The contested future of Greater Manchester's NHS

Plus the rest of our Monday briefing

Dear Millers — today’s briefing looks at the re-organisation of healthcare in Greater Manchester and the jockeying behind the scenes for who controls the billions of pounds worth of funding. We also have some great reads and recommendations for the week ahead, including a fabulous festival of libraries.

Our weekend read was about The Mill’s first birthday and the people who helped us get to this point. If you missed it, you can read that piece here.

This week’s weather

The big story: Who runs the NHS?

Top line: Healthcare has been firmly in the headlines for obvious reasons in the past year. But behind the scenes, there is some interesting political jockeying going on about how Greater Manchester’s NHS should operate.

The crux of it: The government’s proposed NHS reforms, which might become law this time next year, are getting rid of “clinical commissioning groups” (we have 10 of those in GM) and look like they will hand much more power to a central “board of providers”.

  • Insight: This new way of doing things appeals to leaders in Manchester itself and the powerful Manchester University Foundation Trust (MUFT).

  • But according to the Health Service Journal it is being resisted by GM’s outer boroughs, who are “fearful of being dominated by Manchester City Council and the £2 billion behemoth that is MUFT.” They would prefer a more distributed structure, with power going to the local councils, a principle known as “primacy of place.”

Why this matters: The acute trusts in GM get almost £5 billion a year in funding — a huge sum of money in the context of the local economy. How it is allocated will make a big difference to our lives.

The latest: It seems things are going the way of the centralisers. It was reported last week that most of GM’s acute care funding will be assigned to the central board of providers, effectively bypassing borough-level structures. Primary and community funding, which is a smaller chunk, will go to borough-level “locality boards.”

This morning we spoke to Lawrence Dunhill, a reporter at the Health Service Journal (HSJ) who has been reporting on this story. He told us:

They are going to talk a lot about how they are protecting the 'primacy of place' principle, when the reality of how the funding is going to flow straight to the acute sector is likely to give more power and decision-making to the Greater Manchester structures.

Bear in mind: If power and funding are heading in a more centralised direction, that doesn’t mean actual health services are. In fact, last week saw a significant reversal of centralisation when plans to consolidate high-risk general surgery in a smaller number of hospitals were “quietly dropped.”

  • North Manchester, Wythenshawe, Tameside, Bolton and Wigan were going to lose their high-risk surgery functions in favour of four specialist centres: Manchester Royal Infirmary, Salford, Stockport and Oldham.

  • The move proved highly controversial and was challenged through the courts (unsuccessfully) by doctors at Wythenshawe hospital.

Now the HSJ has learned that the plans have been dropped and the re-organisation won’t happen, “which is extraordinary considering the work that went into all the planning, public consultation and judicial review,” a source told the publication.

Bottom line: We will be keeping an eye on these stories about how the NHS is organised in the weeks and months ahead, particularly as the government’s new legislation proceeds. At a high level, the reforms are effectively reversing the “market-based” changes introduced when David Cameron was prime minister, recognising that hospitals can’t really compete for customers in the way coffee shops can. If you live in Bury, you’re unlikely to choose to go to Stockport for your treatment. But the key will be how the reforms impact services at a local level, and that’s what we will be watching.

Can you help us with our reporting? Please get in touch: We’re happy to speak off the record.

Other local news in brief

  • ‘No go’ Didsbury: MailOnline has received widespread mockery after it ran an article claiming that Didsbury was a “no-go area” for white people. The controversial article was based on a book by former Islamist radical Ed Husain, who founded the counter-terrorism thinktank Quilliam. Read more.

  • Student block: Plans for purpose-built student housing on Deansgate have been thrown out by Manchester council after the block was deemed “over obtrusive.” Manchester council’s planning committee agreed with officers that the 28-storey student tower was of “poor quality” and would have a “detrimental impact.” Read more.

  • Missing friend: Rochdale Council has been ordered to pay compensation to a woman who felt “tricked” into taking a missing friend’s child. The council had said she was not entitled to claim fostering allowance for taking care of the teenager. The mother-of-four said she suffered “financial hardship” over the authority’s handling of the matter. Read more.

Home of the week

This stunning 2-bed end of terrace house in Worsley is up for sale for £415,000. It boasts village green views and has lots of character. Or if you are looking for something a bit less dear, The Times has a great piece about what £250,000 will get you in Umbria, Italy, Manchester, Cardiff, West Yorkshire.

Our favourite reads

The Observer: This long read explores the circumstances around the 2016 death of Abdul Hafid, 18, and the convictions that followed. A key piece of evidence used to convict seven teenagers of murder and four of manslaughter under controversial “joint enterprise” laws was a rap video “organised by a youth worker, part-funded by the GMP.” “Was a Moss Side murder trial racist?” the piece asks.

John Rylands Library: We enjoyed this piece about the Manchester Art Treasures Exhibition of 1857, which was held in Old Trafford. It was the largest art exhibition ever held in the UK and it ran for 142 days. Many artworks at the time were held by private owners, and the exhibition was a chance for the public to see them. Over 1.3 million people were recorded visiting the exhibition.

Gal-dem: This was a great interview with Lady Unchained (Brenda Birungi) the curator of ‘Soul Journey to Truth’ who tells the story behind the “emotionally charged” exhibition at HOME. “If most people are like me before jail, they probably won’t believe the stuff that happens in prison.”

1843 Magazine: We enjoyed this feature about Alex Poots, the man behind the Manchester International Festival, the biennale that started in 2007. In late 2004, “he got a phone call asking him to apply for a new job. Manchester city council, he was told, wanted a replacement for its previous and, in the words of the council leader, Sir Richard Leese, ‘mediocre’ annual festival.”

Grist to The Mill: If you want to tell us about a story or pass us some information, please email or We are always happy to speak to people off the record in the first instance, and we will treat your information with confidence and sensitivity. Get in touch.

Things to do

Industrial Dante | On Thursday, on the 700th anniversary of his death, John Rylands Library will explore how Victorian Manchester “embraced” medieval Italian poet Dante Alighieri. The event will be joined live from Rome by Simona Giordano, who has been working on the rediscovered archive of the Manchester Dante Society, and Manchester Art Gallery Curator Hannah Williamson. It’s an online talk. Book here.

Festival of Libraries | There are 133 libraries in Greater Manchester, and from Wednesday there’s going to be a huge celebration — bibliophiles get ready. Alongside Manchester’s gems like Central Library, Chetham’s and John Rylands, there are brilliant local libraries in all the boroughs taking part too. Find out what’s on here. We’re looking forward to:

  • Bolton Central Library and Museum: Rare Book Talk, Wednesday. More information here.

  • Middleton Library: Historic Photo Trail, Wednesday. More information here.

  • The Portico Library: ‘A Tale of Two Libraries’ talk, Wednesday. More information here.

Read our members’ story by Phil Griffin, who charts his life through memories of local libraries in a very lovely personal piece published last week.

Dawn chorus | For our Millers who are early birds, Lancashire Wildlife Trust is inviting you to join them for a ‘dawn chorus’ in Philips Park, Prestwich on Saturday. You’ll learn about the different songs of bird species and enjoy some fresh air. Don’t forget to wear suitable clothing. Book here.

Horizons Festival | Culture vultures rejoice, HOME’s Horizons Festival starts on Saturday. The Manchester Stage at Homeground will be welcoming music and spoken word, featuring performances from Luma Trio, who play Latin American music, North West Turkish Community Association Dance Group and Afrocats Youth Showcase. More information here.

Fossil walk | Join Skylight Circus Arts for a free circus workshop and guided walk to the site of the famous 'Rochdale Scorpion' fossil find on Saturday. A great day for little ones — if you fancy trying your hand at juggling and plate-spinning, before walking to Broadfield Park to see where Mary Lange made her discovery in 1903, then this is for you. More information here.

Letters to the editor

I've read many stories by Thomas [McGrath] via his very interesting blog. This area has such a fascinating history, I didn't know about the women's suffrage connection. I've always been interested in the history of houses and avidly watched 'A House Through Time.’ Manchester hasn't been included in these series yet but there must be a likely candidate in Victoria Park. Anne, Manchester

I have been trying to rent in Manchester and it is equally problematic (‘Inside Didsbury’s red-hot property market’). Lately we've turned our attention to Glossop instead and we find the same issue with block viewings and almost job application style allocation processes, where the landlord will look at brief applications for those who are interested and then select who to go to full application and references with. Properties in good areas, such as Glossop, are remaining on Rightmove for two weeks at most before they are taken down. But even places in Tameside such as Stalybridge, are blink and you miss it. Tess, Manchester