There are a number of interesting points highlighted in the report, which I note (in no particular order or logic) below:
- Employee-owned social enterprises have been spun out to provide services to PCTs since 2008, i.e. prior to the Coalition Government coming to power (para 1).
- Government policy is to “support social enterprises and mutuals spinning out from parts of the public sector” (para 4). This is presumably about much more than the government encouraging the setting up of social enterprises and mutuals as a means to an end, which means that government recognises the added value that such organisations can and do add to the health economy.
- One of the first benefits identified by employee-led social enterprises is of reduced staff absence rates (para 7). I don’t know why, but this always seems to be one of the first measures of success identified by such organisations.
- The Right to Request programme has worked well through having a centrally-run support unit within DH, and that the objectives of the RtR programme are aligned with the wider objectives of the DH (para 9).
By far the most interesting point is raised in paragraph 10:
PCTs approved proposals for spinning out social enterprises where enterprises promised more benefits than the alternatives but did not generally contract for them to deliver these additional benefits.
For me this is part of a wider point relating more generally to third party delivery of services. If, as public bodies and third party organisations (be they private, voluntary or social enterprise sector) wish and claim, third party organisations deliver added value beyond that provided by a “traditional” service, then that added value must be articulated, contracted for, captured and assessed.
I absolutely think it is the case third parties add value; they must continue to drive themselves to demonstrate – both qualitatively and quantitatively – this added value they provide.
In its report, the NAO has taken the view that PCTs and government needs to demonstrate this value; though I agree to an extent, I’d take the view that PCTs and government need to create the space in which third party organisations can demonstrate the added value they create.