A key instrument in developing alternative delivery mechanisms for health and social care has been the 'right to provide' (Department of Health, 2011). This, together with new legal entities (community benefit societies, charitable incorporated organisations) or regulatory forms (community interest companies), has paved the way for new social enterprise and employee owned, co-operative models providing a range of primary and secondary health services. This shift of services out of state provision is not new, but has been revitalised through a wave of policies linked to on the one hand ‘helping people make informed choices about health and social care‘ and on the other to extend competition and choice. Part of this wave has seen the introduction of the Health and Social Care Act, which came into force in 2013, since when 45% of all contracts for provision of social and health care have been awarded to non-NHS providers, with the bulk (33%) going to private providers (Iacobucci, 2014). A significant minority of contracts (10% or 335 in total) have been fulfilled by voluntary and social enterprise organisations. In local government, next generation models have been promoted through Labour support for John Lewis type councils (Lambeth) and Conservative plans for specialist social enterprises to take on wholesale provision of services (Northampton). This paper considers the rise of social enterprise and public service mutuals in the landscape of austerity measures and public sector spending cuts, rationalisation, and re-structuring. Drawing on current examples, the paper raises questions as to the future of alternative public service vehicles in continuing economic distress; the benefits and challenges for third sector providers; the preservation or transformation of public service values; and the impact on trust and confidence in relation to the performance and accountability of new models of care.
|Published - 16 Sept 2015
|Policy & Politics Annual Conference - Bristol
Duration: 16 Sept 2015 → …
|Policy & Politics Annual Conference
|16/09/15 → …