Health: ‘outsourcing’ or real, new social enterprises?

Reading Social Enterprise – Making a Difference: a guide to the Right to Request recently, the latest brochure from the Dept of Health Social Enterprise Investment Fund (SEIF), I was struck by the thin line that exists between ‘outsourcing’ of services and genuine, new social enterprise opportunity.

What I mean by this, is that looking at some of the examples cited, I struggled to see their social enterprise potential – a capacity to trade in the wider marketplace, innovate in delivery, and maximise income-generation so that surpluses can be reinvested in the business and in delivering on social mission.

Apparently, I’m not the only one to have picked up on this danger. The Young Foundation – which has a Launchpad initiative specifically targetting the development of new social enterprise initiatives in health and social care delivery – has spotted the same trend and now places a much greater emphasis on business cases that offer real service innovation and not just service outsourcing.

While the establishment of the SEIF and key health sector policy initiatives such as World Class Commissioning offer huge potential for social enterprises, we shouldn’t let this blind us to the fact that many health service managers do simply want to ‘outsource’ services by shifting them further down the supply-chain.

The danger for ‘outsourcing’ rather than creating genuine social enterprise opportunities seems especially strong if services are being outsourced in a way that only really changes the delivery provider and not the delivery model.

If they are to be sustainable and have growth potential, social enterprises need to be able to trade as widely in the marketplace as they can. Let’s face it: if third sector providers are delivering pretty much what a PCT used to deliver, and continue to have a single ‘monopoly customer’, then they have all their eggs in one basket.

This may make them successful ‘not-for-profit’ providers – but it doesn’t necessarily make them social enterprises.

Those within the sector who are well-placed to have influence on health service policy-makers and practitioners should be promoting the message “social enterprise not outsourcing”. We should be emphasising that social enterprise is about:

  • Additional social/community value
  • Innovation
  • Trading services in the wider marketplace
  • The capacity to grow, maximise income-generation and create employment opportunities.

Anything less is just outsourcing.

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