-
Radical plans to let charities run hospitals. Observer
Sunday January 6, 2002
-
Charity watchdogs in England and Scotland intervened yesterday in
mismanagement and financial irregularities in breast cancer charities on
both sides of the border. John Carvel and Kirsty Scott
Saturday May 24, 2003 The Guardian
-
The commercial fundraiser at the centre of a scandal involving two breast
cancer charities has called in the liquidators. Tash Shifrin
Monday June 9, 2003
- The voluntary sector is setting up an independent commission to develop
plans for a new body to regulate charity fundraising. The move by the
Institute of Fundraising follows the scandal that last month hit two breast
cancer charities, sparking intervention by the charity watchdog and the
courts. Tash Shifrin
Wednesday June 11, 2003 The Guardian
- Fundraising firm had been investigated before. Tash Shifrin
Thursday June 12, 2003
- Labour's leading moderniser Alan Milburn will today argue that the
government can defuse the row over extending choice in the public services by
giving a much greater role to the voluntary sector. Patrick Wintour, chief
political correspondent
Wednesday November 12, 2003 The Guardian
- Charities and voluntary organisations should be given a central role in
delivering NHS services, the former health secretary Alan Milburn said
yesterday in his latest pitch for a radical Labour manifesto. He told
voluntary organisations that groups such as the Red Cross and the Terrence
Higgins Trust could deliver NHS services in partnership with the state. The
government had to move on from believing the only two options were public or
private services. Patrick Wintour
Friday May 7, 2004 The Guardian
- Charity chief executives have today called for "practical detail" on funding
of contracts to provide NHS services, after the signing of a strategic agreement
between the Department of Health and the voluntary sector. The Association of
Chief Executives of Voluntary Organisations (Acevo) has written to the health
secretary, John Reid, and the NHS chief executive, Sir Nigel Crisp, saying the
"insecure, short-term, risky nature" of most public service contracts is an
obstacle to charities providing public services. Earlier this week, Mr Reid and
leaders of NHS organisations, the voluntary sector and local government signed
the strategic agreement aimed at underpinning partnerships in service provision.
The agreement, Making Partnerships Work for Patients, Carers and Service Users,
is the latest sign of ministers' commitment to increase the role of the
voluntary sector in delivering public services. Its stated aims include making
the voluntary sector "part of mainstream service provision". Tash Shifrin
Wednesday September 22, 2004
- Charities should be given a much broader role in delivering public services,
says Stuart Etherington.
Monday November 15, 2004
- Charities should think twice before plunging into contracts to deliver
public services, the umbrella body for the voluntary sector will warn tomorrow
in a move to curb government expectations of large-scale transfers of services
from state providers. Delivery of public services should be "a means to an end
for voluntary and community organisations... not the end in itself," the
National Council for Voluntary Organisations (NCVO) will say. "We need to ensure
a balance between this and our wider role in supporting and promoting civil
society." David Brindle
Monday May
30, 2005 The Guardian
- Nick Mathiason on the rise of a new form of enterprise somewhere between a
charity and a business.
Sunday July 24, 2005 The Observer
- The large-scale transfer of public services to the voluntary sector is
imminent but, as Tash Shifrin reports, the move could undermine the public
perception of charities.
Wednesday July 27, 2005 The Guardian
- How to best deliver public services is one of the major preoccupations of
the Labour government's third term. Commissioning services from a range of
different providers seems to be the preferred answer. Whether in health,
education or offender management, there are numerous proposals for changing the
role of the public sector from being a direct provider to being a commissioner
of services from the commercial or
voluntary and community sectors.
Wednesday November 2, 2005 The Guardian
- Experts give their view on the success of the voluntary sector Compact in a
roundtable discussion.
Wednesday November 2, 2005
- Nearly 800 NHS nurses and therapists in
Surrey have formed themselves into a
John Lewis-style employee-owned company and will find out this Tuesday whether
they can sell medical services to Surrey Health Authority. The new social
enterprise, Central Surrey Health, is set to take the first large-scale transfer
of key services to an employee-owned organisation within the NHS. Nick Mathiason
Sunday November 13, 2005 The Observer
- Care for carers. Congratulations on
Anushka Asthana's article on home
carers (News, last week), highlighting the extremely difficult and vital role
they play in our society. This is a stressful and heroic job, due to become even
harder if state-funded support for carers is to be frozen. When it appears that
we are approaching a period of national debate over the balance between taxes
and spending, it is useful to be reminded of the human cost of cuts in public
funding. In an area where support is already inadequate, local councils would be
better focusing their efforts on delivery of care rather than penalising
families that need more, not less, support. Matthew Kirk London SE16
Anushka Asthana's searing report throws a sharp light on the
government's current mantras for the NHS: choice and contestability. It believes
that it can create more choice for patients by opening up NHS services to
private providers. The result is that attention and resources are diverted
largely to short-term conditions which can be treated quickly and profitably by
the private sector. Severely damaged children and other difficult patients, and
their carers, are offered no choice at all, and the meagre help they receive is
cut even more. That is the kind of thing that happens - inevitably - when the
NHS is driven by choice, rather than need. Richard Heller London SE1.
Letters to the Editor Sunday November 13, 2005 The Observer
- Fears over side
effects of charities' links with
pharmaceutical industry. Pharmaceutical
companies are donating sums of money to charities and patients' groups that
lobby for certain drugs to be available on the NHS. The decision of NICE to
restrict the provision of Alzheimer's drugs to those with a moderate form of the
condition was condemned by the charity For Dementia. For Dementia used the
public relations consultancy GCI Healthcare to publicise its views, another of
whose clients is Shire, the company that makes some of the drugs in question.
Similarly, the public relations consultant for Women Fighting for Herceptin
previously worked for Roche, the drug manufacturer. Charities and the companies
are not obliged to reveal details of donations and services exchanged. Summary by Keep our NHS Public
of Financial Times 24 January 2006
- Blair pledges to
help voluntary groups compete to run services. Tony Blair has promised an
action plan to create fair competition for the voluntary sector when bidding for
public service contracts. Blair said: "We must remove the remaining obstacles
that prevent the sector helping us reshape services around the needs and wishes
of the public." The Association of Chief Executives of Voluntary Organisations
says the sector is hampered by short-term contracts, bureaucracy, a reluctance
by the public sector to pay the full cost, burdensome monitoring, and tax and
VAT rules. Summary by Keep our NHS Public
of Financial Times 6
February 2006
- Trust attacked
over nursing contract scheme. The private sector has attacked the move by
East Elmbridge and Mid-Surrey PCT to allow its nursing staff to form a
not for
profit company and sell their services back in a £20m a year deal. The private
sector says the contract was not put out to tender and the retention of NHS
pension rights by the staff gives them an unfair advantage. 700 staff have
formed Central Surrey Health, one of the first examples of the kind of social
enterprise the government is so keen to encourage in the emerging market of
providers. Norman Rose, director-general of the Business Services Association,
said that while the PCT had no legal obligation to put the contract out to
tender, their failure to do so means that value for money could not be tested.
And because the staff are being allowed to stay in the NHS pension scheme, Rose
said that "if this contract ever is put out to tender on renewal, this new
not-for-profit company would still win because its total costs would be
artificially lower." Private, public and voluntary sectors all complain of the
absence of a level playing field and see themselves as disadvantaged. Michael
Dixon, chairman of the NHS Alliance called for an end to "preferential
contracts" for the private sector in IS-TCs, "where commercial companies are
being paid more for the same work than the local NHS provider, or even being
paid when they do not deliver treatments they were contracted to do." He also
said private sector companies could afford the costs of making lots of bids for
GP services where individual GP practices could not. He said: "There are worries
that private sector providers may underbid to win contracts because they can
afford to, only to raise their prices sharply later." Summary by Keep our NHS Public
of Financial Times 7
February 2006
- Patient care jobs
face axe. Seventy voluntary car drivers could lose their jobs taking
patients to
Shropshire hospitals and care centres after the county ambulance service
lost a £1.5 million transport contract. Instead Shrewsbury and Telford Hospital
Trust and the area's PCTs awarded the contract to the private sector.
Summary by
Keep our NHS Public
of
Shropshire Star 5 April 2006
- Children with cancer
and leukaemia are among the frontline victims of sweeping cuts being forced
through to contain the health service's ballooning
financial deficits,
nurses' leaders warned last night. The
elderly and those with
mental health problems are also suffering, with the closure of beds in
community hospitals and the reduction in numbers of
specialist nurses needed to treat
them. Nurses' leaders yesterday published a dossier of examples to back their
claims and said their research disproved ministers' assertions that trusts are
seeking to balance their books without any detriment to patient care. The
warning came as Patricia Hewitt, the health secretary, came under widespread
attack for
claiming yesterday that the NHS had just enjoyed its "best year ever". In
a speech to Unison's health conference in Gateshead today, Ms Hewitt is
expected to offer a stark message that the NHS must "modernise
or die". As part of a coordinated fightback she will say that, after the
additional resources put into the service by Labour over the past few years,
the NHS was now "back in business". Beverly Malone, general secretary of the
Royal College of Nursing, roundly denounced Ms Hewitt, saying that if this was
the best year for the NHS she dreaded to think what a worse one could be like.
Drawing from RCN research, she gave examples of how patient care was being
affected in second tier services for the vulnerable. Among the examples were:
- Children with cancer and leukaemia in Taunton,
Somerset, are no longer being treated by a community nurse because the
local primary care trust withdrew funding it had promised to the
cancer charity CLIC. The children now
have to make long journeys for treatment, wrecking their chances of continuing
a normal life in their own community.
-
Avon and Wiltshire mental health trust has cut the number of beds by more
than 65 to less than 40. The frail and vulnerable have to go further afield
for treatment.
- In the
Cotswolds, 80 community beds have been closed within the last three months
to reduce deficits. A similar number have been lost in
Felixstowe.
- Ward closures in
Skegness has led to patients having to travel 40 miles to Lincoln.
- Minor injuries units are being closed and opening hours reduced.
Dr Malone said: "NHS deficits are hitting patient services; to claim
otherwise is simply wrong. These are real services for real people with real
illnesses, and we have got to stop treating them as statistics on a balance
sheet." Yesterday it emerged that Downing Street received a report from his
delivery unit last week pointing out that prospects for reaching 11 of the
government's 28
health targets by 2008 were poor. The Department of Health declined to
name the 11 targets that received "red traffic lights", but it was understood
they included public health
objectives such as improved sexual health and reduced children's obesity. John
Carvel and Tania Branigan
Monday
April 24, 2006 The Guardian
- Pain but no
gain. According to the Guardian: "The shockwaves [of the
deficits crisis] are
being felt by health service partners, notably
social services
and voluntary organisations contracted by
the NHS to deliver services. According to the Association of Chief Executives
of Voluntary Organisations (Acevo), valuable statutory funding for charities
is being delayed or withdrawn in an effort to ease NHS budgets in the short
term. The result, it says, is that many services run by voluntary groups are
being left overstretched or are even vulnerable to closure."
Summary by
Keep our NHS Public
of
Guardian 10 May 2006
- The price of
everything. David Janner-Klausner argues that introducing a
market into local health provision can in theory
increase user 'choice'. But in
practice the most likely result is that a few giant firms will end up running
all the services in ever-larger areas. He writes: "There is a risk that the
mechanisms introduced to increase choice will
harm the very communities
that Le
Grand argues would benefit most from it. The point is not only to provide
choice, but also to understand the nature of it, including who the operators
are, whom they employ and whether the competition between them will be real…The
reality will be the emergence of a small number of suppliers, awarded
ever-larger contracts. A similar consolidation has taken place in the bus market
following deregulation…For smaller companies, training, innovation and
participating in bidding processes costs proportionately more than for larger
ones. If they need to invest to fulfil a contract, they are likely to be
considered a risky prospect by lenders because their income streams are not as
diverse as those of larger providers. If they are
charities, their ability to assume risk is
even more limited…if commissioners try to include knowledge-sharing clauses in
contracts, they are likely to find that contractors put a price on sharing their
intellectual property with competitors, if they are willing to do so at all.
This will make market-based provision more expensive and will slow down
innovation when the goal is to speed it up…Since the government is committed to
developing local markets, the likely outcome is that larger companies will have
the edge. Furthermore, commissioners will be tempted to get together and offer
larger contracts, as this can cut costs. Smaller companies will lose out and
agglomeration is almost inevitable. The impact on costs and quality of outcomes
is unclear to say the least.
Summary by
Keep our NHS Public
of
Public Finance 12 May 2006
- Social
enterprise funding pledged by Government. The Department of Health has
pledged to help GPs set up not-for-profit organisations to help fight off the
challenge of private providers. Social enterprises are one of the options
available to GPs who want to set up an umbrella organisation bringing together
several practices to help win NHS contracts.
Summary by
Keep our NHS Public
of Pulse 12 May 2006
- Nurse
entrepreneurs appeal for ministers' help. A group of nurses employed by
Surrey Heath and Woking primary care trust are hoping to mirror their East
Elmbridge and Mid Surrey colleagues and set up a 'community interest' company
to take over their PCT's provider services. According to community services
lead nurse Liz Altheridge, 750 staff currently employed providing services for
the PCT are signed up to the project, but resistance from the PCT plus
difficulty in accessing pump-priming funds is blocking their progress. The new
company will provide all community nursing and health services and would take
control of the local community hospital if it won the contract from the PCT.
Summary by
Keep our NHS Public
of Health Service Journal 18 May 2006
- Pioneering
nurse entrepreneurs course loses government funding. The Department of
Health (DH) will not be renewing funding for a flagship course designed to
help entrepreneurial nurses set up and run social enterprises. From the 2006/
07 academic year, nurses on the ground-breaking course at the
University of Oxford's Saïd Business School will have to pay around £2,000 in
fees. Cheryl Kernot, director of the Social Entrepreneurs Working in
Healthcare course, said: "There is a complete mismatch between government
rhetoric on social enterprise and action."
Summary by
Keep our NHS Public
of Nursing
Standard 6 June 2006
- Nurses like
social enterprise but also want
NHS pensions. Almost
three-quarters of nurses are interested in working for a social enterprise,
according to an RCN survey on the not-for-profit models of provision. An RCN
online survey of nurses found that three-quarters of nurses are interested in
working for a social enterprise, but 86% said they would not transfer unless
they were able to keep their NHS terms and conditions and pensions as a
minimum. Colin Beacock, RCN policy adviser, said that most of the participants
in the survey probably already had an interest in social enterprise, and that
it showed that even those who were pro-social enterprise were worried about
pensions, duration and content of contracts for services and the commitment to
staff training and nurse education.
Summary by
Keep our NHS Public
of
Independent Nurse 20 June 2006
- Tony Blair will today signal a big expansion in the voluntary sector's
provision of public services, saying he will remove all barriers, rules and
bureaucracy that hold the sector back from competing fairly for public
contracts. In a signal of intent, he will say that the sector should play a
bigger role in the provision of a £220m contract to supply NHS community
equipment, such as wheelchairs. Patrick Wintour
Thursday June 22, 2006 The Guardian
- Health staff
have snubbed switch to social enterprise, says union. Plans to transfer
thousands of NHS staff into new free-standing "social
enterprises" received a setback yesterday when their union said staff at a
Surrey primary care trust had voted firmly against such a move. Unison
said 84% of district nurses, health visitors, therapists and others who were
scheduled to be transferred into a new business, Central Surrey Health, at the
end of July, had voted against the idea. The project has been seen as a
trailblazer, with the Department of Health setting up a social enterprise unit
to help other primary care trusts do the same. The department wants the NHS
and PCTs to concentrate more on the commissioning of care, with staff to be
supplied increasingly by new forms of social enterprise, private contractors
and free-standing foundation trusts rather than being employed by the NHS.
Under Central Surrey's plans, 800 staff would form a not-for-profit
partnership, which would be at risk of profit and loss, that would contract
back the services they currently supply to GPs and patients. Unison's claim
that the idea had been decisively rejected was challenged by East Elmbridge
and Mid Surrey PCT, which contended that only 40% of staff had responded.
However, Karen Jennings, head of health for Unison, said staff had delivered
"a massive vote of no confidence". Unison would, with other unions, be
considering options including legal action and industrial action if the
primary care pushed ahead with the transfer.
Summary by
Keep our NHS Public
of Financial
Times 28 June 2006
- Community
hospital cash depends on 'local backing'. The Department of Health wants
acute and primary care trusts to use a series of 'marketing tactics' in
consulting local populations on the future of community hospitals. In order to
gauge fully public opinion, trusts will be urged to abandon "poorly attended
town hall meetings" in favour of consumer surveys and face-to-face events with
"local people randomly invited from the electoral register". The DoH guidance
will tell the NHS to use marketing techniques commonly used to check, for
example, which car people plan to buy or how much they spend on their phone
bill. The DoH said private companies or
public-private partnerships
would be encouraged to invest capital into community services, and that the
NHS would be encouraged to form joint ventures with the
charitable and not-for-profit sectors to
develop community services. Summary by
Keep our NHS Public
of Health
Service Journal 6 July 2006
- Cash crisis?
We'll just have to raise it. Staff at one mental health service, the Young
People's Service (YPS) in
Cambridge, which is earmarked for closure in the autumn, are refusing to
let their unit become just another statistic. Led by consultant psychiatrist
Shankarnarayan Srinath, YPS staff have decided to try to raise the cash
themselves to keep the service going. Following a consultation with the
primary care trust, YPS staff accepted that Cambridge City and South
Cambridgshire PCT is unlikely to reverse its decision and, in response, have
taken the highly irregular step of applying for charitable status. Summary by
Keep our NHS Public
of Guardian
12 July 2006
- Surrey social
enterprise prepares for launch. England's largest so-called 'social
enterprise' offering healthcare services will launch in shadow form on 1
August. Seven-hundred community and primary care staff will then transfer from
East Elmbridge and Mid Surrey primary care trust to Central
Surrey Health when it officially launches on 1 October - provided it meets
five conditions. The company was set up to take over £250,000 worth of primary
and community services by two of the PCT's directors after the government
announced it wanted to reorganise primary care last year. The new company must
now demonstrate that it is committed to the PCT's turnaround plan projects, it
has taken full advice on public consultation, its board has the full 'range of
competencies' necessary, it is 'engaged with staff and local GPs' and its
business plan is bearing practical fruit.
Summary by
Keep our NHS Public
of Health
Service Journal
27 July 2006
- Clinicians
launch community ENT. A group of 150 GPs, practice nurses and managers
have set up a social enterprise venture in an attempt to protect NHS services
from being 'picked off' by the independent sector. City and Hackney ELIC (East
London integrated care) has been set up as a community benefit society. It
is due to start work within the next few months, initially offering
community-based ear, nose and throat services for patients from across the
City of London and Hackney. Project manager Paul Haigh said: 'GPs thought that
it was very much better to be working together to provide locally driven and
run services rather than having private sector companies like UnitedHealth or
others picking off services.' ELIC receives income under practice-based
commissioning and under the terms of its charter may only plough profits back
into improving the service locally. It is also supporting schemes to allow all
its members to get involved in the practice-based commissioning of other
hospital services and is developing new clinical pathways to speed patient
care. Local residents will also be invited to become members from next year.
The start-up costs totalled around £60,000. As ELIC is not yet recognised as
an NHS organisation, should it expand and wish to take on employees, these
would not benefit from NHS terms and conditions. Haigh said: 'This sort of
thing could seem very daunting for people in the NHS who have no experience of
setting up companies. The private sector has its own in-house lawyers and is
engaged in business ventures all the time.'
Summary by
Keep our NHS Public
of Health
Service Journal
7 September 2006
- GPs unite
against private sector. Around 100 GPs in east
London have banded together to form a social enterprise to help fight off
the threat from private providers. East London Integrated Care (ELIC) will
also provide management support for practice-based commissioning and develop
GPSI services for GPs in Hackney. The organisation, launched last week, has
been set up as a community benefit society, meaning its profits can only be
ploughed back into health services. All bar one of Hackney's practice-based
commissioning consortiums have signed up to the scheme, which is not open to
private providers. Dr Clare Highton, a ELIC steering group member, and a
Hackney GP, said the scheme reflected the "long history of working together"
in London's East End. She said: "When bidding against Mercury Health you do
have to have a slick business case."
Summary by
Keep our NHS Public
of Pulse 8 September 2006
- Nurses to leave
NHS and sell services back through limited company. About 700 nurses and
therapists are to quit direct employment with the National Health Service and
sell their services back through a mutually-owned limited company. A
Surrey primary care trust has finally decided to go ahead with the
ground-breaking three-year contract, thought to be worth about £20m a year, in
spite of trade union opposition and criticism from the private sector that the
deal has not been put out to tender. Central Surrey Health "goes live" on
October 1, East Elmbridge and Mid-Surrey PCT confirmed yesterday. It is the
first significant creation of a new "social enterprise", formed by NHS staff,
to take the risk of leaving the NHS to sell their services back to it, in a
move the Department of Health is encouraging. Central Surrey Health will
operate a little like a John Lewis-style partnership, with staff owning the
company, which can make profits but will also risk going bust. Staff will not
be paid dividends, but could receive a bonus, with profits being reinvested
into the business. To get the deal started, staff are being allowed to remain
members of the NHS pension scheme, and are being transferred with existing
terms and conditions protected, including pay rates set by the NHS's new pay
restructuring deal. Patricia Hewitt told a meeting of the Social Enterprise
Coalition there was "huge potential" for such social enterprises to "un-leash
the potential of staff within the NHS to deliver better services for
patients". But the move has been strongly opposed by some of the health
service unions such as Amicus and Unison, which see it as further evidence of
the government's desire to break up the NHS. The Business Services Association
has criticised the deal as being anything but "fair, open and transparent".
Norman Rose, the BSA's director-general, said the primary care trust "is doing
a cost deal with its own staff. I don't see how it can know whether it is
getting value for money".
Summary by
Keep our NHS Public
of Financial
Times 14 September 2006
- Charity accuses
government of withholding cash to balance books. A leading
charity has accused the Department of Health of
keeping back a payment of almost £4m in order to
pay off its own debts.
The Community Service Volunteering scheme has been due £3.7m since last April.
The situation has prompted charity chiefs to warn that they are prepared to
take the government to court over its failure to hand over money promised for
services delivered by charities. Capital Volunteering helps volunteers to give
assistance to people with mental health problems and also supports people with
mental illness who want to take on a volunteering role as part of their
recovery. The project now faces closure unless the money comes to light.
Summary by
Keep our NHS Public of Guardian
20 December 2006
- Extra £70m to
be pumped into health and social care. Over £70m is to be used to support
social enterprises in health and social care over the next four years. The
move was announced by Ivan Lewis, the health minister, as the Commons public
services committee said it would be launching an inquiry to look at the "costs
and benefits" of the government's use of voluntary and not-for-profit
organisations. The department of health may also be challenged by private
providers to put out to tender a number of contracts among 25 "pathfinder"
social enterprises which it is supporting. Representing key private sector
providers, the NHS Partnerships Network has already accused the government of
improper procurement procedures over the granting of a contract to seven
hundred nurses and therapists to leave the NHS and re-provide their services
as Central Surrey Health, without laying the contract open to competition from
other providers.
Summary by Keep our NHS Public of Financial
Times 25 January 2007
- Nurse steps in
over axed blood tests. Nurse Pat Brady is
launching her own blood test clinics - weeks after being made redundant by
the NHS. Mrs Brady was the only member of staff forced out of a job when
Coventry Teaching Primary Care Trust controversially decided to scrap its
community blood test service. Mrs Brady said: "I came up with the idea when I
was talking to an elderly lady a few weeks ago and she told me she had been to
the new hospital and the trip had cost her £25 in a taxi. I thought starting
my own service out in the community could help people like her." Mrs Brady
said she and many of her colleagues had been sad to hear the service was being
scrapped. But she believes the decision will become such an extra burden on
the hospitals and cause so many complaints that the service will be
reintroduced in the future. About 500 people are protesting about cuts to the
blood test service in Cheylesmore. The clinics were cut back as part of a bid
by the PCT to save £10.5m. From next week, people will have to attend either
University Hospital, Walsgrave, for blood tests, or a unit on the Coventry and
Warwickshire Hospital site, in the city centre.
Summary by
Keep our NHS Public of Coventry
Evening Telegraph 26 January 2007
- NHS volunteers
'not about cuts'. An NHS trust in
Surrey says a hospital volunteer scheme which will see people helping to
feed patients is not a cost-cutting exercise. Members of the Epsom and Ewell
branch of Age Concern have adopted the Roseberry Ward at
Epsom Hospital. It
means trained volunteers can provide a "befriending service" and help with
feeding. Health campaigners said they hoped it would not lead to staff cuts.
Dr John Lister, from the pressure group Health Emergency, said he could
"understand why public-spirited people want to help their local hospital", but
he hoped their "good intentions and goodwill" would not be used to save money.
Summary by
Keep our NHS Public of BBC
Online 5 February 2007
- More funding
for new social enterprises. Social enterprise organisations are set to
receive a further cash injection in the government's comprehensive spending
review. Department of Health social enterprise lead Julie Dent, currently
seconded to the Social Enterprise Coalition, told delegates at a conference
that 'extra revenue' would be made available to aspiring social enterprise
organisations when the government announces the review later this year. Last
month the DoH announced a £73m fund to be given to start-up social enterprises
in health and social care.
Summary by
Keep our NHS Public of Health
Service Journal 15 February 2007
- After Eden,
things look rosy in the social enterprise garden. So far, relatively few
social enterprises in the health and social care field have won contracts to
deliver NHS services, although there are a small number of fairly
well-established examples. South East
London Doctors Co-operative, a non-profit-making limited company owned,
managed and financed by 460 GP members, provides out-of-hours services for
around 900,000 patients in Lambeth, Lewisham and Southwark.
Sandwell Community Caring Trust is a charity that runs residential and
respite care and supported living programmes for people with physical and
learning disabilities in the West Midlands, and the Kath Locke Centre in
Manchester was the first NHS primary care facility in the country to be
run by a social enterprise. In September 2006, health secretary Patricia
Hewitt (who worked in the not-for-profit sector before becoming an MP, and
while trade and industry secretary established a new legal structure, the
'community interest company', to help such bodies) wrote a pamphlet setting
out why social enterprises should play a greater role in 'unleashing the
potential of staff within the NHS to deliver better services to patients'. The
community foundation trust model, currently under discussion by the Department
of Health and Monitor, could offer one means to redesign services. Another
approach, Ms Hewitt suggested, was to find ways to allow the NHS to routinely
contract with, or set up its own, social enterprises - for example to deliver
services organised around care pathways such as stroke, diabetes or other
long-term conditions, and perhaps to work in joint ventures with charities and
voluntary groups. Already there is no shortage of social enterprises keen to
enter the NHS market. In October the DoH's social enterprise unit invited
applications to become 'pathfinder' social enterprise projects. It got more
than 400 responses in six weeks. The 25 winners, announced at the January
conference, will receive DoH backing up to a total of £1m to help them develop
NHS-commissioned provision ranging from services for specific patient groups,
like dementia patients, to wider activities encompassing primary and community
care across whole districts. Ian Carmichael, a former primary care lead at
South West strategic health authority, is now on secondment to set up one of
the pathfinder social enterprises, the
Forest of Dean Health Enterprise Trust, which aims to take over the
running of two community hospitals and become an 'umbrella provider' for the
area's 80,000 population. He said: 'To make our ideas into reality we need to
employ a lot of staff, and we're going to need a way of giving them access to
NHS terms and conditions or it won't work. As a temporary solution, secondment
might be the answer but even that is fraught with problems so this is
certainly something that needs sorting out from the centre.' At least one
social enterprise - Central
Surrey Health - has managed to find a way of keeping its staff in the NHS
pension scheme while delivering services on a contractual basis, albeit
without having gone through a formal tendering process. The nurse and
therapist-led mutual limited company took over a three-year, £60m contract to
supply community services including speech and language therapy to East
Elmbridge and Mid-Surrey PCT in October 2006.
Summary by
Keep our NHS Public of Health
Service Journal 15 February 2007
- A bridge
between patients and policy-makers. Concerns have been raised about how
charities and the NHS are working together on the ground. The government is
championing the notion of a patient-led NHS. A consultation document published
last June, A Stronger Local Voice, outlines the need for more patient
involvement in health. But there are concerns about how this is working on the
ground and controversy, for example, about primary care trusts' failure to
adequately consult the public over decisions to put GP surgeries out to
competitive tender. Charities can bridge the gap between the public and the
policy-makers by helping people to articulate their grievances in coordinated
campaigns ti get ministers' attention. A thorny issue exists around charities
accepting donations from the pharmaceutical companies manufacturing the drugs
at the heart of some patient-led campaigns. For example, two charities at the
forefront of the Herceptin campaign - Breakthrough Breast Cancer and
Cancerbackup - all receive funding from Roche, which makes the breast cancer
drug.
Summary by
Keep our NHS Public of Guardian
21 February 2007
- Health service
staff consulted over changes.
Hull Teaching Primary Care Trust is putting proposals to split its
commissioning and service provision arms to staff for consultation from today.
The plans include setting up a social enterprise company to provide services
such as sexual health and district nursing. The company will be called City
Healthcare Partnership Ltd and will be able to bid for contracts and exercise
control over its own finances, choosing how to invest any money it makes.
However staff must be consulted before the move is made. Andrew Burnell, PCT
director of provided services and nursing, who will head the new company,
said: "The Government wants PCTs to look at their provided services and
improve value for money and productivity. Social enterprise in the NHS uses
business as its core principle. We can be adaptable and take risks. We will
make money, but we can invest any surplus back into staffing, the business or
the community. This could put Hull on the map. Out of the first group of PCTs
nationwide, we are one of the biggest, with 1,200 staff."
Summary by
Keep our NHS Public of Hull
Daily Mail 22 March 2007
- Minister backs
social enterprise model in healthcare market. Social
enterprises-businesses for which the bulk of profits are reinvested in the
community-will be one of the keys to transforming health and social care in
the next decade, claims the health secretary, Patricia Hewitt. Ms Hewitt was
speaking at the launch of Healthy Business, a publication from the Social
Enterprise Coalition, which describes nine social enterprises already
operating successfully in health care. They include an out of hours GP
service, a nurse run general practice, and a community led primary care
centre. The government has put increasing weight behind encouraging new
providers into the health market. Last year's Our Health, Our Care, Our Say
white paper on primary care identified social enterprises as an important
means of raising quality and stimulating innovation.
Summary by
Keep our NHS Public of British
Medical Journal 30 March 2007
- £1m company to
tackle inequalities in North West A company established to deliver better
public health for people across the North West is set to launch in the next
few months. NHS North West
is planning to pump £1m into a community interest company in an attempt to
improve the health of its population and stem the tide of rising health
inequalities. The strategic health authority hopes the company, under its
'living better, living longer, caring more' campaign, will develop a
region-wide health programme supported by a social marketing campaign. NHS
North West is currently recruiting a programme director to run the company and
will bring together stakeholders from public sector organisations across the
region to form a board. In a briefing paper to the SHA board, director of
public health Dr Ruth Hussey said 'leadership and direction on health messages
would be best accepted from an independent organisation', as public confidence
in what are seen as government messages is low. The company will run the
public health programme over four years, focusing on obesity in its first
year. According to the briefing paper the programme also aims to: transform
public sector approaches to communication with the public about health; build
capability for improved communication with the public and private sectors;
engage the public and private sectors in understanding the health impact of
key policies and strategies in order to facilitate policy change; measure and
disseminate the impact of the programme through research and evaluation.
Summary by
Keep our NHS Public of Health
Service Journal 26 April 2007
- Hospices hit by
new fees rule. Hospices with charitable status are to be charged the same
amount of regulation fees as NHS or private sector providers. Help the
Hospices says that the Healthcare Commission's decision is unfair because
hospices will not be able to recover the costs, while other sectors can.
Summary by
Keep our NHS Public of Times
22 May 2007
- Clean conscience. When one council [Leeds]
could no longer deliver on its home care promises, it turned to social
enterprises to do the job - with tidy results. Fay Wertheimer
Wednesday May 30, 2007 The Guardian
- Changing faces. As national Volunteers Week begins today, Simon
Teasdale looks at the changing profile of volunteers in the NHS.
Friday June 1, 2007 SocietyGuardian.co.uk
- Project to encourage diverse range of NHS volunteers. Ed Miliband,
Minister for the Third Sector, and Ivan Lewis, Health Minister, launched a
£265,000 scheme to open NHS volunteering to a wider range of volunteers by
getting under–represented groups involved – especially young people and those
at risk of social exclusion.
Care & Health 8 June 2007
- Voluntary
hospital car service distress.
Devon Primary Care Trust has announced the complete withdrawal of the
subsidised voluntary hospital car service in a statement reminiscent of
Orwellian Newspeak. It reads: "Devon PCT has been working closely with South
Western Ambulance Services Trust (SWAST) and partners from the voluntary
sector, Devon County Council, patient representatives and other health trusts
to provide a more equitable service with a local focus for local need." It
continues: "The new arrangements are being put in place to ensure fairness and
give patients access to a wider choice of travel options." These words are
meant to inform the public that from now on they will have to pay 40 pence a
mile to community transport groups to get to hospital instead of a flat rate
of £4 or £5. The "more equitable service" providing a "wider choice of travel
options" consists of "public buses and trains". Although discussions have
taken place between the trust and local community transport associations (CTAs),
sources say that the trust broke these off, effectively leaving the CTA's to
deal with the problem alone. Some patients have already been unable to afford
up to £40 for a roundtrip and many volunteers are being put in a difficult
position in providing the service.
Summary by
Keep our NHS Public of North
Devon Journal 14 June 2007
- Voluntary sector and the dangers of hype. The report reveals that
voluntary organisations are not as good as the rhetoric would have us believe.
It is a truth universally acknowledged that a government with a public service
is in need of a charity to make its delivery more flexible, responsive and
customer friendly. But a report today from the National Consumer Council (NCC)
blows apart the belief that voluntary organisations show higher levels of
responsiveness. Alison Benjamin
Wednesday June 20, 2007 The Guardian
- Choose or lose out. Contracting for public services means a culture
change for charities - and it will not be easy. Adam Sampson [chief
executive of Shelter]
Wednesday July 18, 2007 The Guardian
- Social Enterprises and the NHS- changes patterns of ownership and
accountability. Doubts about the long term viability of social enterprise
groups within the NHS are raised by new research.
Care & Health 24 July 2007
- Main points of the third sector review. The final report of the
government's third sector review sets out measures to build on partnership
with the third sector and feed into the upcoming comprehensive spending round.
Tuesday July 24, 2007 SocietyGuardian.co.uk
- Hospices 'face
funding struggle'. More than one in four charitable hospices is now in
deficit as funding promised in the government's 2005 manifesto has failed to
materialise. A study of 186 of the UK's 194 charitable hospices has found that
many are struggling as the amount of government money they receive as a
proportion of their spending has fallen for the last three years, despite the
manifesto pledge to double the funds available. In England the figure stands
at 32%, having fallen from 34% in 2004 and 33% in 2005. The figures also
reveal that the amount received varies massively - from 62% to nothing. Help
the Hospices chief executive David Praill said: "We are asking the government
to deliver Labour's election manifesto commitment to doubling the amount given
for palliative care as a matter of urgency. Charitable hospices provide the
majority of in-patient palliative care services as well as a range of day
care, hospice at home, bereavement support services and training for doctors
and nurses. We are not asking for 100% funding, but we do need the government
to cover the cost of services that the NHS would otherwise have to provide.
The donations we get from charity fundraising activities in local communities
are already badly needed and cannot be stretched to cover core NHS
responsibilities indefinitely as well. The situation will only worsen with an
ageing population and more and more of us living longer with terminal illness
- this issue has to be addressed now." Unison head of health Karen Jennings
said: "The hospice movement is a unique service which has led the way in
palliative care. They receive fantastic support from many relatives who raise
funds for the service, often for years after the death of a family member. But
they cannot survive on fundraising alone." A Department of Health spokeswoman
said that funding for hospices was part of a strategy being developed on end
of life care. "We appreciate the immense contribution that the voluntary
sector continues to make to specialist palliative care," she added. "We are
also aware of the concerns some in the voluntary sector have around funding
for specialist palliative care."
Summary by
Keep our NHS Public of BBC
24 July 2007
- The difference is clear. Social change comes from the demands of
people. After a year talking to hundreds of third sector organisations as part
of our review, I am more convinced than ever of the sector's essential role in
helping to make social change happen. Ed Miliband
Wednesday July 25, 2007 The Guardian
- How capitalism got a conscience. The third sector, which ploughs
profits into social goals, is worth £8.4bn a year. Marianne Barriaux
Wednesday July 25, 2007 The Guardian
- Clarity needed
on 'stealth' social enterprises. Social enterprises working with the NHS
have become unaccountable and bureaucratic as they become distanced from their
community-focused roots, academics have warned. The first published study into
social enterprise in the health service, carried out by Durham University and
commissioned by Unison, highlights concerns over the changing role of the new
organisations - considered to be third sector groups using business-like
strategies. The study says they are "disconnected from their roots in the
co-operative movement, community-focused businesses and regeneration
activities". They are being ever more widely defined as organisations that put
surpluses back into the health community, to include foundation trusts or even
private firm BUPA. This has led to confusion and lower public accountability,
and financial concerns are compromising the organisations' original mission.
The study says: "Responsiveness to the local community could be lost in the
search for viability in a competitive market or through services being
provided by multinationals. Collaboration and sharing of good practice could
prove difficult in an increasingly commercial and contractual environment."
Launching the report, David Hunter, professor of health policy and management
at Durham University's centre for public policy and health, said social
enterprises "are not a panacea." "The danger is that as contracts replace
grants, social enterprises will become risk averse and heavily bureaucratic,"
he added. "It's a policy that's been rushed through in great haste, without
thinking through some of the key elements of accountability. This has happened
by stealth, without any sort of public discussion. Many people don't know what
social enterprises are." Unison head of health Karen Jennings said: "There are
concerns that the traditional programme of social enterprise may be undermined
by the great emphasis on business elements. Contractualisation means social
enterprises that don't have a great deal of experience may go under or be
taken over." Commenting on the report, King's Fund director of policy Jennifer
Dixon said: "Social enterprise is an attractive label that many new providers
will want to claim and there is a need to be clearer about what the
characteristics are. Social enterprises must have some social purpose at heart
and should be reinvesting any financial surpluses to support that aim."
Summary by Keep
our NHS Public of Health
Service Journal 26 July 2007
- NHS staff face
shake-up. Some 1,200 staff could leave the NHS to sell their services back
to it in
Hull, which includes the Yorkshire constituency of Alan Johnson, the
health secretary. The City Health Care Partnership would become the largest,
mutually owned, not-for-profit social enterprise to be spun out of the health
service so far, with staff joining a community interest company. Key issues,
such as whether staff will still qualify for NHS pensions, have still to be
resolved. Ivan Lewis, the social care minister, will announce the opening of a
fund that will provide £73m of loans, grants and equity capital in the next
four years to assist new social enterprises. The cash is available for both
NHS and care services, with one part of its goal being to encourage primary
care trusts to become chiefly commissioners of services, rather than
providers. However, of more than 25 early "pathfinders" that the health
department financed with £1.4m last year, only four involve NHS staff leaving
to sell their services back, according to the department. It is the approach
taken by 650 nurses and therapists in central Surrey that is the biggest such
social enterprise to be launched to date. Other projects see charities, new
entrepreneurs or partnerships involving the NHS or social services creating
projects to provide a range of services from mental health to nursing and
midwifery, as well as organisations that help refugees, or people with
long-term conditions, in the community.
Summary by
Keep our NHS Public
of Financial
Times 17 August 2007
- Big cash boost for social enterprise. A new Department of Health
(DH) social enterprise investment fund is to pour £73m over the next four
years into organisations providing health and social care services in local
communities. The fund is part of the government's push to expand social
enterprise in health and social care provision, outlined in the 2006 white
paper Our Health, Our Care, Our Say. The cash will be used to start, set up
and build social enterprises that meet specific health and social care needs.
The care services minister, Ivan Lewis, says the launch of the fund follows
the success of a £1.4m pilot project this year that tested the capacity of
social enterprises to make a tangible difference in neighbourhoods across the
UK. Community Docs for All, one of the enterprises taking part in the pilot,
is setting up a locally managed primary care service in
Weston-super-Mare. Annie Kelly
Wednesday August 22, 2007 The Guardian
- Charities call for Compact to expand role. When the government
launched the Compact Commission and appointed the first compact commissioner
last year, ministers promised it heralded the start of a new dawn in the
relationship between local government bodies and their voluntary sector
partners. Less than a year later, the commission is floundering. In June,
Angela Sibson quit as chief executive. Now its head, John Stoker, the compact
commissioner, has resigned. It is difficult to see how it will now effectively
pursue its first work programme, launched with a fanfare by Mr Stoker and the
then minister for the third sector, Ed Miliband, in April. There is a terrible
synergy between the current state of play at the commission and the failure of
the compact itself to live up to expectations. Annie Kelly
Wednesday September 12, 2007 SocietyGuardian.co.uk
- Second thoughts. We must keep religion out of public services, says
Andrew Copson. In the welter of comment on public service reform, a dramatic
change that has passed largely unnoticed is a massively increased role for
religious organisations in the provision of statutory public services - an
area of the welfare state that has long been secular. In our new report,
Quality and Equality, the British Humanist Association highlights the threats
this entails. It is not just that Britain is overwhelmingly and increasingly
non-religious, and that services provided this way present a total mismatch
between policy and reality, but that the policy opens up severe gaps in legal
protection for service users and employees, and threatens social cohesion in
years to come. The law protects workers from discrimination on the grounds of
religion or belief. But equality law allows for religious organisations to
claim exemptions from duties not to discriminate, and the TUC and others have
cited concerns. Pecan, a previous contractor with Jobcentre Plus, was heralded
only this week by government as suitable to take on work with offenders.
Pecan's equal opportunities policy states that, "to maintain Pecan's Christian
distinctiveness to serve the aims and objectives of the charity", it will only
hire staff willing to sign up to the Evangelical Alliance "Basis of Faith",
regardless of the position they are applying for. In Scotland, CrossReach,
with a budget of £45m largely from local authorities, requires serious
Christian commitment from nearly all employees. Public sector staff
transferred to organisations such as these will find their career prospects
damaged unless, for example, they participate in prayer meetings at work and
follow a religious lifestyle at home. Not everyone will be affected, but the
government plainly wants religious organisations to take on large parts of
Jobcentre Plus and of the National Offender Management Service, so tens of
thousands of staff are at risk. Service users too may suffer. Unlike citizens
served directly by a public body, those receiving that same service from a
religious organisation under contract are not legally protected against
discrimination on grounds of religion or belief under the Equality Act 2006,
nor do they have protection under the Human Rights Act for rights such as
freedom of belief, privacy and sexual relationships. Some religious
organisations in the line up for contracts are explicit that they do not want
to be bound by human rights law. The Salvation Army, which already delivers
large parts of the welfare system in Australia, told parliament's joint
committee on human rights that "whilst it is appropriate for the state to be
religiously neutral, this is impossible for an organisation such as the
Salvation Army, which delivers its services as a direct outworking of the
Christian faith." With no evidence to support its view, the government claims
to believe that religious organisations add value and provide better outcomes,
simply because they are religious. Yet their policy threatens to ringfence
thousands of public service jobs for religious believers, just as one in three
senior posts in schools are already ringfenced, and to undermine the rights of
service users and employees. Wholly secular public services are the best
answer, but without it the law must be reformed to guarantee that all
deliverers of public services are held to the same basic standards of equality
and human rights. · The Quality and Equality report can be downloaded at
humanism.org.uk. Andrew Copson
The Guardian, Wednesday December 5 2007
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