Key measures include a John Lewis-style ‘Right to Provide’ scheme which will enable all staff working anywhere in NHS and care services where it is clinically appropriate to set up as independent organisations to run the services they deliver.
Health Secretary Andrew Lansley told the conference: “For too long staff and patients have seen their local services dictated by Whitehall officials who have never seen the work they do day-to-day. This is wrong and stifles the energy and ambition that all health professionals should have to deliver the very best they can for their patients.
“I’ve heard from many NHS staff over the years that they could run their services better if they were given room to breathe and felt their voices were heard. I want as many of them as possible to come forward now and take more control of the NHS and care services they provide.
“By giving staff real control of their services and patients real choice over who they receive care from we’re restoring the balance of power. This is what we mean when we talk about Big Society — reconnecting people with the services they provide and rely on.”
Even as he was announcing his reforms, health practitioners and co-operators were meeting elsewhere in London to discuss the implications of the plans.
A one-day conference held at the King’s Fund attracted delegates from across the UK as well as overseas experts who set about addressing the practicalities of health service reforms.
The conference, ‘Creating not-for-profit providers of health and social care’ provided a platform for GPs and other health service workers to meet with co-operators and, through debate, presentations and workshops, explore the possibilities for health co-operatives and other forms of social enterprise to be established.
In his opening remarks the chairman of ‘the voice of primary care’ — the NHS Alliance — Dr Michael Dixon admitted to being “an enormous fan of co-operatives and social enterprise,” believing them to be “the way forward for the NHS.”
He also said that primary care had a very good track record in co-operation. “Out-of-hours co-operatives came out of the blue, but within about a year had spread across the country. I regard them as one of the most successful co-operative models we’ve ever seen.”
The policy agenda was explored by representatives of leading think tanks and the Department for Health while the case for co-operatives and mutuals was made by speakers from Co-operatives UK and Mutuo.
The conference also heard from GPs already in the process of restructuring their practices and an international perspective was provided by a speaker from Quebec University.
While it was clear that the reforms being introduced to the health service weren’t universally welcomed there was also a determination from delegates to seize the opportunities they presented.
Meanwhile, Co-operatives UK Secretary General Ed Mayo has given the Government’s proposed NHS reforms a cautious welcome, but says ministers need to make the process “easier and more predictable.”
Said Mr Mayo: “Countries like Japan and Spain have very extensive experience of co-operatives running hospitals and acute services. It’s a perfectly reasonable model and it’s not privatisation, because it’s democratically owned and assets are held in perpetuity but these are businesses and there are risks of failures.
“However there will need to be a radical step forward in the understanding of mutual models among ministers and civil servants for this to succeed.”
A small number of NHS organisations became mutuals during Labour’s time in office and current ministers have cited practices such as Central Surrey Health, which has turned all 770 staff into ‘co-owners’.
However Mr Mayo said these ‘pioneers’ had been “walking through wet cement” in terms of organisation and urged ministers to simplify the process and make it more transparent.
“The devil is in the detail,” he added. “Pensions, procurement, tax, legal matters, security of contract — at the moment there’s an anarchy about this part of the programme and the true test of the Government’s intentions is action, not words.”