Greater Manchester; Doing Things Differently
“This is Manchester. We do things differently here”. The phrase, uttered by the late Tony Wilson, one of the founders of Factory Records, sums up the culture of Greater Manchester. It has been adopted by Mancunians as a badge of identity and honour. The phrase also adorned the manifesto of Mayor of Greater Manchester, Andy Burnham.
The sentiment lives on in the unlikely area of public service reform. In 2016, the formation of the Greater Manchester Health and Social Care Partnership Board saw the City-Region become the first to adopt devolved powers over health services. Two years on, Andy Burnham’s speech to NHS Providers Conference demonstrated the desire for the conurbation to continue blazing a trail. In his role as Shadow Secretary of State for Health, Burnham’s flagship policy was termed Whole-Person Care; the full integration of health and social care. His new thinking marks an evolution of this policy to something that could be accurately described as Whole Life Care. Burnham’s philosophy for public policy making in Greater Manchester can be summed up as “give us the power to do things differently”. With what levers he has, he is making an impact through interventions such as in his homelessness campaign and around DWP devolution and the Working Well Programme.
The ambition isn’t just for health and care services to be integrated, it’s much wider. Bringing in all aspects of public policy making from education, welfare, skills, transport and housing, Burnham is championing a place-based approach. He cited Bevan’s original ministerial responsibilities of health and housing as a demonstration of how the policy areas are interlinked and admitted that recommendations of the Marmot Review in 2010 could not be implemented because of how siloed Whitehall has become.
Burnham’s speech was complemented by a range of policy interventions, such as a guarantee that nurses studying at Manchester universities will be guaranteed employment within the Greater Manchester NHS and the creation of a new mental health service for universities within the City-Region. As would be expected, he highlighted the financial and workforce challenges facing public services. However, it is his comments on culture that will be of most interest to those with a stake in local services.
“Instead of driving towards more institutions, fragmentations and outsourcing, it is about the very opposite – a one integrated public service team with that ethos at its heart…It’s about more than structures. It adds an ingredient too often lost in the bureaucracy of public services: trust.”
It is clear that organisations wishing to engage with services in Greater Manchester have to do so within this philosophy. Transactional relationships will only get you so far as the Mayor’s ambitious plans show. Organisations now have to demonstrate to decision makers that they are on this journey together and that they can bring real value to the person at the centre.
Burnham mentioned relationships eight times in his speech. The relationships between services and the public, the relationships between different services, public and private, and the relationships between central and devolved government. Getting the relationships right will go someway to embedding the culture underpinning real, transformative service change in Greater Manchester.