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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Why relations between Theresa May and Philip Hammond became tense so quickly

The political imperative of controlling immigration is clashing with the economic imperative of maintaining growth. 

There is no relationship in government more important than that between the prime minister and the chancellor. When Theresa May entered No.10, she chose Philip Hammond, a dependable technocrat and long-standing ally who she had known since Oxford University. 

But relations between the pair have proved far tenser than anticipated. On Wednesday, Hammond suggested that students could be excluded from the net migration target. "We are having conversations within government about the most appropriate way to record and address net migration," he told the Treasury select committee. The Chancellor, in common with many others, has long regarded the inclusion of students as an obstacle to growth. 

The following day Hammond was publicly rebuked by No.10. "Our position on who is included in the figures has not changed, and we are categorically not reviewing whether or not students are included," a spokesman said (as I reported in advance, May believes that the public would see this move as "a fix"). 

This is not the only clash in May's first 100 days. Hammond was aggrieved by the Prime Minister's criticisms of loose monetary policy (which forced No.10 to state that it "respects the independence of the Bank of England") and is resisting tougher controls on foreign takeovers. The Chancellor has also struck a more sceptical tone on the UK's economic prospects. "It is clear to me that the British people did not vote on June 23 to become poorer," he declared in his conference speech, a signal that national prosperity must come before control of immigration. 

May and Hammond's relationship was never going to match the remarkable bond between David Cameron and George Osborne. But should relations worsen it risks becoming closer to that beween Gordon Brown and Alistair Darling. Like Hammond, Darling entered the Treasury as a calm technocrat and an ally of the PM. But the extraordinary circumstances of the financial crisis transformed him into a far more assertive figure.

In times of turmoil, there is an inevitable clash between political and economic priorities. As prime minister, Brown resisted talk of cuts for fear of the electoral consequences. But as chancellor, Darling was more concerned with the bottom line (backing a rise in VAT). By analogy, May is focused on the political imperative of controlling immigration, while Hammond is focused on the economic imperative of maintaining growth. If their relationship is to endure far tougher times they will soon need to find a middle way. 

George Eaton is political editor of the New Statesman.