Earlier this week, Shadow Home Secretary, Andy Burnham was named as Labour's candidate to become the new Mayor of Greater Manchester. Over the coming weeks he will begin to set out a vision for the region. This will inevitably focus what he would do with the plethora of new powers that have been passed down to the local level as part of the 'Northern Powerhouse' agenda.
By far the most radical and financially substantial element of Manchester's devolution deal is the region's £6bn annual NHS budget described by Simon Stevens as 'the greatest act of devolution... in the history of the NHS'. These new powers - along with Manchester's record as one of the areas in the country with the poorest health - should ensure that the NHS and health is placed at the heart of Burnham's campaign.
Top of his list should be reversing some of the complexity and fragmentation created by the calamitous 2012 Health and Social Care Act. Following the Lansley reforms, we now have more healthcare commissioners than providers across England - with a particularly problematic split be-tween health and social care. This fragmentation makes delivering coordinated and integrated care almost impossible. Burnham and local NHS leaders should therefore start by consolidating the alphabet soup of commissioning bodies in the health system into one 'system leader' able to drive integration within health and between health and social care, as well as shift care into the community.
Another priority should be getting serious about prevention and health inequalities. There is a stag-gering 20-year gap in healthy life expectancy between rich and poor in Greater Manchester and the region has one of lowest life expectancies in the country. Some of this variation can be addressed within the NHS, but much of it cannot. This is because ill health stems from everything from the level of skills and education we have, to the type of jobs we do and the accommodation we live in. Estimates suggest social and environmental factors account for up to 80% of variation in health outcomes.
This means that to really get to grips with health inequalities, health policy needs to be joined up with a range of other public services. The 'northern powerhouse' project provides Manchester with a unique opportunity to do this because health is being 'devolved' alongside a range of other public services. For example, Burnham could use new powers over welfare policy to start getting people with long term health issues back into work by implementing a welfare earn back approach as set out by IPPR. Or he could follow in the footsteps of Sadiq Khan and use his new transport powers to introduce regulation to phase out the use of diesel cars which produce toxic pollutants that cause lung conditions, stokes and cancers. These bold actions would both save lives and reduce costs for NHS.
Taking control of Manchester's health budget will not be easy. Funding will be a big headache - as the region faces a £2billion black hole in the finances over the next five years. Finding the necessary efficiency savings will be no mean feat given that many of the easy savings have already been made over recent years. However, if Andy Burnham gets this right, he could transform the health and wellbeing of the region and point the way towards a new health and care system for the whole country.
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