There is a risk of sounding like a curmudgeon if you quibble about the decision to devolve control of Manchester's NHS budget to the city.

Worse, you risk sounding like the Labour Party's front bench.  It is an unequivocably exciting moment for democracy and effectiveness – and rare to benefit both at once.

But there is a quibble about the direction localism is taking, and although the decision to launch a Manchester NHS (can it be local and national at the same time?) is bold and ambitious – it remains the same old pattern.