It is the right time to seriously look at whether new models of working, such as the devolved approach in Greater Manchester, can provide the solution, or at least part of the solution, to the challenges the NHS is facing. By Andy Burnham
Twenty years ago, Gordon Brown stood up in the House of Commons and announced the biggest funding increase the NHS had ever seen. After decades of underfunding, spending would rise six per cent a year to match European Union levels. This investment, coupled with a programme of reform and modernisation, meant that by the time Labour left office in 2010, waiting lists were at a record low and public satisfaction at a record high.
As we begin a new decade, the NHS is in need of a new remedy. An injection of cash, whilst welcome, is unlikely to provide a sufficient answer to the questions the 2020s will be asking of the NHS.
The challenges of an ageing and growing population, and the opportunities that come with new technologies and advances in treatment, require a different approach.
These ambitions we know are shared in integrated care systems up and down the country. But the real test is whether, without devolution, they can be realised. That is why we believe it is time now to seriously look at whether new ways of working such as health devolution provide some of the answers to reducing the demand for additional services. Or to put it another, more positive, way – can a devolved approach focussed on improving the public’s health, as well as integrating local services, improve the quality of people’s lives, reduce demand and ensure a financially sustainable and person-centred health and social care system?
That is what we are trying to do in Greater Manchester. When we took control of health and care spending and decisions in 2016, we promised to create a system of population health, where health is at the centre of all public policy-making. We said we would go beyond the ambitions in the Five Year Forward View by connecting all the things which create good health – from education, to housing, to work.
Having a good education, a safe and secure place to live, and a decent job – are core determinants of good health. In Greater Manchester, we recognise that connection and have developed a new model for public service delivery based on person, place and prevention.
And we can report good progress.
- We have invested in and improved access to Children’s Mental Health services, and we were the first place in the country to routinely publish waiting times data for children and young people’s mental health services.
- We are tackling physical inactivity three times faster than the national average.
- We have helped 6,000 people, primarily out of work due to poor health, back to work.
- We have recorded a 37 per cent drop in the number of people sleeping rough on our streets, thanks our ground-breaking A Bed Every Night scheme – funded in part by the Greater Manchester NHS.
- Our care homes continue to see an increase in good and outstanding ratings – from 54 per cent in April 2016 to 81 per cent currently. For home care, there has been a similar increase from 62 per cent to 90 per cent.
And yet at the same time Greater Manchester, like the rest of the UK, has struggled with some key performance targets.
So it is the right time to seriously look at whether new models of working, such as the devolved approach in Greater Manchester, can provide the solution, or at least part of the solution, to the challenges the NHS is facing.
And at a time when the new government is making positive noises about devolution, there has arguably never been a better time to put forward a case for more local responsibility.
That is why the Health Devolution Commission begins work today.
It will look in detail at what a devolved approach to health can deliver. The focus will not just be Greater Manchester but every area – including Scotland and Wales – which is taking a different approach.
The aim will be to develop recommendations that could not only lead to improved health and care outcomes but a new blueprint for the NHS in the 21st century.
The Health Devolution Commission, of which Andy Burnham is co-chair with Norman Lamb, has been launched today with a call for evidence. For more information visit www.healthdevolution.org.uk