NHS Alliance - Semantics of the Big Society

NHS Alliance - Semantics of the Big Society

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  The semantics ofthe ‘Big society’ Social enterprises, mutuals and co-operatives Geraint Day and Mo Girach “When I use a word it means just what I choose it to mean – neither more nor less.” That was what Humpty Dumpty said rather scornfully when discussing semantics with Alice at one point during her adventure Through the Looking Glass.i The Brave New World of the United Kingdom Government's plans for the National Health Service (NHS) in England contain some new jargon when it comes to NHS reform. The Government's programme for government refers to social enterprises, mutuals and co-operatives, for example: “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.” “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.”ii Here we give a guide to readers wishing to pursue three of the particular organisational forms for the running of enterprises within the health and social care sectors:  social enterprise,  mutual,  co-operative. A social enterprise is an enterprise that is intended to fulfil a social purpose. It may use market-based mechanisms to operate. But its aim is to fulfil a social end. A social enterprise may be a so-called 'not for profit' organisation. (‘Not for profit’ is usually meant to indicate that there are not distributions to external shareholders.) It may be a 'for profit' body, where the business profits are applied to achieve one or more social aims. The key thing to bear in mind is that the main intention of a social enterprise is to not solely to operate commercially but to achieve other goals, such as specifically social or environmental aspirations. Examples of social enterprises include The Big Issue, the Divine Chocolate Company, Hackney Community Transport, co-operatives and The John Lewis Partnership. According to the Social Enterprise Coalition there are
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  around 62000 socialenterprises in the UK, collectively employing about 800000 people.iii Perhaps sounding somewhat circularly defined, a mutual is an organisation that operates according to the principles of mutuality. A mutual has members. The intention is that the members benefit in some way as a result of the activity of the mutual. Examples of mutuals include housing associations, building societies, credit unions, friendly societies, co-operatives, employee-owned enterprises (such as the John Lewis Partnership), NHS foundation trusts, football supporter trusts and mutual insurers. According to the policy body Mutuo there are some 20000 mutuals in the UK, collectively employing over 900000 people. iv Mutuo reckons that about 35000 people in each UK Parliamentary constituency who are members of mutuals; about half of the electorate in each. A co-operative is an organisation with members who have a democratic say in what is done with any profits (usually called surpluses). Co- operatives conform to a set of internationally agreed principles, which are:  voluntary and open membership;  democratic member control with each member having an equal say;  member economic participation;  autonomy and independence from the state;  education training and information for members;  co-operation with other co-operatives;  concern for community. Examples of co-operatives include The Co-operative Group, Midlands Co- operative, and The Phone Co-op. According to Co-operativesUK, there are nearly 5000 co-operatives in the UK owned by 11 million members (about a fifth of the total population) employing over 200000 people in all. v They operate in sectors including from housing, agriculture, energy, retailing, credit unions, and healthcare. Although they need to conform to the seven principles listed above, they need not contain “co-operative” in their title. What's in a word? The reader may have noticed that some of the words have cropped up under each of the three categories of organisation. For instance, credit unions have been mentioned as both mutuals and co-operatives. Co- operatives themselves have been mentioned under all three headings. Without going any further into semantics or setting hares running, the term social enterprise may be taken to include mutuals and co-operatives. Yet not all social enterprises are either co-operatives or mutuals. Nor are all mutuals co-operatives. When it comes to co-operatives, as has been mentioned, they are a particular type of organisation with a form and purpose that is understood internationally. The origins of co-operatives go back to eighteenth century Scotland and the nineteenth century England. Their principles and values have been agreed by an International Co-operative Alliance comprising organisations having a total of over 800 million members.
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  Please note alsothat people may be members of more than one mutual or co-operatives. So the employee and membership figures given earlier cannot all simply be totted up. As the UK Government has said, public services should concentrate on outcomes. So don't get bogged down in the jargon. But do try to learn about the forms – and real examples of – the possible structures that may be applied to the running of public services. Or, to put it another way, “The question is,' said Alice, `whether you can make words mean so many different things.' “The question is,” said Humpty Dumpty, which is to be master – that’s all.”i Mo Girach is Special Advisor on Social Enterprise and Co-operatives to the NHS Alliance Geraint Day is a specialist in health co-operatives August 2010 i Lewis Carroll, Through the Looking Glass, Chapter VI: www.sabian.org/Alice/lgchap06.htm, originally published in 1872. ii The Coalition: our programme for government, Cabinet Office, London, Section 27, p 29, May 2010. See www.hmg.gov.uk/programmeforgovernment. Extracts quoted are Crown copyright. iii Social Enterprise Coalition website: www.socialenterprise.org.uk/pages/about-social- enterprise.html (consulted on 14 July 2010). iv Mutuals Yearbook 2009, Mutuo and Kellogg College, University of Oxford. See www.mutuo.co.uk/wp-content/shared/mutuo-yearbook-2009.pdf. v UK Co-operatives website consulted on 29 July 2010: www.uk.coop/economy/figures. See also The UK co-operative economy A review of co-operative enterprise 2010, Co- UK operatives , p 4, Manchester, 2010.