The last time I was on TV was
Wednesday the 25th February 2015. In fact I spent much of that day
giving TV and radio interviews which was a surprise to me. It was an even bigger
one for my friends and family who turned on their TV’s only to see me on the
news! That weekend I wrote in my blog that it had been such a perfect day. The reason I appeared on radio and TV was to
comment on the ‘leaked’ news, which had been sent by over eager Manchester Councillors to BBC Radio
Manchester. This was the news the signing of a Memorandum of Understanding,
described as a ground-breaking deal, for the Devolution of Greater Manchester, was
due to happen later on in the week.
A researcher from BBC Radio Manchester
contacted me very early on that Wednesday morning and said could I come and give a live
interview for their 07.00 news broadcast. I said yes and then spent a fruitless
15 minutes on-line trying to find something, anything about what has become to
be known as ‘Devo Manc’. Now I am pretty good at digging out information, but
in that 15 minutes I found very little. The researcher had been vague in his description
of what he wanted me to speak about, but he did say it was about bringing
together health and social care services across Greater Manchester.
I have long been a promotor
of integrated health and social care so felt I could at least offer a
view as to what the benefits might be if that is what ‘Devo Manc’ turned out to
be all about. I knew that in 2011 the first combined authority in England was formed (made up of all
10 Local Authorities across greater Manchester). I also
knew that the 12 Clinical Commissioning Groups (CCG) had, in 2013, formed into
a Greater Manchester CCG Association. And of course I knew that the then Chancellor
(George Osbourne) was personally backing the creation of the so called NorthernPowerhouse. All in all I felt relatively confident.
The reality was something
different. Many of the interview questions I was asked on that day were about the
political implications of the 10 Local Authorities gaining control of the £6 billion
health and social care budget – the question I was most asked was whether I thought
hospitals would close as Local Authorities used the money to spend on other activities. Some 2 years on, I still get asked that question as organisations move ever
closer to achieving full integration of the commissioning and provision of
health and social care. However difficult the task has been, the 37
NHS and Local Authority organisations across Greater Manchester, who together employ
some 100,000 people, are now beginning to work together more effectively.
I think there is a way to go yet,
but the emphasis is shifting (very slowly) towards both promoting health, and
in providing health and care services differently, and often doing so closer to
people’s homes and communities. In partnership with others, there appears to be
more innovative thinking over what emergent technologies can offer in terms of
cost reduction and the maintenance of quality services. In this context I can
also see a glimmer of an approach that is definitely more focused upon people
and places and not organisations.
I hope the same will be true for
the ‘Devo London’ deal (described as both ground-breaking and a landmark deal).
The announcement was made on the 15th Nov, but I only saw it early
last week. I’m probably more Northern centric in my reading of news. Over a 100 organisations have
been working together in developing the concept prior to the launch. Work on pilot schemes to
illustrate and provide evidence of what might be achieved in working closer
together has been ongoing for some 18 months. The early outcomes are impressive and
encouraging. What makes this devolution different to the Manchester one is the availability
of funding through the release of NHS owned land and property to fast track the
scaling up of these pilots.
Not unsurprisingly, the NHS
is a major landowner in the capital. The estimated value of this land and
buildings is said to be more than £11 billion. Many of these assets are not used
effectively, and 13% of community based buildings need rebuilding and 51%
need refurbishing. The plan is to release the money raised through the sale of surplus assets to both create ‘fit for purpose’ health and social care resources in the community. and provide opportunities of for more housing developments. What it might mean
for those living and working in London can be seen here. It looks to be a very ambitious plan, but I believe it is one that can be achieved.
Perhaps Parliament itself could
learn some lessons from the Manchester and London devolution initiatives in acknowledging the benefits of working together. Last Saturday (18th Nov) saw some 90
MPs sign a letter asking the Prime Minster to set up a ‘cross-party’ convention
on the future of the NHS and social care in England. What they wanted was for
the current Chancellor to address the short term pressures in the health system
in his budget (something he subsequently did) and for the Prime Minister to
establish a cross-party process to develop longer term solutions. Now it can't be just me who thinks creating such a group and a way of non-partisan working would be a great idea – after all its not really such a revolutionary thought in a world that is enthusiastically embracing devolutionary
action.
No comments:
Post a Comment