It happens more regularly than the startled headlines suggest. An earthquake somewhere in England rattles the crockery and wakes up citizens in the middle of the night. Later, many miles away, we read our newspapers, shake our heads in that ‘well I never’ sort of way, and get on with our day.
But something truly seismic would appear to be happening in Manchester. The tectonic plates of our health service are on the move again. Yesterday, we learnt that responsibility for the £6bn NHS health and social care budget is going to be devolved to the civic leadership of Greater Manchester. This is no BACS transfer that’s for sure!
Truth be told those plates have been grinding along for years. I have a faint recollection of being on a fascinating study visit to Manchester about ten years ago as part of an otherwise underwhelming leadership course. Civic leader after leader trouped in to tell the largely skeptical audience of a long-term vision for dealing with their own affairs at last. Free from the constraints of Whitehall micromanagement. Also, how it was re-discovering the innovative edge that made it the centre of our industrial revolution in the 19th century. And more recently there has been a public consultation on its Healthier Together intitiative.
Well, now those ambitions and collective vision would seem to be one huge step nearer.
What it might mean for health and social care research is an interesting question? Understandably the issue may not be top of everyone’s minds this morning. But it’s an important one to ask. If these changes are to lead to real improvements in health and wellbeing for the citizens of Greater Manchester then research must be at the heart of the enterprise.
I am a fairly regular visitor to Manchester; as a speaker and as a Board member of the NIHR Greater Manchester Primary Care Patient Safely Translational Centre
. I do not know the place well although I lived there as a boy in the late seventies. But I have formed some impressions of this wonderful City and the research opportunities and challenges that it faces in meeting the needs of a diverse population with complex health needs.
The Government’s strong and very public backing for Manchester as a ‘Northern Powerhouse’ in science and research – most recently expressed in the Autumn Statement with the Chancellor of the Exchequer, George Osborne’s, announcement of a £235 advanced material science institute – will be important. Celebrated research initiatives such as the Salford Lung Study
demonstrate its innovative edge in clinical research. It’s capability and capacity to lead research is encapsulated in its success in winning grants and awards like the aforementioned Primary Care Research Centre – one of only two of its type in the country. The leadership across key organisations including the Greater Manchester Academic Health Science Network
(AHSN), and the recently launched Clinical Research Network (North West Coast)
is strong. And it has one of the best run and most influential regional citizen forums in research in the shape of the North West People in Research Forum.
And yet, and yet, my experience is also that getting engagement in research across social care and primary care in Greater Manchester is difficult to say the least and the resulting picture patchy. This fact alone takes on greater significance when you realise that health and social care, lock, stock and barrel, will be run out of the Town Hall. Will the new Board get the importance of research to the success of their new venture and see it as an opportunity to build on their innovative heritage? Or will they pass it down the corridoor to some forgotten office open between the hours of 9 and 12, and 2 and 4.30, where the door has frosted glass and the receptionist even frostier?
One other passing thought about what the events in Manchester might mean for the rest of us in England. Ever since the Health and Social Care Act 2012 was passed – if not before! – there have been active campaigns beseeching us all to rise up against the privatisation of the NHS. In looking so hard at it this way, perhaps we have missed the fact that what we have really been entering is an era of creeping provincialism in how our health service is run. Whether you think this is good or bad will depend on your political standpoint I guess. But we should take note of the experience of countries such as Canada in trying to ensure consistency, continuity and viable networks across such strong geo-political borders.
Whether the seismic activity in Greater Manchester results in an idyllic spa-like island or sink hole through which £6bn will disappear is going to be the health story of the year ahead.
Have a good day.