There must be an election coming. After five years of making savage cuts to council budgets, and five years of fragmenting and privatising, George Osborne has waited until five weeks before this Parliament ends to endorse Labour’s plan to integrate the NHS and social care.
We can all speculate about the reasons for his Road to Damascus-style conversion and have every right to be suspicious of the real reasons behind the rushed timetable unveiled this week. But the great thing about our political leaders in Greater Manchester is that they are always more interested in getting the best deal for our people than playing party politics. That’s what sets them apart from others and means they get so much done.
Unlike Mr Osborne, they are not sudden converts to NHS and care integration. So they have my full support in pushing for the best deal from whichever Government is in power.
Osborne’s plans could allow Greater Manchester to get on with the job of delivering Labour’s policy of Whole Person Care. But, before any final deal is signed, there are major questions that the Chancellor needs to answer.
Firstly, how much money is actually on offer and will it be enough?
On Tuesday, this paper revealed huge deficits in Greater Manchester’s hospitals after years of council budget cuts too. And we know that pressure is growing as our population gets older. We all need to be vigilant against the danger that this Government is only offering to devolve a funding crisis and then blame us when things get worse.
This raises my second question: what will happen if the funding is insufficient? Will our hospitals be left to sink or swim or will we continue to get backing from the rest of the NHS?
These questions are highly relevant. Last September in Manchester, Ed Miliband committed to the extra £2.5 billion year that the NHS needs. This is a promise Mr Osborne has failed to match.
My third worry is whether these proposals would mean yet another reorganisation for Greater Manchester’s NHS – only two years after the last one. It would be the very last thing that we need, wasting time and money.
Fourthly, will Greater Manchester still be stuck with the Tory competition agenda after devolution – or does this give us an escape route? This is important as mandatory tendering is the biggest obstacle to integration and we can only succeed if it is removed.
If George Osborne can provide proper answers in all of these areas, then I believe his package could help us deliver Labour’s health and care policy. But this is not the deal that I would be offering to Greater Manchester if I am Health Secretary in ten weeks’ time. I believe I can offer a much better one.
Firstly, Labour will be devolving more money to Greater Manchester’s NHS and councils – raised by our new Mansions Tax – allowing it to build an NHS that starts in people’s homes, looks after them there and gets the rid of the culture of 15-minute care visits. There will be money for the extra nurses, GPs, homecare workers and midwives that we need.
Secondly, rather than create new bureaucracies, I will move quickly to devolve more power to our councils and councillors. Integration needs to be led at a local level – as we are already seeing in Salford, Stockport and Wigan.
Thirdly, I will waste no time in repealing George Osborne’s Health & Social Care Act which has foisted a toxic culture of competition on the NHS. This has led to the privatisation of part of our ambulance service in Greater Manchester – without a single community or council be asked their view or giving their approval.
Under my deal, the people of Greater Manchester will have full power to protect the public NHS and prevent future privatisation.
So the good news is, at the end of a fast-moving week, we can be confident that devolution and integration are coming and that Greater Manchester could have the chance to deliver Labour’s NHS policy whichever government is in power after May.
After all the damage that Mr Osborne and his Tory and Lib Dem allies have inflicted on our NHS in Greater Manchester, this seems like the least he should be doing for us.
First published in the Manchester Evening News