Health and social enterprises

As the government moves ahead with reforms to the National Health Services (NHS), civil society remains unsure of its role in healthcare delivery.

The government says that it is eager to work with the third sector and Prime Minister David Cameron said that he wanted to see charities and social enterprises as “the first sector.”

But actions speak louder than words and the government’s decision, announced last week, to end the Right to Request programme, through which social enterprises could bid to deliver public health services, suggests that the coalition is keeping the third sector out of the loop when it comes to reforms to the NHS.

“Anyone in a Primary Care Trust (PCT) that wanted to exercise their right to start a social enterprise under Right to Request needed to do so before 30 September,” said Rebecca Chaloner from the government’s Department of Health’s social enterprise unit on October 4 at the Social Enterprise Coalition’s Health and Social Care Forum.

The government assured that the programme was only scrapped because it fell under the jurisdiction of PCT, which under the NHS reforms is to be abolished by 2013, and that a similar initiative will be set up through its Decentralisation and Localism bill.

A spokesperson for the Communities and Local Government department said: ‘More details on the right to bid to run state services, and the community right to buy, enabling community organisations to bid to take over local community assets, will be announced in the Localism Bill in November.’

Until the new bill is passed it is unclear how or if social enterprises can continue to bid to deliver health services.

In July, when the Liberal Democrat coalition published its white paper for reforms to public health care services, Health Secretary Andrew Lansley said the government wanted to turn healthcare provision into the “largest social enterprise in the world.”

Association of Chief Executives of Voluntary Organisations (ACEVO), a network of British third sector leaders, welcomed this plan but now says the government needs to do more to engage with civil society “in a genuinely collaborative way” for its plan to be a success.

Ralph Michell, head of policy at ACEVO, said: “Public health is high on the political agenda. There are some potentially big changes in the pipeline and if this isn’t voluntary sector territory I don’t know what is.”

On October 7 ACEVO published a report outlining 14 recommendations from civil society for the reorganisation of public health delivery. Above all the report called on the government to give the third sector a bigger voice in the decision making process and to stimulate the growth of “new providers” of healthcare – namely social enterprises.