are eventually finalised in Manchester will be unique to Manchester, we hope that this agreement will be the first of many, and we would welcome talks with any city region or locality consortium that wants to do something similar.’

Manchester LMC honorary secretary Dr Tracey Vell, who was recently invited onto the Greater Manchester’s devolution health committee has told Pulse that the city is looking at a setting up a new model of integrating health and social care across several ‘hubs’ shared by primary and secondary care.

Commenting on today’s announcement, GPC deputy chair Dr Richard Vautrey said it was ‘not really clear what the benefits’ of healthcare devolution to cities were.

He said: ‘I don’t think you necessarily need a big political gesture to achieve local cooperation. What you need is the will of organisations in the area to work closer together.’

He said he also saw ‘a risk of politicising the health and social care system in an area’ if local elected politicians were put in charge.

He said: ‘While that might bring greater accountability, there’s also a risk that you end up with particular individuals, who don’t necessarily have a full understanding of the clinical aspect of healthcare delivery, fighting to preserve a local service for local political rather than good clinical reasons.’

Readers' comments (21)

  • Will they offer this only to areas with surplus or will they wipe the slate clean and give the same power to areas with "distressed economies"?

    Obviously the outcome would be that any problems will have to be sorted locally so if there is a outbreak of an illness locally or tragedy there may not be funds to mange the same.
    Also this may mean that there maybe large deprived areas with no local healthcare as it may not be viable to have practices where consultation rates are much higher than national average or small surgeries!
    Obviously devolution means Agent Hunt will no longer be responsible for the health of the CitYzens of these areas (pun intended)
    Corollary is Cities can consider local taxes if there are deficits in those areas which maybe acceptable for some but not for others. Mansion tax or Super car tax anyone?
    Time will tell.

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  • You would think they would wait and see if it worked before doing another reorganisation.Why dont they pilot it first rather than go at it like a bull in a china shop.

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  • "to grow your local economy" - what language is this?

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  • Will NHSE's budget be cut so that this is at least cost neutral for the NHS?

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  • And another load of backroom staff and offices created. It will created the admin jobs they promised!
    No doctors though.

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  • Bizarre that he would do this with local government, but not reverse the centralisation that is NHSE and properties!

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  • Vinci Ho

    This is the Tories playing with the politics of a federated UK virtually. Devolution of power sounds pleasing to those who want 'independence' but what is the underlying agenda? I suppose it is to do with funding and finances. You have to 'apply' for this power for your city and you have to have a metro mayor for single point accountability. Hence , he or she must 'unite' all local authorities in that 'City'. Then you have your own social and health budget in control. All local councils and CCGs will SHARE the cake, exciting ?Yes, the question remains 'what will be the central government doing instead?'
    Wait for the Queen's speech , ladies and gentlemen .

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  • A marvellous way to disguise what isn't being spent on the Health Service . The word "National " can now be dispensed with.

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  • And here it is. The great con. There is no money for the direction of healthcare travel. No money for the elderly frail who will need increasing care. No money for the promised 24/7 health services promised by Cameron and Co. So what's the solution? Create the impression that this can all be done by local devolved budgets. The only thing being devolved is central responsibility when this all go's pear shaped. So the government can point and say "well it's your fault" in the same way Ccgs and foundation trusts are currently scapegoats for unavoidable deficits. Clever politics when no realistic solution is in sight.

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