£6bn a year of health spending is to be handed to Greater Manchester. It is the first region of England to get full control of a merged health and social care budget from April next year. George Osborne describes it as a really exciting development, making Manchester an economic power house. The King’s Fund calls it reform on a breathtaking scale.
Dr Louise Irvine was interviewed on the BBC News Channel this evening about Manchester being given control over health spending.
BBC: I’m joined by Dr Louise Irvine of the National Health Action Party. She’s a prospective parliamentary candidate by the way for South West Surrey against the Health Secretary, Jeremy Hunt and also a London GP. She is very well qualified to talk about this. This is being sold to us as being a long time coming. It’s needed. Increasingly the NHS is taking care of social care as well with conditions such as dementia on the up.
Dr Louise Irvine: Well, it is being sold to us in the same way as the Health & Social Care Act was sold with sweet words and it sounds very plausible and quite harmless. But, the context is everything. This is another major re-organisation. Although it is happening in Greater Manchester not across the country, it carries all those risks. I think this is a very risky experiment with health and social care for the people of Greater Manchester.
BBC: Why is it risky? We’ve seen it happen in Northern Ireland. It’s coming to Scotland. We’re now seeing it in Greater Manchester. This sounds like they are doing it a step at a time to see how it goes.
Dr Louise Irvine: Well, it’s risky because the context is of very severe cuts to social care, to public services There’ve been 20% real cuts in the last five years. And, also cuts to healthcare because funding hasn’t matched demand and need. So, if you’ve got two very restrictive budgets coming together, you’re going to get a very desperate situation. They’re going to be fire fighting and trying to find ways of making ends meet in that way. What worries me is that because social care is means tested, and charged for, a blurring of the distinction between health and social care could lead to an erosion of the fundamental principle of healthcare being free at the point of need.
BBC: Do you not accept that nobody knows what Greater Manchester needs and the problems it is dealing with in its health service and its social care service than Greater Manchester?
Dr Louise Irvine: Greater Manchester didn’t vote to have an elected Mayor. There was a referendum and they said they didn’t want that. I don’t think the people of Greater Manchester have been asked about this. I think if they had been, they would be very concerned about it. You mentioned Alzheimer’s as an example. The problem with Alzheimer’s is we are finding more and more of the health care for people with Alzheimer’s is being re-defined as social care. And they are being charged for this and it is causing real distress to thousands and thousands of families. If we were to see that happening to more and more of our healthcare we could actually have the erosion of that fundamental principle of free healthcare. And also, it is a way of the government divesting themselves of responsibility and blame for the cuts that they know are coming. Instead of blaming and holding to account our government, people will just be blaming the local authority.
BBC: But if you also asked a lot of people in Greater Manchester this evening or indeed anywhere around the country, by their own experience, a lot of people would tell you that the National Health Service isn’t working either.
Dr Louise Irvine: The National Health Service is working very well. It is one of the most cost effective and efficient services in the world. It could be better. There is always room to improve. I don’t think this is going to be an improvement for the people of Manchester. In fact, they could find themselves facing the mother of all postcode lotteries because that body will be deciding what is and is not provided under that budget.
BBC: You say it could be better, I mean that’s putting it politely. What we saw over the last few months was a number of hospitals across the country declaring a state of emergency.
Dr Louise Irvine. Exactly. The reason for that state of emergency was not just cuts to hospital funding and staffing but the cuts to social care funding which led to elderly people not being able to be discharged home into the community. So, a limited budget for health combined with a decimated social care budget is not a recipe for a healthy future. We need to put responsibility back to the government to fund our NHS properly and to fund our social services properly. This solution will just lead to this body of people trying desperately to make ends meet.
BBC: Dr Louise Irvine, thank you for coming in.