A few recent news articles about the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

Unison: Why we worry about social enterprises in the NHS | Social enterprise network | Guardian Professional

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A quick look at the Right to Request scheme set up by the last Labour government, giving staff the right to ask to form a social enterprise, led to just 20 being established. Very few existing social enterprises were driven by bottom-up demand from staff and in most cases they have voted overwhelmingly to stay in the NHS. The majority of requests were management led, top-down initiatives, where employee engagement was little more than an afterthought. So much so, that Unison called for a free and fair ballot of staff before any new social enterprises were set up.

So how have these existing social enterprises worked out? There’s very little hard evidence of the benefits cited by the government of greater patient choice or more innovation. This pours cold water on government attempts to expand social enterprises, to create in its words, “the largest social enterprise sector in the world’.

The recent Kings Fund report on social enterprises was the result of a survey of a small number of directors and chief executives of social enterprises and foundation trusts rather than staff, as was acknowledged in the report. This also found that some of the aims of social enterprise such as greater staff and client engagement, less bureaucracy and more innovation can be achieved without the upheaval of structural change. Indeed these advantages can be and are demonstrated in many types of organisations and services – public, private and not for profit. They are much more dependent on a culture that promotes and rewards motivated staff, collaborative management and the active involvement of service users.

Even if there was clear evidence that existing social enterprises delivered improvements for patients, the conditions in which they will have to operate in the future have changed dramatically. The first generation of NHS social enterprises were set up when competition was at a minimum. The new breed will be forced to compete in an open market with private companies, under the government’s “any qualified provider” plans. Social enterprises are just another vehicle for the government to drive more competition into the NHS – a move that will ultimately mean patient care will suffer as the race to provide the cheapest service will damage the quality of care.

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Service users doubtful over NHS personal budgets – 8/12/2011 – Community Care

“Deeply engrained clinical, organisational and managerial cultures” needed to change to make mental health services less medicalised and more person-centred if personal health budgets were to work, found a report today by the NHS Confederation’s Mental Health Network, based on a survey of users.

The report follows a poll of professionals by the network, which found social workers and other mental health practitioners were unconvinced that personal health budgets would deliver improvements for service users.

Only a minority of service users surveyed said they would take up a budget, many saying they were confused about what a personal health budget was and were unclear about how it would integrate with similar social care budgets.

This comes with the government planning to roll out personal health budgets from October 2012 following pilots in 68 areas.

The Mental Health Network has urged the government to postpone the roll out, extend the pilot schemes and begin an extensive programme of professional engagement as soon as possible.
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Warnings over staff cuts after negligence costs rise | News | Nursing Times

Cuts to staffing and training budgets have been described as a “false economy” and “short sighted” after new figures showed the spiralling cost of lawsuits against the NHS.

The NHS Litigation Authority’s annual report showed that the number of clinical negligence claims brought against the NHS rose by 32 per cent in 2010-11, to 8,655. The NHS paid out £863m to claimants last year, up from £787m the year before.

Chris Cox, legal director at the Royal College of Nursing, said the figures were no reflection on the safety of NHS care, and warned that there would be a rise in clinical negligence cases if staffing numbers and skill levels were cut back. “It’s short-sighted to think it is too costly an exercise to maintain this level of staffing”, he told Nursing Times.
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