Social enterprise delivery of health should never be about the dismantling of universal provision

Further to this earlier post, Third Sector Online yesterday published a story in which the Government’s spokeswoman on health in the House of Lords, Baroness Thornton, stated that despite its policy that the NHS should be the preferred provider of health services, this did not mean that there was any “expectation or intention either to freeze out private or third sector providers, or to diminish their contribution to NHS services”.

Baroness Thornton was previously the chair of the Social Enterprise Coalition. Stephen Bubb, chief executive of ACEVO says he feels sorry for Thornton, claiming that she has had to “defend the indefensible”. “If the NHS is the preferred provider, then the third sector is not,” says Bubb, “and no amount of waffle and rhetoric about how great we are will cover up the fact that the Government has broken its promise to treat us on equal terms.”

I’m not entirely sure that I see Bubb’s problem with this. His vociferous criticism seems to revolve around the idea that a greater role for social enterprise and the NHS remaining the preferred provider are mutually exclusive. But is that the case?

A circular letter from the NHS chief executive David Nicholson dated 13th October 2009 and written in the wake of Andy Burnham’s speech which prompted this row seeks to clarify the position. In it Nicholson says:

“Our over-riding principle is to provide high quality care for patients delivered by providers who offer the best care. We remain committed to the participation of independent and third sector providers where this is the right model for patients – for example, where we need new services/service models, or substantial increases in capacity, or to offer increased choice to patients or to stimulate innovation.”

The letter goes on to say:

“The ‘NHS as the preferred provider’ is about getting the best care for patients and looking after the NHS staff who care for them. Our aim is to ensure that NHS staff are treated fairly and engaged in decisions, so that they know what is happening and when, what changes are being sought and why, and have a full opportunity to contribute to improving and re-designing the services that they provide. Service improvement and re-design should not be something which is imposed on NHS staff but something which they own and lead.”

Now call me old-fashioned, but I don’t find very much to disagree with there. I have never believed that social enterprise and third sector delivery of health should be — even inadvertently — about the dismantling of the NHS and its fundamental principles of universal provision. That to me would not only be counter-productive, it would be betrayal of what social enterprise is about as well as a betrayal of the NHS.

  1. Simon Lee Reply

    The David Nicholson letter is very helpful and certainly gives another perspective on things.

    It might just be that this (i.e. the Andy Burnham speech) is really pre-election tactics designed to keep the unions happier and that, whatever happens in May, things will calm down a bit.

    We can then go back to social enteprises having opportunities in health and social care contracting where that is appropriate.

    • Alun Severn Reply

      Simon — You’re right: it might all be a pre-election storm in a teacup, of course…

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