NHS Alliance - Semantics of the Big Society


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NHS Alliance - Semantics of the Big Society

  1. 1. The semantics of the ‘Big society’ Social enterprises, mutuals and co-operatives Geraint Day and Mo Girach“When I use a word it means just what I choose it to mean – neither morenor less.” That was what Humpty Dumpty said rather scornfully whendiscussing semantics with Alice at one point during her adventure Throughthe Looking Glass.iThe Brave New World of the United Kingdom Governments plans for theNational Health Service (NHS) in England contain some new jargon whenit comes to NHS reform. The Governments programme for governmentrefers to social enterprises, mutuals and co-operatives, for example: “We will support the creation and expansion of mutuals, co- operatives, charities and social enterprises, and enable these groups to have much greater involvement in the running of public services.” “We will give public sector workers a new right to form employee- owned co-operatives and bid to take over the services they deliver. This will empower millions of public sector workers to become their own boss and help them to deliver better services.”iiHere we give a guide to readers wishing to pursue three of the particularorganisational forms for the running of enterprises within the health andsocial care sectors:  social enterprise,  mutual,  co-operative.A social enterprise is an enterprise that is intended to fulfil a socialpurpose. It may use market-based mechanisms to operate. But its aim isto fulfil a social end. A social enterprise may be a so-called not for profitorganisation. (‘Not for profit’ is usually meant to indicate that there arenot distributions to external shareholders.) It may be a for profit body,where the business profits are applied to achieve one or more social aims.The key thing to bear in mind is that the main intention of a socialenterprise is to not solely to operate commercially but to achieve othergoals, such as specifically social or environmental aspirations.Examples of social enterprises include The Big Issue, the Divine ChocolateCompany, Hackney Community Transport, co-operatives and The JohnLewis Partnership. According to the Social Enterprise Coalition there are
  2. 2. around 62000 social enterprises in the UK, collectively employing about800000 people.iiiPerhaps sounding somewhat circularly defined, a mutual is anorganisation that operates according to the principles of mutuality. Amutual has members. The intention is that the members benefit in someway as a result of the activity of the mutual. Examples of mutuals includehousing associations, building societies, credit unions, friendly societies,co-operatives, employee-owned enterprises (such as the John LewisPartnership), NHS foundation trusts, football supporter trusts and mutualinsurers. According to the policy body Mutuo there are some 20000mutuals in the UK, collectively employing over 900000 people. iv Mutuoreckons that about 35000 people in each UK Parliamentary constituencywho are members of mutuals; about half of the electorate in each.A co-operative is an organisation with members who have a democraticsay in what is done with any profits (usually called surpluses). Co-operatives conform to a set of internationally agreed principles, which are:  voluntary and open membership;  democratic member control with each member having an equal say;  member economic participation;  autonomy and independence from the state;  education training and information for members;  co-operation with other co-operatives;  concern for community.Examples of co-operatives include The Co-operative Group, Midlands Co-operative, and The Phone Co-op. According to Co-operativesUK, there arenearly 5000 co-operatives in the UK owned by 11 million members (abouta fifth of the total population) employing over 200000 people in all. v Theyoperate in sectors including from housing, agriculture, energy, retailing,credit unions, and healthcare. Although they need to conform to the sevenprinciples listed above, they need not contain “co-operative” in their title.Whats in a word?The reader may have noticed that some of the words have cropped upunder each of the three categories of organisation. For instance, creditunions have been mentioned as both mutuals and co-operatives. Co-operatives themselves have been mentioned under all three headings.Without going any further into semantics or setting hares running, theterm social enterprise may be taken to include mutuals and co-operatives.Yet not all social enterprises are either co-operatives or mutuals. Nor areall mutuals co-operatives.When it comes to co-operatives, as has been mentioned, they are aparticular type of organisation with a form and purpose that is understoodinternationally. The origins of co-operatives go back to eighteenth centuryScotland and the nineteenth century England. Their principles and valueshave been agreed by an International Co-operative Alliance comprisingorganisations having a total of over 800 million members.
  3. 3. Please note also that people may be members of more than one mutual orco-operatives. So the employee and membership figures given earliercannot all simply be totted up.As the UK Government has said, public services should concentrate onoutcomes. So dont get bogged down in the jargon. But do try to learnabout the forms – and real examples of – the possible structures that maybe applied to the running of public services.Or, to put it another way, “The question is, said Alice, `whether you can make words mean so many different things. “The question is,” said Humpty Dumpty, which is to be master –that’s all.”iMo Girach is Special Advisor on Social Enterprise and Co-operatives to theNHS AllianceGeraint Day is a specialist in health co-operatives August 2010i Lewis Carroll, Through the Looking Glass, Chapter VI: www.sabian.org/Alice/lgchap06.htm, originally published in 1872.ii The Coalition: our programme for government, Cabinet Office, London, Section 27, p 29, May 2010. See www.hmg.gov.uk/programmeforgovernment. Extracts quoted are Crown copyright.iii Social Enterprise Coalition website: www.socialenterprise.org.uk/pages/about-social- enterprise.html (consulted on 14 July 2010).iv Mutuals Yearbook 2009, Mutuo and Kellogg College, University of Oxford. See www.mutuo.co.uk/wp-content/shared/mutuo-yearbook-2009.pdf.v UK Co-operatives website consulted on 29 July 2010: www.uk.coop/economy/figures. See also The UK co-operative economy A review of co-operative enterprise 2010, Co- UK operatives , p 4, Manchester, 2010.