Roundup: Britain's Manchester wins significant devolution power in health care

Britain's flagship city of Manchester, at the epicenter of the government's Northern Powerhouse drive to boost the economy in the north, took one giant leap forward Friday in what could change the way the country is governed.

The city has been handed a 8.6-billion-U.S.-dollar budget to run its own health and social services in an area with a population of 2.8 million. It's been described as the biggest experiment in devolution for generations.

It's also the biggest shake-up in Britain's National Health Service (NHS) since it was set up in 1948 and will be eagerly watched by politicians from all parties as well as professionals and social commentators.

Currently, funding for NHS health services in Britain is determined by the national government, but as from Friday the politicians and health professionals of Manchester are in control of their own destiny.

The budget will be run by a new body which will make decisions on how to target specific health issues, integrating both health and social care services.

The body, called Greater Manchester Strategic Partnership, is made up of nearly 40 organizations, representing hospitals, health bodies, family doctors and representatives of Manchester city council and its nine local authority neighbors.

Like other areas of the industrial north, Manchester suffers from poor health.

The shift of power has been welcomed by former MP Tony Lloyd, who is Manchester's interim mayor.

Lord Peter Smith, political leader of Wigan, one of the 10 boroughs, is chair of the new strategic partnership.

He said: "The big vision is about people and getting people's health in Greater Manchester better. We spend 6 billion pounds (9 billion U.S. dollars) on health and social care but life expectancy in Greater Manchester is not as good as it should be."

The new health rulers in Manchester have already set targets for the future. These include healthier children and fewer low weight babies, cutting the number of premature deaths due to heart disease, respiratory diseases and cancer, and improving health by reducing poverty.

When Chancellor George Osborne last year announced the biggest step in devolution in more than a century, he described it as a "really exciting development."

Osborne added: "This is what the NHS wants to see as part of its own future. It's also about giving people in Manchester greater control over their own affairs in that city."

Simon Stevens, head of NHS England, heralded it as having "the potential to be the greatest act of devolution there has ever been in the history of the NHS."

But the hand-over of control over health is not without its critics. The main fear is what will happen to health care in Manchester if the budget is not sufficient to meet the costs of running the NHS, or if cuts in spending have an impact.

Neil McInroy, chief executive of the think-tank Centre for Local Economic Strategies, described the move in the Guardian newspaper on Friday as "an 'opaque and technocratic plan' that few fully understand, devised behind closed doors with little consultation with the public or frontline staff."

In the same article, Kath Checkland, professor of health policy and primary care at the University of Manchester, who also works as a family doctor, warned the plan would not be welcomed by many family doctors, particularly those in more wealthy areas who may fear their practices will lose out to those in more deprived areas. Endit