The Guardian‘s Patrick Butler offers an interesting response to yesterday’s NHS white paper in terms of its impact on social enterprise. He’s certainly right that the new government’s current conception of what a social enterprise is seemingly treads a fine line between positive woolly-thinking and euphemism.
Butler also suggests there’s currently “an ideological schism in the social enterprise movement about what a social business looks like” between “a laissez-faire view that any company which can prove it delivers social benefit, however loosely, is a social enterprise” and the Social Enterprise Coalition’s view that: “that companies worthy of the name must adhere to certain criteria, recognised in a charter mark“.
I should probably be relishing the fact that this suggested split gives me a rare opportunity to sit round the libertarian bonfire in the ‘laissez-faire’ camp on an economic issue but my position’s actually a bit more nuanced than that – and some of the nuances are particularly relevant when it comes to healthcare.
My problem isn’t the setting of criteria for what social enterprise is. My problem is that this definition should be about ways of delivering products and services, and the social impact of products and services, rather than the legal structures and theoretical constitutional commitments of organisations.
For me, social enterprise healthcare is high quality healthcare, provided free at the point of delivery, on the basis of need by an organisation that operates to an agreed set of ethical criteria in terms of its treatment of patients, staff and the wider community. A not-for-profit company might not do that, a for-profit company that’s constitutionally able to give out more than 50% of its profits in dividends might do that.
I’m not arguing that outsourcing of healthcare is necessarily a good thing – I don’t think that more market competition is the only answer to the challenges facing the public sector – but, given that some of more outsourcing of healthcare is going to be happening, I want the social enterprise movement to concentrate on saying ‘this is what we can make happen that’s better’ rather than ‘this is how much profit we’re not giving away’.