Health and care policy is increasingly promoted within visions of the competitive city-region. This paper examines the importance of policy boosterism within the political construction of city-regions in the context of English devolution. Based on a two-year case study of health and social care devolution in Greater Manchester, England, we trace the relational and territorial geographies of policy across and through new “devolved” city-regional arrangements. Contributing to geographical debates on policy assemblages and city-regionalism, we advance a conceptual framework linking crisis and opportunity, emulation and exceptionalism, and evidence and experimentation. The paper makes two key contributions. First, we argue health and care policy is increasingly drawn towards the logic of global competitiveness without being wholly defined by neoliberal political agendas. Fostering transnational policy networks helped embed global “best practice” policies while simultaneously hailing Greater Manchester as a place beyond compare. Second, we caution against positioning the city-region solely at the receiving end of devolutionary austerity. Rather, we illustrate how the urgency of devolution was conditioned by crisis, yet concomitantly framed as a unique opportunity by the local state harnessing policy to negotiate a more fluid politics of scale. In doing so, the paper demonstrates how attempts to resolve the “local problem” of governing health and care under austerity were rearticulated as a “global opportunity” to forge new connections between place, health, and economy. Consequently, we foreground the multiple tensions and contradictions accumulating through turning to health and care to push Greater Manchester further, faster. The paper concludes by asking what the present crisis might mean for city-regions in good health and turbulent times.

中文翻译：

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组建健康城：竞争性的城市区域主义和政策助推主义推动大曼彻斯特走得更远、更快


在竞争激烈的城市地区的视野中，卫生和保健政策得到越来越多的推广。本文探讨了英国权力下放背景下城市地区政治建设中政策支持的重要性。基于对英国大曼彻斯特地区卫生和社会保健权力下放的为期两年的案例研究，我们通过新的“权力下放”城市-区域安排追踪了政策的关系和地域地理分布。为了促进有关政策组合和城市区域主义的地理辩论，我们提出了一个将危机与机遇、模仿与例外论以及证据与实验联系起来的概念框架。该论文做出了两个关键贡献。首先，我们认为医疗保健政策越来越倾向于全球竞争力的逻辑，而没有完全由新自由主义政治议程定义。培育跨国政策网络有助于嵌入全球“最佳实践”政策，同时称赞大曼彻斯特是一个无与伦比的地方。其次，我们警告不要将城市地区仅仅定位为权力下放紧缩的接收端。相反，我们说明了权力下放的紧迫性如何受到危机的影响，但同时又被地方政府利用政策来谈判更灵活的规模政治，从而将其视为一个独特的机会。在此过程中，本文展示了如何将在紧缩政策下解决医疗和护理管理的“地方问题”的尝试重新表述为在地方、健康和经济之间建立新联系的“全球机会”。因此，我们突出了通过转向健康和护理而积累的多重紧张和矛盾，以推动大曼彻斯特走得更远、更快。 本文最后提出，当前的危机对于健康状况良好和动荡时期的城市地区可能意味着什么。