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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How Theresa May laid a trap for herself on the immigration target

When Home Secretary, she insisted on keeping foreign students in the figures – causing a headache for herself today.

When Home Secretary, Theresa May insisted that foreign students should continue to be counted in the overall immigration figures. Some cabinet colleagues, including then Business Secretary Vince Cable and Chancellor George Osborne wanted to reverse this. It was economically illiterate. Current ministers, like the Foreign Secretary Boris Johnson, Chancellor Philip Hammond and Home Secretary Amber Rudd, also want foreign students exempted from the total.

David Cameron’s government aimed to cut immigration figures – including overseas students in that aim meant trying to limit one of the UK’s crucial financial resources. They are worth £25bn to the UK economy, and their fees make up 14 per cent of total university income. And the impact is not just financial – welcoming foreign students is diplomatically and culturally key to Britain’s reputation and its relationship with the rest of the world too. Even more important now Brexit is on its way.

But they stayed in the figures – a situation that, along with counterproductive visa restrictions also introduced by May’s old department, put a lot of foreign students off studying here. For example, there has been a 44 per cent decrease in the number of Indian students coming to Britain to study in the last five years.

Now May’s stubbornness on the migration figures appears to have caught up with her. The Times has revealed that the Prime Minister is ready to “soften her longstanding opposition to taking foreign students out of immigration totals”. It reports that she will offer to change the way the numbers are calculated.

Why the u-turn? No 10 says the concession is to ensure the Higher and Research Bill, key university legislation, can pass due to a Lords amendment urging the government not to count students as “long-term migrants” for “public policy purposes”.

But it will also be a factor in May’s manifesto pledge (and continuation of Cameron’s promise) to cut immigration to the “tens of thousands”. Until today, ministers had been unclear about whether this would be in the manifesto.

Now her u-turn on student figures is being seized upon by opposition parties as “massaging” the migration figures to meet her target. An accusation for which May only has herself, and her steadfast politicising of immigration, to blame.

Anoosh Chakelian is senior writer at the New Statesman.

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