Co-operative Fortnight

"The consensus was that employee / worker owned offered an alternative delivery for the NHS but it was not a panacea"

No. The panacea would be letting the taxpayers keep their own money and letting the free market operate. Just as it does for the other essentials of life such as food, shoes and clothes.

In England the United Kingdom Coalition Government has specifically mentioned co-operatives as one options for the running of public services. In that respect The King's Fund conference was addressing one aspect of the Government’s programme:

“We will give public sector workers a new right to form employee-owned co-operatives and bid to take over the services they deliver. This will empower millions of public sector workers to become their own boss and help them to deliver better services.”
(The Coalition: our programme for government, Cabinet Office, London, Section 27, page 29).

In that same section of the Government programme there is a reference to co-operatives more generally, albeit alongside other types of enterprise:

“We will support the creation and expansion of mutuals, co-operatives, charities and social enterprises, and enable these groups to have much greater involvement in the running of public services.”
(Same reference as above. The extracts quoted are Crown Copyright.)

For the National Health Service (NHS) it is clear – and subject to what may be in the Health Bill 2010 – that co-operatives could be an option, but that “employee-owned” co-operatives need not be the only option. Indeed the governance of existing NHS foundation trusts is a multistakeholder model, borrowed in part from the co-operative sector.

In order for the NHS to fully explore the options it is important to try to understand what the different models mean. The co-operative sector has over 150 years of experience of running enterprises in all sectors. As I said on the day, co-operative membership is voluntary. Several speakers also talked about the importance of democracy. And co-operatives all have to adhere to the seven principles agreed by the International Co-operative Alliance. Millions of people in health and social care co-operatives around the world do so already.

It is also crucial for clarity about who controls a public sector service. NHS foundation trusts, for example, are not the property of their employees, but have wider accountabilities to the public. Usage of the term “employee-owned” could be taken to mean that the property (intellectual and otherwise) of a health enterprise could be vested in the workers. Is that what the Government intends? Nothwithstanding the successes and the benefits of employee ownership as a motivator and performance enhancer (as Petra Morris highlights) that would have profound implications for the future ownership of such services. And for what might happen to them were a contract later to be lost with an NHS commissioning body, for instance, as one speaker at the conference warned.

For the Government's intentions for England we shall have to await the Health Bill. In the meantime we should all ponder on the question of “ownership” at the same time as pursuing a common goal of improving the NHS for all.

Geraint Day
www.linkedin.com/in/geraintday