The handing over of the health budget to Greater Manchester authorities carries both risk and opportunity says Diane Coyle, who argues that delivering on data and analysis will be key for policymakers.
The risk is obvious: as with the entire Devo Manc process, those concerned have to make it work. They have to spend the devolved funding effectively, deliver the services involved to a higher standard, and gain democratic legitimacy among their voters in what has so far been a top-down process.
The opportunity lies in being able to reshape the way public services are structured and to align them better with the needs of local people and businesses. An obvious example is integrating health and social care. This might save money, although the King’s Fund has warned of dangers in trying to join up the services with inadequate funding. More importantly it ought to improve the care received by people who need it.
It will make Greater Manchester more like many other European regions, such as Scandinavia, where the two are combined, and are locally rather than nationally accountable. The voice of local people will be louder in Manchester than it can ever be in Whitehall. The evidence given to a recent House of Commons select committee inquiry persuaded the MPs that this experiment was both essential and likely to succeed in Greater Manchester.
The changes coming about in April with the devolution of powers still represent a step into the unknown, and the priority will be making services work smoothly without hitting organisational stumbling blocks. Beyond that, there is though, an even wider opportunity, which is joining up all Greater Manchester services in support of a vision of what a genuinely thriving region will look like – joining up economic growth, better opportunities for everyone, improved health and wider well-being.
Economic growth of the conventional kind – profitable businesses, investment, plenty of jobs, rising incomes – is important. Without it, it is hard to achieve other aims. The conventional economic statistics show Greater Manchester has a long way to go to catch up The South East in terms of productivity or incomes per person, although improving the out-of-date and inadequate regional statistics is something the devolution agenda has made essential.
Data is king
Professor Charles Bean’s independent Review of Economic Statistics highlighted the importance of better regional data: “This is a long-standing need, but one that has become more pressing with the increased emphasis on the devolution of decision-making power to the nations, regions and cities of the UK. The lack of information to diagnose the specific economic challenges facing geographic units below the level of the UK as a whole represents a handicap for policy and business decisions.”
One obstacle to doing so is the cost of the data collection methods if extended to all relevant regions, but the report recommends looking at the use of ‘administrative’ data, in other words information already held by government bodies such as HMRC.
Another possibility is looking to new data techniques such as web scraping (the process of obtaining data from websites). It will be vital for users of the statistics, including regional policy makers, to work with the Office for National Statistics to prioritise the information needs and think creatively about cost-effective ways of providing the statistics that will be vital for local democratic accountability.
Economic health check
The relevant information will not just consist of the conventional economic measures, however. Increasingly policy makers around Europe and the other rich OECD countries (The Organisation for Economic Co-operation and Development) are looking “Beyond GDP” to measure how well the economy is performing. In the UK, the Office for National Statistics has begun to publish national Economic Well-Being indicators including, for example, measures of income distribution, unemployment and household wealth.
The New Zealand Treasury has introduced a Well-Being Framework that goes wider than economic measures to include indicators of things like the local environment, health, safety, housing, and culture. The European Union is developing a similar framework and is also drafting a set of regional social progress measures. Greater Manchester is mid-table overall but scores poorly on nutrition, health, and medical care, as well as education.
Many of these approaches are in their early stages, and require more work to be developed fully. Of particular importance in the devolution context is working through exactly the set of indicators relevant to holding policy makers to account.
There is every reason to think a one-size-fits-all approach will not be appropriate, and the specifics will need tailoring to the local needs and priorities. But for all the need to work out how to implement it, and find the relevant data, this approach could offer Greater Manchester a way to think about pioneering an integrated set of policies and services. These could reinforce each other to address the levels of deprivation in some parts of the region, tackle known shortcomings in health and well-being, develop the skills needed locally, and so deliver widely-based economic growth and prosperity.
- In the run up to 1 April, when Greater Manchester is handed control of its £6bn health and social care budget, we’re running a series of blogs from leading commentators on what it really means for the region. Read more on Devolution issues.