Social enterprises are increasingly one of ministers’ preferred delivery mechanisms for breaking down the NHS monopoly. Care minister Phil Hope recently announced £450,000 funding to establish six social enterprise projects, designed to move services out of the state sector.
NHS West Midlands is to set-up respite care schemes for disabled young people and their families, which has the additional objective of reducing homelessness amongst those who fall out of the care system. Croydon Primary Care Trust, working with Croydon council, will set-up a Partnership for Older People’s Village, to support local elderly people.
Another scheme looks particularly suited to operating as a social enterprise – Gateshead council is supporting a project that will train and enable older people and those with disabilities to share their skills and knowledge with others who need independent assistance.
Other projects just receiving financial support will help build the infrastructure for more social enterprise development in the health sector in Birmingham, Bristol and Kent. Further social enterprise projects are likely to emerge, thanks to the creation of a Social Enterprise Unit within the Department of Health and because of a specified ‘right to request’ for health workers to put forward their own proposals to create independent social enterprises in place of existing arrangements.
Much of this commitment to social enterprise is a welcome legacy of Pat Hewitt, from her time as health secretary. She knew from her constituency involvement as a Leicester MP of the excellent work of local social enterprises, supported by the city’s Co-operative and Social Enterprise Development Agency.
Yet this progressive approach sits oddly with much else of what has happened in recent years. Hewitt herself, since leaving the Cabinet, has become a senior advisor to Cinven – a private equity firm that has bought one of the largest private hospital groups from BUPA. She is also a specialist advisor to AllianceBoots – owned by a major private equity group, KKR – that wants to run GP practices for the NHS. Another former health secretary, Alan Milburn, advises other private equity firms heavily involved in the privatisation of the NHS, as does Lord Warner, a former health reform minister.
Just as peculiar is the fact that ministers have failed to operate with a similar approach favouring social enterprises in the care sector. Since 1993, social care provision has moved, roughly speaking, from being 90% in the public sector, to becoming 90% in the private sector.
There are some beacon examples of social enterprises running home care services, for example in Sunderland and Shepshed. Yet for the most part, social care is now in the hands of private equity firms. Much of this business could – and I suggest should – have gone to social enterprises.