Editorial: Beware of the Manchester health and social care integration experiment

At the time of writing, the general election is 59 days away. How else to explain the announcement at the end of last month that £6bn NHS funding would be handed to a new devolved local authority body in Manchester?

It's something of a political coup for a coalition government to pull off such an agreement in predominantly Labour territory and so close to an election regarded as being too tight to call.

What is even more impressive is that this was apparently achieved within the current NHS regulations, without the need for massive reorganisation. Although the suspicion persists that it could, once again, herald massive potential NHS change at a time when there appears to be little appetite for it.

It certainly appeared to wrongfoot the Labour party, which seems intent to nationalise the NHS further, with its encouragement to GPs to become salaried, rather than devolving healthcare budgets at local level.

What it is more difficult to argue with is the notion that health and social care should be more integrated, even if the idea of pooling budgets does fill with fear the hearts of those who worry that NHS funding will be used to prop up local authority services facing cuts.

Writing in a personal capacity BMA deputy chairman Dr Kailash Chand describes the move as either 'a triumph for local democracy championing the fundamental needs of total healthcare as defined by WHO in partnership with clinicians, or creating real risks of yet another false dawn'.

What will be more worrying for GPs is the reaction of Greater Manchester LMC. It criticises the lack of involvement of GPs in the plans for the new funding arrangements.

Plans to integrate health and social care in Manchester are a bold experiment, but one which will ultimately be jeopardised if a profession so crucial to their success is to be denied a voice.

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