George Osborne and David Cameron speak to business leaders at the AQL centre on February 5, 2015 in Leeds. Photograph: Getty Images.
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Osborne's dramatic Manchester NHS plan is a dangerous distraction

The Chancellor's politically-motivated project undermines the goal of the national integration of health and social care. 

The most significant political story today is George Osborne's confirmation that he intends to hand Greater Manchester control of the region's £6bn health and social care budget (a quarter of total government spending in the area). Never in the history of the NHS has there been such devolution in England. The announcement was due to be made on Friday, during a visit by Osborne to the area, but the Chancellor's plans were foiled after the Manchester Evening News got hold of a draft "memorandum of understanding" between the region's councils and the Treasury. 

This being Osborne, who remains the Conservatives' chief electoral strategist, the politics are crucial. He has framed the move, which would take effect from April 2016, as part of his drive to create a "northern powerhouse", a project with the political aim of decontaminating the Conservative brand in that region (one inspired by Osborne's special adviser Neil O'Brien, the former director of Policy Exchange). The Tories are also hailing the proposed integration of health and social care spending as evidence that they are making the running on a cause that Andy Burnham, the shadow health secretary, has long championed. 

But if the politics are clear, the policy is not. By promising Greater Manchester control of health spending, the Conservatives have set a precedent that several other areas will want to follow (Tessa Jowell, the Labour London mayoral candidate, was swift to demand equivalent powers for the capital). In so doing, they have driven a coach and horses through Labour's proposed national integration of health and social care. As Burnham noted in his response, the resultant danger is the creation of a "two-tier" NHS which destroys the principle of a universal and comprehensive service. In the middle of the greatest funding squeeze in the NHS's history, Osborne's "devo Manc" project, which would likely necessitate another reorganisation, risks being a dangerous distraction. Under Burnham's alternative vision, health and social care would be nationally integrated (producing up to £6bn in savings) with individual local authorities and GP commissioning bodies working in harness to build new services. 

Osborne's proposal of stand-alone devolution to Manchester resembles an answer in search of a problem. Worse, it threatens to create new dysfunctions. At the last count, the region's hospitals were running a deficit of £40m. Who will pick up the bill in the event of a crisis? Though the Conservatives will protest otherwise, the move risks being the first step in the ultimate unravelling of a truly national health service. 

George Eaton is political editor of the New Statesman.

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PMQs review: Theresa May shows again that Brexit means hard Brexit

The Prime Minister's promise of "an end to free movement" is incompatible with single market membership. 

Theresa May, it is commonly said, has told us nothing about Brexit. At today's PMQs, Jeremy Corbyn ran with this line, demanding that May offer "some clarity". In response, as she has before, May stated what has become her defining aim: "an end to free movement". This vow makes a "hard Brexit" (or "chaotic Brexit" as Corbyn called it) all but inevitable. The EU regards the "four freedoms" (goods, capital, services and people) as indivisible and will not grant the UK an exemption. The risk of empowering eurosceptics elsewhere is too great. Only at the cost of leaving the single market will the UK regain control of immigration.

May sought to open up a dividing line by declaring that "the Labour Party wants to continue with free movement" (it has refused to rule out its continuation). "I want to deliver on the will of the British people, he is trying to frustrate the British people," she said. The problem is determining what the people's will is. Though polls show voters want control of free movement, they also show they want to maintain single market membership. It is not only Boris Johnson who is pro-having cake and pro-eating it. 

Corbyn later revealed that he had been "consulting the great philosophers" as to the meaning of Brexit (a possible explanation for the non-mention of Heathrow, Zac Goldsmith's resignation and May's Goldman Sachs speech). "All I can come up with is Baldrick, who says our cunning plan is to have no plan," he quipped. Without missing a beat, May replied: "I'm interested that [he] chose Baldrick, of course the actor playing Baldrick was a member of the Labour Party, as I recall." (Tony Robinson, a Corbyn critic ("crap leader"), later tweeted that he still is one). "We're going to deliver the best possible deal in goods and services and we're going to deliver an end to free movement," May continued. The problem for her is that the latter aim means that the "best possible deal" may be a long way from the best. 

George Eaton is political editor of the New Statesman.