Chancellor George Osborne’s announcement that the entire £6bn health and care budget for Greater Manchester is to be handed over to local control has repercussions for the whole NHS. It opens up a new front in national and local moves to overhaul the funding system, regulate systems instead of organisations, make services locally accountable and to breach the wall between social care and health.
While many people in the NHS dislike the idea of direct local government control, local politics has always been a powerful influence on reconfiguration debates. The NHS compares poorly with councils when it comes to making tough decisions about services, and many politicians and council managers are angered by the way NHS trusts run up uncontrolled deficits – something that is not tolerated in town halls. Perhaps local government will have the courage to take decisions that seem so difficult for the health service.
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