Co-operative care

Continue reading the main storyRelated StoriesSocial enterprise's plans for NHS hospital Government defends NHS reforms Ministers want to turn the NHS in England into "the largest social enterprise sector in the world". They envisage a network of small co-operatives and mutuals run by doctors and nurses not managers. But would that be a good thing? And is it even practical?

"'Public sector' and 'public service' are not interchangeable phrases," says Geoff Walker, chief executive of Sandwell Community Caring Trust.

"I used to have to deliver the 'public sector' with all the management, admin and local politics that come with that. Now all I do is deliver a service - all I have to do now is keep 700 people happy."

Geoff's organisation is a social enterprise that provides care services for adults and children. Since it started in 1997, it has grown from having 85 staff looking after 62 people, to employing 475 for the aforementioned 700.

It's exactly the sort of thing the government wants to see more of - particularly with the number of elderly people growing and the clamour for more early years intervention rising.

It's all part of the Big Society - but just like other aspects of that idea, there are plenty who think it's, at best, impractical - at worst, downright dangerous.

'Mushrooming'

Co-operatives and mutuals are not new - we've banked with them, shopped in them - but they're far from widespread in the health and care sector.

Continue reading the main story“Start QuoteAt the moment we're in the rhetoric phase”

End QuoteJonathan BlandSocial Business International The exact form varies but in general, such organisations are run and owned by their members, control their own funding and direction, and have clear social rather than commercial objectives.

One that is doing well is Ripplez - a not-for-profit enterprise based in Derby which gives intensive support to teenage mothers.

Chris Tully, nurse and midwife turned managing director, says: "There were 10 of us, including seven nurses, and we took a vote on whether we should do it. It was a risk - plenty of people weren't convinced - but we're professionals and we wanted to prove we could do it."

Ripplez is, in Chris's words, "mushrooming" and has just attracted some philanthropic investment.

"We can spend that money how we choose and we're using it to give our parents more involved in what we do," she says.

"The NHS is supposed to do that - give people a say in their care - but it doesn't really, it just pays lip service to it."

Even in Sandwell though, social enterprise isn't universally popular - there were protests when the Primary Care Trust tried to become one - but Geoff Walker is relentlessly positive.