On 1 April this year, the deal for the devolution of all health and social care funding to Greater Manchester was signed. This was the culmination of more than a year of hard work, and is truly groundbreaking – local control and influence over £6bn of health and social care funding. Our strategic plan has been published, based on the locality plans produced by each local authority district – a plan built on local need and local knowledge. Devolution works on many levels. Health devolution has transformed possibilities for health and social care. Not just integration – a long-term ask from local government – but it will enable a properly integrated system across all parts of the health service and social care. It will bring better outcomes, reduce cost and simplify the system. Everyone has a tale about how wonderful the NHS is – and usually a tale about how it could be better if we genuinely integrated the different parts
There are four main areas for change. First, start well, live well, age well – prevent more ill health. Second, local community services working better together. Third, hospitals working more closely together. And fourth, shared buildings, roles, ideas and ways of working.
This is whole-system change – genuine shared control over a £6bn budget. We still have 37 different organisations sitting round the table to plan this, but it is major progress.
There is also something it is not. It is not privatisation of or the break-up of the National Health Service. The national targets still apply, and NHS England sits round the table with us. This is about how we can spend the money that we have between us more effectively and produce better outcomes
If we do not change anything we do, the amount of money we will need by 2020 to deliver the same services will be nearer £8bn. We all know that, despite their protestations the Tories are not going to spend more on the NHS. So the only way to protect it is to look at how we do things differently. A great example is the pilot scheme we are running in part of Manchester with older people who call an ambulance because of a trip or fall in their own home. Usually, they are taken to hospital, admitted and stay for an average of 10 days. With the pilot, they are assessed by a team who go out with the ambulance, and where possible support is provided for them to be treated and stay at home with extra support. With the right help, most of them can. It saves money, but, much more importantly, people do better and are happier if we can keep them at home. Their care package does not have to start again from scratch after a hospital stay, and they are in familiar surroundings with their existing support still in place.
So I believe we are preserving the real values of the NHS. Care, free at the point of use, delivered locally, and with the users needs listened to and taken into account. What could be more Labour than that?
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Sue Murphy is deputy leader of Manchester city council. She tweets @smurph99
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Free at the point of use? It doesn’t feel very free when I have to hand over a prescription charge (which rises every year, without fail, but only in England) at the chemist’s counter. If I lived in Scotland, I wouldn’t have to pay a penny. Still, I guess it’s my own stupid fault for living in England. It might help if the government banned health/welfare tourism and shed a few layers of the NHS’s flabby bureaucracy. That might improve things at the sharp end for those who pay for the whole shebang.
What, asks Sue Murphy, could be more Labour than care, free at the point of use, delivered locally, and with the users needs listened to and taken into account?
Well, leaving aside the role of George Osborne in driving Devo-Manc, it would be even more Labour if “users” became “citizens”: active, engaged and involved people who are both benefitting from care and directly improving the health of others through community action on health.
The notion of “users” – passive consumers of care – is technocratic and elitist.
It is the basis of the all-too-common view that blames the victim for their avoidable disease.
It has failed to prevent the crisis in our nation’s health reflected in the obesity epidemic – leading to chronic diseases like diabetes.
People need to be active in helping the health of others if they are to help themselves. United we stand for better health – divided we fall ill.
That’s more Labour. And less – much less – Tory.
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