Section

New Mutuals

Over the last ten years or so, new mutuals have been established in a wide range of community business and public service areas.

They share common governance features with long established mutuals from the co-operative and financial services sectors. Most importantly, they have emerged from the same roots as their forebears: organisations established by communities to serve communities.

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NHS Foundation Trusts - Governance Review

Peter Hunt of Mutuo and Chris Ham of the Health Services Management Centre, University of Birmingham, were commissioned to review the membership governance of NHS Foundation Trusts. Their report, published in July 2008 gives an interesting insight into how membership is beginning to influence NHS Foundation Trusts.

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What is the role of the Governors of an NHS foundation trust?

Foundation trusts are not only new, but their governance arrangements are novel.

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NHS Reform: Consumerism or citizenship

Reform of the NHS is progressing rapidly, but it is difficult to discern a clear underlying theme or sense of direction of that reform.

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In The Public Interest - The role of mutuals in providing public services

New mutuals have been established in a range of public service areas. How do they compare with state providers and what should be done to facilitate more mutuals?

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Mutual Childcare - Child’s Play

Stephen Burke, Neil Homer, Paloma Tarazona, Kathryn Graham and Cliff Mills

The Government has committed itself to extending the provision of quality childcare and early education services. It recognises that as the economy grows, childcare provision is vital in underpinning the regeneration of our most disadvantaged communities and ensuring parents can find work or appropriate training.

But the Government’s National Childcare Strategy, launched in 1998, is not delivering for all children and parents. Stephen Burke of Daycare Trust and Paloma Tarazonaof Social Enterprise London argue that Community-based social enterprises offer the best hope of addressing the chronic shortage of childcare in the UK.

Child’s Play demonstrates how social enterprises are the most successful vehicles for the provision of childcare to both poor and prosperous communities, and that the development of new stakeholder models may hold the key to affordable, sustainable quality provision for all.

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Community Football Clubs - Back Home

Christine Oughton, Malcolm McClean, Cliff Mills & Peter Hunt

Football in this country is in turmoil. Many football clubs have serious financial problems; several face major threats to there very existence. Although the collapse of the ITV Digital deal last year was largely responsible for creating the current financial crisis, football was already experiencing financial pressures prior to the collapse of that agreement.

Much of football’s pressures are as a result of clubs’ structural dichotomy, which forces them to operate as both football clubs and profit-maximising businesses. This is especially true for those clubs, which are now Public Limited Companies. Clubs have found it difficult to balance the needs of shareholders and fans, and the collapse of the ITV Digital deal has raised new awareness about the corporate governance of football clubs.

The report explores the causes of this crisis and proposes that clubs can strengthen their long-term business foundations by taking a more inclusive approach to there corporate governance.

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Education - Co-operation and Learning

Since it came to power in 1997, the Labour government has made it clear that education is at the top of the agenda. Many reforms have taken place since then, with the most recent legislation encouraging greater engagement with the private sector.

This report argues that education is too important to be left only to state or private sector provision. We believe that there is now a need and an opportunity to develop new solutions and models of service delivery that can unleash the benefits of commitment from a wider range of stakeholder groups. In particular this report draws upon international experience to demonstrate the benefits that derive from the direct involvement in governance of schools of a range of stakeholders and their success in developing a vocationally based curriculum.

Co-operation and mutual enterprise is an under-realised resource for those interested in twenty-first century learning and teaching. It is also true that learning and teaching is an under-realised opportunity for those in twenty-first century co-operative and mutual enterprise.

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Delivering Care on Call

This document seeks to provide a clear guide for Primary Care Trusts and GP Co-operatives considering the future of Out of Hours (OOH) primary care provision.

It builds on the proposals put forward in ‘Care on Call – a mutual approach to out of hours primary care services,’ (Mutuo, January 2004) that new mutual providers may be created to ensure that OOH cover is continued under the new GMS contract.

It outlines the main practical issues that PCTs and GP Co-ops must consider in providing continuing care.

It describes the practical steps to follow in establishing the framework for the new mutual OOH provider.

This includes a methodical approach to dealing with questions around procurement, the establishment of a new corporate entity, and practical issues around the transition of services to the new provider.

The process that is proposed in this document has been road tested with a number of pathfinder projects, where this option is currently being implemented.

Additional information on the mutual sector, the benefits of mutual structures and a comparison between the Company Limited by Guarantee and Industrial & Provident Societies is published in the appendices.

PCTs and GP Co-ops requiring further advice and assistance are recommended to discuss their needs with the partners listed at the rear of the document.

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Care on Call

This publication coincided with the implementation of the new GP contract in April 2004, which meant that doctors were no longer obliged to provide out-of-hours (OOH) cover and could choose to opt out of the service entirely. Under the new contract arrangements, the responsibility to ensure OOH cover is available for all patients, transfers to local primary care trusts (PCT).

This publication seeks to encourage the provision of out of hours cover from local community mutual organisations. New bodies will be established, with a membership drawn from GPs, other healthcare staff, administrative staff, and potentially patients from the local community. Existing GP Co-operatives will also be encouraged to transfer to these new arrangements.

In researching this publication, Mutuo facilitated a number of seminars that brought together representatives from GP co-operatives, PCTs, the Department of Health and the mutual sector. This publication has been informed by the discussions that took place at those events.

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Making Healthcare Mutual

Hazel Blears MP, Cliff Mills and Peter Hunt

Following Alan Milburn’s announcement that the public will be given a key role in the management - and in effect become the owners - of NHS Foundation Trusts, Health Minister Hazel Blears spells out the political philosophy behind the Government’s NHS reform programme. She draws a clear policy between the Labour movement’s co-operative roots and the Government’s new direction, and indicates that the Government is committed to extending mutual ownership across the NHS, into areas such as primary care.

Blears states that the new governance arrangements for foundation hospitals will be modelled on successful mutual and co-operative organisations, placing ownership in the hands of employees and patients and replacing decades Hazel of central State ownership with local public ownership. She illustrates that this reform programme is every bit as radical and progressive as that which created the NHS over fifty years ago, drawing on the traditions of social and community ownership that inspired the founders of the NHS, and placing a premium on local accountability for local services.

Cliff Mills explains why the Industrial and Provident Society model is ideally suited to this new approach to the ownership and governance of essential services, while Peter Hunt puts the proposed reforms in the context of a resurgence of mutuality that has the potential to transform the public sector.