I know nothing about writing blogs – but I know what I don’t want for the NHS in Manchester;
1.  I do not want the NHS to be “devolved” to a bunch of Council Leaders with no clinical knowledge whatsoever of healthcare, treating patients and saving lives.
2.  I do not want accountability and responsibility for the “National” Health Service to be “devolved” from the Health Secretary to a cabal of “unelected”  Quangos like Monitor and NHS England (and its 9,”Commissioning Support Units”?) stuffed full of their “free-market” acolytes, “privateers”, “McKinseyites,” Accountants, and Management Consultants – hell bent on using the NHS as a “cash-cow” to line their own pockets!
(Note: A recent FOI request by “Private Eye” to NHS England about its spending on “Management Consultants” whilst slashing health budgets was rejected on the grounds of “commercial confidentiality”!  However it must show expenditure over £25,000 which revealed that in 2013/14 it spent:
*  £2.8 million on McKinsey (and its ‘sham’ “Healthier Together”)consultation.
*  £13 million to the Big 4 (“bent”) accountants PWC, KPMG, EY and Deloitte. (Deloitte pocketing – £7 million;  KPMG – £ 3.48 million and PWC £1.84 million).
I do not want the NHS budget squandered on even more “unelected quangos” of pointless bureaucrats like the proposed “new strategic body”:
The Greater Manchester Strategic Health and Social Care Partnership Board – supported by:
A joint commissioning board drawn from the 10 local authorities, clinical commissioning groups (CCGs) and NHS England.
Question: Where are the “Hospital”Representatives on the above commissioning boards? The Specialists, Consultants, Surgeons, Specialists, Oncologists, Cardiologists, Neurologists, Urologists,  Radiologists, Radiotherapists, Pathologists, Psychologists, Geneticists, Haematologists, Paediatricians, Clinicians, Doctors, Nurses, Midwives, Allied Health Professionals, Paramedics et al – THE FRONT LINE OF THE NHS WHO ARE TREATING AND SAVING MILLIONS OF LIVES DAY IN DAY OUT…???
I do not want the NHS budget to be squandered by a “Cabal” of uninformed, uneducated “non-medical” Councillors and their crony “Business Consultants” on local authority vanity projects” commissioned by Bernstein, Leese and their “overpaid”, “under-worked”, money-grabbing cohorts!
I do not want an “unelected” Mayor to be foisted on Manchester – against the will of its residents who previously REJECTED AN ELECTED MAYOR IN 2012!!!  How dare George Osborne and Howard Bernstein override the will of Mancunians by “imposing” a Mayor we didn’t vote for and don’t want!  MANCHESTER MUST BE GIVEN A REFERENDUM TO VOTE ON THIS ISSUE!
I do not want the National Health Service to be turned into a Regional Health “Business Opportunity” for grubby Council Leaders, Quangos, Privateers and Accountants!

What I DO WANT:

Is a National Health Service free at the point of use for everybody regardless of ability to pay – with responsibility for its administration, services and funding in the hands of the elected Secretary of State for Health and the Department of Health.
A Health Service, run by Clinicians, Specialists, Surgeons, Nurses and Doctors “WHO CARE FOR PATIENTS, WHO CREATE LIVES, REPAIR LIVES, SAVE LIVES” – AND WHO MAKE THE NHS THE GREATEST INSTITUTION  THIS COUNTRY HAS!

 

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8 Comments

  1. george Nieman says:

    The running of the NHS should be by those who work within this great system, or at least Medical-Nursing and others should be included in the decision making

  2. Monitor is an arm’s length body of the Department of Health but is not accountable to the electorate is it?

  3. Martin Rathfelder says:

    The old model where the Secretary of State is the only democratically accountable person in the whole of the NHS will not do any more.

  4. This document speaks volumes as to what is the real agenda:

    https://keepournhspublicnorfolk.wordpress.com/nhs-5-year-forward-view-the-end-of-the-nhs/

    Our country is being asset stripped by the corrupt and immoral, good article.

  5. How we respond to the proposed devolution of health services to Greater Manchester depends on whether we view it as an initiative to improve health and social care provision or as something else. It is difficult to say with any certainty what the motivations behind the proposal might be but there are a number of factors that should make us cautious about claiming it is the latter.

    First, we should ask why such an announcement has been made in the run-up to the General Election and who might benefit from it in this context. George Osborne has said that it is all part of his drive to deliver a ‘northern power house’ and that the proposal has indeed been actively advanced by the local authorities across Greater Manchester. Perhaps they have indeed made a compelling and overwhelming case for greater devolution. Perhaps this signals not only a better way to deliver health care but also a different way in which public policy is to be constructed in the future, from the bottom up? It seems unlikely, however, that a Conservative government is going to be any more receptive to bottom-up initiatives than it has previously.

    Coming [just] ahead of Labour’s own future plans for the NHS it does the Conservatives no harm that currently the majority of parliamentary seats in Greater Manchester are held by Labour. It is no doubt of further benefit that the parliamentary constituency of the Shadow Health Minister, Andy Burnham, is also in Greater Manchester. This enables George Osborne is able to say that these Labour councils including Burnham’s constituents fully support this Conservative proposal. Or to put the message another way ‘not even the councils in a Labour stronghold support Labour on health, but prefer our way’. Andy Burnham’s somewhat cautious response immediately after the announcement indicated the success of the strategy to date, not only putting him on the back foot regarding devolution but clearly aware that in his objections he was speaking against his own party supporters and the powerful Labour leadership in GM.

    Osborne himself along with other Tory MPs with seats in the surrounding area of GM can also benefit by demonstrating a commitment to the north-west region. Perhaps this explains why the announcement came from the Treasury rather than the Minister for Health? Indeed, how do we explain the silence from the DoH since the announcement? If this is a new model for health and social care delivery one might have expected to see the ministers and officials from all relevant departments to have had something to say about it.

    Osborne declared that the proposal is also all about his party’s commitment to reducing the central state and increasing local powers. However, there is no evidence of this happening in any other policy domain. The Coalition’s response to the Scottish independence referendum hardly suggests a strong commitment to devolution. It is odd too that the commitment to devolution does not extent to offering other local authorities the chance to take over local health care budgets.

    Second, even if we do not think that this is simply a pre-election ploy calculated to derail Labour’s health plan’s, undermine the Shadow Health Minister’s own personal standing and promote the north-western credentials of Chancellor Osborne there are still some other concerns before we can think of it as a genuine proposal for a better health and social care service.

    It would not be the first time that a new policy initiative has been trialled in a select number of places before being rolled out across the country, if successful and after a thorough evaluation. However, no such programme or time-scale has been mentioned in this case and there is no indication that other local authorities should begin to gear themselves up for health care devolution.

    Indeed there is no indication that the GM devolution is to be subject to any evaluation at all and no evidence has been presented as to the soundness of the policy proposal in the first instance. It is clearly not the outcome of ‘evidence-based’ policy. George Osborne states he has confidence in the capacity of elected members in GM to manage the devolution of health care but apparently not anywhere else. Yet we are not given any clues as to why GM councillors are so better equipped. Similarly, no case has been made as to why it is better to locate the health budget under local authority control rather than either locate the social care budget under health or alternatively find some hybrid governance model. Again, we should ask why, if it is committed to an improved health and social care service, the government proposes to begin the process with a new, and geographically partial, form of governance rather than focus on say the purposes of the NHS and its underpinning values?

    It would not be the first time that a new policy initiative has been rushed through without proper or sufficient thought but has been retrieved later in the implementation process. Perhaps this is simply another case in point? Here we need to remember that this proposal actually changes nothing in relation to how health and social care is to be delivered. There is nothing to indicate that GM has a different vision about health and social care. Indeed the recently released Memorandum of Agreement clearly states that GM must work within the guidelines and requirements laid down by the NHS. In other words, for example, this devolution will not avoid the continuation of commissioning health services and thus the further privatisation of the NHS.

    Let us assume, for a second, that the proposal proves to be everything its advocates claim it will be and that GM, under a new energetic and entrepreneurial mayor, does indeed produce a more dynamic, efficient and effective health and social care service for its citizens? That might be good for the citizens of GM but will the model be transferable elsewhere and to everywhere? Or will we simply see pale imitations of GM across the country with some areas working well, some doing okay and some a disaster. You might think this is what we have today but surely it is not something we should aim to replicate in the future? Not only will this create a patchwork service but one that is based not on diverse and varied health needs across different parts of the country but rather on the capacity of locally elected councillors to run a cradle to the grave local health and social care service suitable for the 21st century that includes not only health promotion but also the most sophisticated acute health care provision. Moreover, with the private sector playing what is likely to be a significantly increased role then the very idea of a ‘national’ service is severely undermined. And what if the experiment fails? Well all that will do is once again demonstrate both the incompetence of local [Labour] councils and confirm the importance of the private sector taking over health and social care while allowing the Conservatives to say, ‘we gave you the opportunity to prove us wrong and you failed. We have no other choice, but to privatise.’

  6. “The old model where the Secretary of State is the only democratically accountable person in the whole of the NHS will not do any more”

    Why not? The model says that the NHS is independent (that is, clinicians and the support from managers, determine how the service is run) and politicians are not involved in the day to day running. That the SoS has the over all accountability supports the idea that the service should be clinical-led, not politician-led.

    How will councillors be “accountable” for DevoManc? Can you seriously see councillors not being re-elected because of a screw up in the health service? Can you seriously see a councillor resigning because health inequalities have increased, or life expectancy has decreased? I don’t.

    If you really wanted democratic accountability you would support directly elected roles, for example, the Police and Crime Commissioner is directly elected – and held accountable – for the police, why not an equivalent for the vastly larger devolved NHS budget? And dare I mention that the Coalition Agreement said that the Coalition (which presumably includes Osborne) would introduce elected boards to PCTs. Why not have that model, and make Greater Manchester’s Joint Health and Wellbeing Board contain directly elected members? Why are the politicians in Manchester afraid of democracy?

    Councillors already have a broad remit, DevoManc broadens it much too far.

  7. Martin Rathfelder says:

    The fact that Osborne is behind it does not recommend it to me, but it’s not clear what he gains from the proposals. He certainly won’t win any seats in Manchester because the marginal seats are in the outer boroughs where voters will be suspicious of being dominated by Manchester. Do I see councillors losing their seats over health issues? I certainly do. Health issues are very powerful. But not those Richard mentions. What counts is closing hospitals. Councillors may think they can raid the NHS budget to prop up other services, but the reverse is more likely.

    1. As socialists one should always assume that things are rarely what they seem. There is probably little immediate gain if any for Osborne personally and equally it is unlikely to term GM voters to turn Tory in greater numbers than previously. This is a tactic for the benefit of the Tory Party and one that Osborne is best placed to pull off partly because of his constituency links with the region. In the short term is very cleverly derails Labour’s health policy [its strongest vote winning policy area], in part by confusing it with devolution [just look at the conversation on ‘ManCon’ where very few are talking about the potential impact for the NHS and most talking about localism], and on Burnham’s own doorstep just for good measure. In the longer run it provides the opportunity, should it fail, to further undermine labour controlled local authorities and speed up or extend privatisation in the NHS. Whatever the outcome, it also has Labour in GM caught up directly with the privatisation of the NHS again undermining the party’s position nationally. What it clearly is not is either a policy to advance devolution across England nor is it a policy to ensure the better delivery of health and social care. There simply is no evidence to support either of these positions.

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