Decisions made under Greater Manchester’s proposed devolved health and social care system could be overturned by the health secretary if they think the decisions are “wrong”, a minister has indicated.

  • Minister indicates government would retain power to block ‘wrong’ decisions
  • Is unclear about how Cities Bill powers may be used to transfer NHS powers
  • Former Labour health minister to propose NHS responsibilities can be transferred to combined authorities

The comments were made during a Lords committee discussion on the Cities and Local Government Devolution Bill on Wednesday.

Jeremy Hunt

Baroness Williams thought a health secretary ‘would have something to say about’ decisions in Greater Manchester

In February, Greater Manchester’s 10 local authorities, along with the conurbation’s clinical commissioning groups and NHS England, agreed a deal with the government to gain control of the region’s health and social budgets from April 2016.

Asked about whether the bill would be used to transfer NHS powers to new authorities, or mayors, in Manchester or elsewhere, local government minister Baroness Williams pointed to early proposals already published in Manchester, and was unclear about the future potential for this.

On Monday, former Labour health minister Lord Warner is due to propose that “any NHS responsibilities” can be transferred to combined authorities when the health secretary believes this is in the “best interests” of residents, and that the deal lasts for “a minimum of five years”.

On Wednesday, the minister was pressed by Lord Warner and Lord Hunt, deputy leader of the opposition in the Lords, on how the bill would affect the NHS.

Lord Warner asked what would happen if Greater Manchester’s partners agreed to controversial proposals, such as taking “a large number of beds out of acute hospitals”.

In response, local government minister Baroness Williams of Trafford, a former leader of Trafford Council, said she expected a health secretary “would have something to say about it” if he thought “all of them collectively were making the wrong decision”.

She added: “I was not saying that the secretary of state would overrule them for overruling’s sake, but if it was fundamentally a wrong decision, I am sure that he would have the power to intervene.”

Baroness Williams said the government “cannot have a situation where there is unfettered ability for people to do things without any checks and balances”.

She said a “bad decision” would be one which had “negative” consequences for patients and service users, and added: “The secretary of state would have to intervene or call into question the decision of the collective bodies that had made it in partnership.”

Lord Woolmer, also a Labour peer, said this was “not devolution” and added: “To say that a local decision is a bad decision because it differs from a view that the secretary of state takes does not seem to me to be in the spirit of devolution.”

Health secretary could overturn devolved decisions