Darzi report opens way to a social enterprise model

Charities and social enterprises have been promised a greater role in providing contracts to the NHS under proposals unveiled yesterday by health minister Lord Darzi.

His long-awaited report, High Quality Care for All, gives staff the "right to request" transfer from the NHS to a social enterprise model (Third Sector Online, 27 June) while keeping their pensions.

Primary Care Trusts will be obliged to consider such requests and award each new enterprise a contract to provide services for an initial period of up to three years.

In addition, from spring 2009, each PCT will publish a strategic plan for local healthcare provision, emphasising the importance of links with the third sector and other partners.

Darzi also sets out new responsibilities for third sector groups already working in the NHS. Under a new set of voluntary agreements, between the Government, the third sector and private sector organisations, and known as the Coalition for Better Health, each group will have to commit to providing better health outcomes for the nation.

Third sector groups will also have to conform to the standards of Darzi's new NHS constitution, which sets out what patients have a right to expect from the health service.

"We intend to legislate, as soon as parliamentary time allows, to require all NHS bodies and private and third sector providers providing NHS services to take account of the constitution in their decisions and actions," the report reads.

Ivan Lewis, care services minister, told Third Sector: "We know that social enterprise has the capacity to innovate and do things differently and shift the system to a more preventive approach.

"The reason that the growth of social enterprises has not been as strong as we would have liked it to be is that there were barriers to development, but we have swept those away."

Lewis dismissed the idea that the proposals would benefit new healthcare social enterprises, set up by NHS staff, at the expense of existing enterprises. "You need to look at the work we are doing to encourage and support social enterprise through the £70m fund and the Department of Health's social enterprise unit," Lewis said.

He also denied that taking staff out of the NHS would pave the way for privatisation of healthcare. "New enterprises will be given three years – once awarded a contract – where they won't need to compete," Lewis said. "Should social enterprises be given special treatment? No – and they have never asked for social treatment. They have asked for a level playing field."

Bill Freeman, director of development at Navca, criticised the plans. "We see little point in simply transferring existing NHS staff into new organisational structures and buying back their services, and are disappointed if this is the strongest message about the value of the sector coming out of this review," he said.

"Surely a more genuine commitment to independent non-profit organisations would be characterised by greater investment in local third sector organisations with a track record of service innovation and delivery and a desire to grow."

Freeman added that he hoped the report's call for local user involvement would mean a role for existing local organisations. "We would not favour the creation of more new organisations for this purpose, which would weaken local social capital and cohesion," he said.

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