We are in uncertain times for the future of our NHS.
Greater Manchester has become the first English region to be handed full control of its £6bn health budget. Devo Manc holds out the promise of meaningful and deep integration within the health service, and between health and social care.
This integration has great potential to offer real benefits to patients. In particular, it could help to deliver genuinely patient-centred and coordinated care. The economic disparity between London and Manchester had created a health gap that could only be redressed by bringing the NHS under local control.
Of course the devolution of powers to Greater Manchester is not without risk. The first challenge is to ensure that people in general, and the BMA membership in particular, actually understand what it is.
While people want to have their voices heard, I am concerned that up until now our communities and the BMA have not been offered sufficient involvement in the devolution process. Some don’t know what it is, others see it as just another layer of bureaucracy – another politician and less power for the people. These new deals have been done with no public awareness, no public consultation, no democratic engagement, no scrutiny and no impact assessment.
The NHS in Greater Manchester is under intense pressure with more than 200,000 patients on the waiting list and hospital deficits hitting record highs. As hospital figures reveal that nearly three-quarters of NHS trusts have seen patients waiting more than 100 days for discharge in the past three years, it is clear that now, more than ever, chronic underfunding is preventing NHS staff from providing patients with the level of care they deserve.
Devolution presents a real opportunity for Greater Manchester to deal with some of the problems facing the NHS, and also some of the more longer-term public health challenges, especially around health inequalities. But, without the right financial support, it is going to be very difficult.
Social care is collapsing – in Greater Manchester for 2016/17 we are facing an £81m black hole in social care funding, rising to almost a quarter of a billion pounds by 2020 – yet this Government feels grammar schools are a greater funding priority than care for older people.
One of the real challenges of this devolution is to ensure that all services remain stable and are invested in and that we don’t have a situation of robbing Peter to pay Paul.
The challenge and the opportunity are significant. If the project doesn’t use the £6bn devolved budget in a radically different way around our health and social care system, it will be facing a major deficit of £2bn by 2021 – a recipe for another NHS reorganisation failure.
The NHS has already been seriously damaged by the policies of all three major political parties in the last decade. If this continues, England will have a completely different healthcare system in five years’ time – ‘NHS’ in name alone. Things will be much worse in terms of access, equity, health outcomes and cost.
This general election, more than Brexit, should focus on redefining the future of the NHS. These few weeks are an unparalleled opportunity to reset the future of the NHS.
Kailash Chand is BMA north-west regional council chair
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Firstly, I really don't think that this is a true picture if you state BMA not offered sufficient involvement as a member of BMA was seconded into programme initially , you have been a member yourself of GP advisory group, the BMA have been to visit and were received by senior management. I have spoken at BMA NW events. The BMA have not sought any other contact.
Secondly no scrutiny or public consultation is simply not true.
Whilst devolution is not perfect in every way I do think that we have to correct obvious errors of reporting.
Overall, whilst there will be much sympathy for the direction of travel in Greater Manchester, there will be concern about the way in which decisions have been taken and the pace and scale of change. The unfolding policy and politics will be with us for many years and there will be much to learn.
y is everyone pretending the tories want to destroy the NHS so "it has to be privatised!"the constant changes r just a way of wasting money that EVERYONE knows is much needed elsewhere in NHS
There's little doubt in my mind that those who think there has been meaningful clinical or public involvement in decision making are terribly deluded. Attending meetings or giving talks are good but nothing happens inbeteeen.
There are high stakes here because of the massive political reorganisation of the NHS in Greater Manchester. Hopefully the new Regine will start at a point of reviewing Engagement, and bring fresh thinking to the GM devo experiment. There are things that could be done better.
I am immensely concerned to read that adequate consultation took place. Please speak to any average health care worker or GP , you will be shocked to know the unawareness. Do even people who are selling Devolution in Manchester know what will happen to NHS. Lumping all practices in a supermarket of 30,000 or 50,000. The end of Continuity of care. Destroy the smaller outlets of care and create a structure with no identity, lesser accountability,
Look at what happened when we joined EU in 1977, gradually you lost your Sovernity. When you realised , you'r referendum ended in Brexit.
Experiment to create integration of social and health without defining the boundaries and rules and responsibilities will surely end up in a expensive experiment . Good bye NHS.