Social Enterprises and the NHS - Unison

Government support was needed so that a critical mass
of social enterprises could get to a stage at which they
could compete. However, the provision of mainstream
services through social enterprises was relatively recent
and it was difficult to know how they would develop or
whether they would be viable. Indeed some interviewees
hoped for a lull after an initial burst of different social
enterprise models, so that there was time for evaluation.
And this is going to take quite a while, because there’ll
need to be evidence built up over time of how the
organisations behave, what it’s like to work in them, and
at the moment, all you can do is point to other public
sector environments where this has already happened
and say well that’s the sort of thing that you could be
looking at (National organisation with an interest in social
enterprise).
Much depended on whether the difficulties previously
described in sub-sections 5.3 and 5.4 could be
overcome.
5.4.2 Social enterprises: impact on the shape of the
third sector
The expansion of social enterprise was likely to be
contingent on developments in the third sector,
described as becoming less reliant on grants and more
focused on social enterprise. There was a difference of
opinion over whether the third sector was keen to
provide mainstream services.
Many interviewees considered that third sector
organisations would need to band together into social
enterprise networks before they could launch
themselves as social enterprises outside traditional
niche markets. There needed to be ‘networks of small
organisations in primary care’, in order to provide more
care in community settings. Social enterprises could
also network with the private sector, with GP-based
services, or with secondary care. As things stood,
however, there was little involvement in providing
mainstream primary care services and little evidence on
which to base views on whether or not they would be
successful in this field. Although the general view was
that social enterprises would maintain their advocacy
role, interviewees differed in their views about the likely
direction of the third sector, the effects of a growth in
social enterprise on the ethos and balance of
organisations, and on the permeability of barriers
between private companies and social enterprises.
Some thought that the majority of charitable
organisations did not want to diversify into mainstream
public services. There was concern about the effects of
competition across the third sector and a concern that
small social enterprises providing niche services should
Social Enterprises and the NHS
5 Social enterprises: views from the field (1) national stakeholders
not be driven out by larger organisations. At the same
time, it was important for all third sector organisations to
develop sensible business strategies in order to survive.
While there could be tensions between large
organisations and preserving a local focus, it was also
argued that innovation was not the sole province of
small and poorly funded organisations.
We sometimes do ourselves a disservice on this by
talking as though we have to be kept on the knife edge
of existence if we’re going to carry on being innovative
and imaginative, and I’ve heard ministers argue that,
you know, very, very short-term funding is the only way
of keeping charities on their toes (NVO representative).
Social enterprises would inevitably become caught up in
competing for tenders against large organisations and
there was therefore a risk that successful social
enterprises would mirror the organisations they sought
to replace, become victims of their own success and
less able to perform their ‘gap spotting’ role.
If you’re really successful as a social enterprise, you will
grow, you will become more corporate, you become
certainly more bureaucratic, you become less nimble
(Union representative).
Others considered that the constitution of social
enterprises and the incorporation of social aims into
governance arrangements would help maintain focus
and that social enterprises would maintain their integrity,
notwithstanding possible growth and development.
The thing that drives businesses to be the way they are
is because they’re making profits for shareholders. If
you don’t have that element of motivation, then you
inevitably will not be like other businesses, you’ll always
be different, and you’ll always be true to the reason
why you’re in the business in the first place (National
organisation with an interest in social enterprise).
However, others saw fluid boundaries between social
enterprises and the private sector, with successful social
enterprises treading a path from the third to the first
sector.
I would hope to see local organisations, especially in the
area we’re talking about, primary care, because I think
they’d be close to where people are. I would expect
some of them to be successful and with their success
to migrate into large successful private sector
organisations (National commentator).
The private sector would not be a passive bystander to
these developments but would be quick to capitalize on
the promotion of social enterprises, and possibly enter
into partnerships with them, a point made by a number
of interviewees.
I think there’s a very clear core of social enterprise from
people who understand social enterprise who protect
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