We have reached crossroads in the role of social enterprises and co-operatives in primary and also social care. The concept of social enterprise (we have about over a dozen legal structures and definitions) is being diluted and further reinforced with the Social Value Act. The profit motive is being thinly disguised at the expense of accountability and social outcomes.
The inequality in the market place are now embedded in commissioning models and procurement procedures in the NHS and local government which further exemplifies market distortions and thus works against cooperatives and community led social enterprises. Despite these challenges we have an emerging social enterprise movement with approximately 1000 health care co-ops working within the NHS with a combined turnover of £600m according to the latest figures from Co-operatives UK.
I believe that with the Co-operative Party working with a future Labour government we can kick start a new NHS revolution where co-operatives, social enterprises and mutals can help to improve health outcomes and greater accountability for patients and the public.
We could develop a manifesto or strategy to mainstream co-operative models in the NHS covering the following actions and recommendations below:
- Redefinition of what is a social enterprise in the context of health and social care to stop private companies and venture capitalist to use this as a back door way to privatise services;
- Social enterprise and co-operatives have clear lines of accountability to staff, service and wider beneficiaries;
- Social enterprises, co-operatives and mutals become second tier preferred providers after the NHS in commissioning future healthcare;
- Develop best practice guidance by reviewing EU, Department of Health and NHS England procurement and commissioning policy;
- Development of a subsidy and social investment programme to facilitate and support the capacity of existing and emerging social enterprises and mutals;
- Monitor the regulator to review and take action if there is clear evidence of bias or discrimination against social enterprises, mutual, and third sector providers by the private sector or commissioners from the public sector;
- Monitor to have a new statutory duty and remit to promote cooperatives, mutual and social enterprises;
- Develop a 5% level on all gross profits made by private sector providers in the NHS to fund a social enterprise capacity building which is matched funded by the Treasury;
- Re introduction by NHS England of Social Enterprise Leadership Programme to support clinicians, managers, commissioners, front line staff and service user groups to develop the leadership skills to develop social enterprises and ethos of mutualism to redesign services;
- Develop a clear portfolio for the Minister for Social Care, Minister for Public Health along with Treasury Secretary to lead a task force in reviewing current Foundation Trusts and social enterprises in becoming fully fledge mutals and cooperatives with clear social outcomes for NHS services;
- NHS England to appoint network of Social Enterprise Champion in the Nine English Regions ( similar arrangements can be made in Wales, Scotland and Northern Ireland ) to work with the NHS and local government in developing social enterprise models to support integration of health and social care services;
- Support the development of service user and BAME led social enterprises with capacity building funding, soft loans/grants and technical expertise.
As we approach the 65th anniversary of the NHS we need again the Sprit of 45 to develop the role of clinicians, managers and patient and services groups to develop a new collective responsibility and commitment to the NHS for the next 65 years which is still free at the point of access regardless of income, economic status and non-discriminatory as part of the protected characteristics under the Equality Act 2010.
The Co-operative Party is in a perfect position to shape the role of social enterprise and mutualism as part of our values around social justice and equality for all in the NHS.
Cllr Patrick Vernon OBE is a councillor in the London Borough of Hackney and a member of Ed Miliband Task Force for Mental Health and Society