Council holding health budget for Manchester could mean further reorganisation, GPs warn

By Neil Roberts on the 25 February 2015

Reproduced from GP Online article here

Plans to devolve NHS funding to the local authority in Greater Manchester could lead to more reorganisation and money lost from health budgets, local GPs have warned

Dr John Hughes: warning over reform plans (Photo: JH Lancy)

Dr John Hughes: warning over reform plans (Photo: JH Lancy)

Reports suggest the government will announce that the £6bn health budget for the region could be handed to an elected mayor from April 2016.

The Manchester Evening News said the outline plans would see an integrated health and social care budget controlled by the devolved authority covering 2.7m people.

CCGs would remain in place but work alongside the council’s health and wellbeing board to co-commission services, reports suggest.

Devolved NHS budget

The Greater Manchester Combined Authority, made up of 10 local councils, wants full devolution of £22bn of public spending in the region.

Prominent local GP and health campaigner Dr Kailash Chand said he had mixed feelings about the plans, which are expected to be announced by chancellor George Osborne later this week.

Dr Chand said while integrated health and social care with more local decision-making about services would be welcome, he feared the plans could mean more reorganisation.

‘I don’t want to see the breakup of the NHS, and I don’t want to see more reorganisation. We are sick and tired of so many reorganisations. If this plan brings more reorganisation it will be very demoralising,’ he said.

Dr Chand said the plans should seek to restore the responsibility for providing health services which the secretary of state lost in the 2013 Health and Social Care reforms.

Council clash with NHS

Manchester GP Dr John Hughes said there could be problems caused by the significant differences in priority between local authorities and public health on the one hand, and primary care on the other.

Local social care budgets had been ‘slashed across the board’, he warned, ‘so it is going to be a big black hole that will almost certainly be filled by some robbing from health’.

Dr Hughes said he thought the plans could be designed to shift blame for failure and overspend from government to local councils.

BMA chairman Dr Mark Porter said while patients would benefit from more joined-up health and care, the plans must ensure NHS funding is not used to prop up the ‘woefully underfunded social care budget’.

He said clinicians must retain a central role in decisions over NHS services, and the health secretary must remain responsible for providing ‘a universal and comprehensive health service’.

‘The NHS has just undergone unprecedented upheaval, there must be no more games with our health service and we need to avoid a situation where the NHS moves from being a national to a local political football.’

King’s Fund assistant director Richard Humphries told the BBC Today programme that a full transfer of responsibility for the NHS budget would be reform ‘on a breathtaking scale’ with serious risks.

If…the plan is to take the money away from CCGs and NHS England and to give it to local government, that, on the range of options to achieve integration, is on the nuclear end of the spectrum,’ he warned.