Manchester health devolution could be 'recipe for disaster', local government source warns

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Giving Greater Manchester control over the region’s £6bn health budget could be ‘a recipe for disaster’, a senior local government source in the conurbation has warned.

The source told HSJ’s sister title Local Government Chronicle that the proposed deal, which would see radical devolution and integration of health and social care budgets in the conurbation from April 2016, was “a double edged sword”.

They said while it could be the “saviour” of local public services at a time of increased budget pressures, they warned that it could “put back the cause of devolution for decades” if leaders did not make the right investment and priority decisions.

“If we get that wrong it could be a huge tragedy,” they said.

Manchester health devolution plan

The source said they had concerns about how council leaders would be expected to “get their heads around all of the big decisions” on top of running their own councils.

They said: “To then expect leaders of authorities to run a huge combined authority with billions of pounds of resources and life and death services; well, I just think it’s a recipe for disaster.”

A draft memorandum of understanding between NHS England and the conurbation’s local authorities and clinical commissioning groups has outlined a “roadmap” for full devolution of powers and budgets.

The source said there had been a briefing on a potential deal “a couple of months ago” but added negotiations had “obviously moved on rapidly since then”.

They added: “If it works, I think it will be good and with the way local government budgets are going, this could be the salvation of local services. So much of our money is spent on adult care so this could be our saviour in that we can ensure resources are distributed much more effectively with the NHS.”

The source said they believed the directly elected mayor would be the person held to account, although an election is not set to take place until 2017. An interim mayor is set to be appointed in June.

However, the source believed the scrutiny arrangements had “not been properly thought through” as they thought council leaders would be “too busy” to devote enough time to it.