Assembling the Healthopolis: Competitive city-regionalism and policy boosterism pushing Greater Manchester further, faster

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 the geopolitics of competitive city-regionalism, we advance a conceptual framework linking crisis and opportunity; emulation and exceptionalism; and evidence and experimentation. In doing so, 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. Second, we caution against positioning the city-region solely at the receiving end of devolutionary austerity. Rather, we show how the urgency of devolution was conditioned by crisis, yet concomitantly framed as a unique opportunity by entrepreneurial local state managers. As such, we illustrate how the local state harnessed policy boosterism to negotiate a more fluid politics of scale. The paper demonstrates how efforts to resolve the ‘local problem’ of governing health and care 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.