Controversies and agreements in the interface between social enterprise and health
1. Controversies and agreements in
the interface between social
enterprise and health
Cam Donaldson
Yunus Chair in Social Business & Health
Glasgow Caledonian University
Presented at Fuse Quarterly Research Meeting
26th January 2016
2. Outline
ā¢ Moving upstream:
ā¢ From third to fifth waveā¦
ā¢ ā¦and in-between
ā¢ The place of social enterprise:
ā¢ Including a bit about Muhammed Yunus
ā¢ What is social enterprise?
ā¢ Why do we need to evidence it?
ā¢ āEvidencingā it: Why? How? Challenges
ā¢ Social finance
4. How do we get to the ācauses of the causesā?
5.
6. āBanker to the Poorā
ā¢ 1965: Fulbright Scholar
ā¢ 1971: Economics PhD from Vanderbilt
ā¢ Post Liberation War: returns to Bangladesh to work in government under
Nurul Islam and then becomes Head of Economics, at Chittagong
University
ā¢ 1976: Lends $27 of his own money to inhabitants of Jobra Village
ā¢ 1983: Grameen Bank (Village Bank)
ā¢ Late 90sāearly 00s: Grameen II
ā¢ 2006: Nobel Peace Prize jointly awarded to Yunus and Grameen
ā¢ Later in ā00s: Social Business
ā¢ 2010: Controversiesā¦
ā¢ 2012ā¦
8. Social enterprise: venturing a definition
ā¢ Primary purpose for the common good:
ā addressing social vulnerability
ā¢ Trading is main source of income:
ā actual or aspiring to
ā¢ Profits used for social/community benefit:
ā not individual benefit
ā¢ Assets locked or held for common benefit
ā¢ Approach includes being a good employer, democratic,
empowering communities, co-operation, social justice
9. What we are not about
ā¢ Replacing the NHS
ā¢ Replacing public health
ā¢ Promoting benefit cuts
ā¢ Corporate social responsibility
But, ānew relationshipā with government in:
ā¢ Not only service provision
ā¢ But also something much more pervasive than that
ā¢ May require subsidisation (e.g. HealthWORKS)
And recognising that:
ā¢ Again, long traditions in European countries
ā¢ The interest is in social vulnerability and ābottom-upā
11. Why do we need to āevidenceā it?
ā¢ Are organisations doing what they claim to
do?...
ā¢ ā¦and what other wider societal benefit
might they engender?
12. Why do we need to āevidenceā it?
ā¢ Are organisations doing what they claim to
do?...
ā¢ ā¦and what other wider societal benefit
might they engender?
ā¢ Seeking government attentionā¦
ā¢ ā¦and perhaps government resources
13. Why do we need to āevidenceā it?
ā¢ Are organisations doing what they claim to
do?...
ā¢ ā¦and what other wider societal benefit
might they engender?
ā¢ Seeking government attentionā¦
ā¢ ā¦and perhaps government resources
But, most importantlyā¦
ā¢ Communities themselves
14. How do we evidence it?
People and studies
ā¢ 3 to 35 people in 5 years; 11 PhDs:
ā Staff, students and interns from Austria, Bangladesh, Canada, China, Egypt,
France, Greece, Italy, Malaysia, Poland, South Africa, Spain
ā¢ Studentships: University; international awards; self-funding
ā¢ Develop people and disciplines: social sciences, health sciences, humanities
ā¢ Smaller studies (funded by Scottish Funding Council) with specific social
enterprises (e.g. Theatre Nemo; WeeEnterprisers)
ā¢ Other small grants (Ā£30,000 from Santander Bank; Ā£38,000 from Glasgow
Council for the Voluntary Sector)
ā¢ Then some ābiggiesā:
ā MRC/ESRC, Ā£1.96m, āDeveloping methods for evidencing social enterprise
as a public health interventionā (CommonHealth)
ā European Commission, ā¬3.17m [ā¬333,425 to GCU], āEnabling the flourishing and
evolution of social entrepreneurship for innovative and inclusive societiesā
(EFESEIIS)
ā Chief Scientist Office of Scottish Governmentās Health Department, Ā£211,000, āFair
credit, health and wellbeing: eliciting the perspectives of low-income individualsā
(FInWell)
18. A WORKING HYPOTHESIS
SOCIAL ENTERPRISE:
- social mission
- trading
- no share ownership
- etc.
ENGAGEMENT
COMMUNITY
Improved
health and
well-being
ASSETS AND DEFICITS
INDIVIDUAL
Social capital
Cohesive/
connectedness
19. Developing a working hypothesis:
Conceptual Framework (Mk 1)
Roy M et al. The Potential of Social Enterprise to Enhance
Health and Well-being: a Model and Systematic Review. Social
Science and Medicine 2014; 123: 182ā193.
20. How do we evidence it?
ā¢ Conceptualisation
ā¢ Systematic review:
ā Social enterprise:
ā¢ as a public health initiative (Roy et al. again!)
ā¢ as an alternative provider of (community health) services
ā¢ in specific roles (preventing homelessness and social isolation)
ā Microcredit:
ā¢ short and longer-term impacts on health
21. How do we evidence it?
ā¢ Conceptualisation
ā¢ Systematic review:
ā Social enterprise:
ā¢ as a public health initiative (Roy et al. again!)
ā¢ as an alternative provider of (community health) services
ā¢ in specific roles (preventing homelessness and social isolation)
ā Microcredit:
ā¢ short and longer-term impacts on health
ā Challenges of systematic review:
ā¢ lack of studies; heterogeneity; comparators
22. How do we evidence it?
ā¢ Conceptualisation
ā¢ Systematic review
ā¢ Populate the model:
ā Qualitative research:
ā¢ Interviews with clients, employees, executives, policy-makers
ā¢ Embedded within organisations (āPassage from Indiaā)
ā¢ Financial diaries with microcredit clients
ā¢ Q methodology
ā Comparative studies:
ā¢ How do social enterprise clients compare with those in other
settings? (homelessness; social isolation; community-based
chronic disease management)
23. How do we evidence it?
ā¢ Conceptualisation
ā¢ Systematic review
ā¢ Populate the model:
ā Challenges with primary research:
ā¢ generalisability; comparator groups; retention
24. What is social finance?
ā¢ Monetary investment in a social policy objective
ā Investor get financial return whilst public services are delivered
ā¢ Conventional view: trying to bring the discipline and resources of private
investment to more āsocialā goods
ā¢ Associated with:
ā debt crisis
ā drive to greater efficiency
ā outcomes-based financing
ā¢ Social investment market worth Ā£190m in UK in 2010:
ā Likely worth a lot more if we include earlier āPrivate Finance Initiativeā
ā āBig Society Capitalā, āInspiring Scotlandā, āSocial Investment Scotlandā
ā Win-win: āopening up serious resources to tackle social problems in new and innovative
waysā (Nick Hurd, UK Minister for Civil Society, 2012)
ā Cabinet Office Centre for Social Impact Bonds
ā¢ Most famous example = HMP Peterborough:
ā Short-sentenced prisoners (less than one year)
ā Investor receives 2.5% return if 7.5% reduction in reoffending is achieved, relative to a
control group
ā Higher rates of reduction trigger higher returns up to maximum 13.3%
ā Met targets, but suspended!
25. Two papers by GCU Yunus Centre staff:
McHugh N, Sinclair S, Roy MJ, Huckfield L and Donaldson C.
Social Impact Bonds: A Wolf in Sheepās Clothing? Journal of
Poverty and Social Justice, 2013; 21: 247-257.
Sinclair S, McHugh N, Huckfield L, Roy MJ and Donaldson C
Social Impact Bonds: Shifting the Boundaries of Citizenship,
Social Policy Review 26: Analysis and Debate in Social Policy
2014: 119ā136.
26. Challenges
ā¢ Measurement and attribution of social outcomes
ā¢ Unintended consequences:
ā Contract terms vs needs
ā Provider types
ā¢ Size and āinvestment readinessā:
ā āshadow stateā
ā āsocial enterprise readinessā
ā¢ Governance:
ā One less link in democratic accountability
ā¢ Further questions about the role of the market
ā Distortion of social priorities
ā¢ Everything is an āassetā: an ideological shift
ā¢ Butā¦evidenceā¦āWays to Wellnessā
27. Keeping in touch
Yunus Centre for Social Business & Health
ā http://www.gcu.ac.uk/yunuscentre/
ā Email: cam.donaldson@gcu.ac.uk
ā¢ Website:
ā http://www.commonhealth.uk/
ā¢ Blog:
ā https://commonhealthresearch.wordpress.com/