Think Tank

Mutuo conducts research into many types of mutual, publishing documents that expand our understanding of the sector and outline the potential for new mutual organisations in both public and private sectors.

Thinkpieces

WHAT IS THE ROLE OF THE GOVERNORS OF AN NHS FOUNDATION TRUST?

These are still early days for foundation trusts – or “public benefit corporations” as the Health and Social Care (Community Health and Standards) Act 2003 calls them.

Curiously, this Act created a completely new corporate structure in the context of health legislation. Although now approaching three years old, these novel corporate entities are mere striplings beside their more elderly colleagues, companies and mutual societies, which have been around for 150 years or more and are still evolving.

Foundation trusts are not only new, but their governance arrangements are novel, being based upon two groups of officers (directors and governors) rather than just one (directors alone) which is more common. Co-operative and other mutual societies, on which foundation trusts are modelled, have two groups (elected representatives and appointed professional managers), but the allocation of functions in those organisations is not the same as foundation trusts. It is therefore not surprising that the role of the governor of a foundation trust should be the cause of some puzzlement.

It is healthy to be open and honest about the novelty of these arrangements – there is no direct parallel – and to have an open discussion about how best to make them work. The comments below are intended to assist in that debate, and are based upon working with a number of applicant and authorised foundation trusts, and also with other large mutual or membership-based organisations.

Please feel free to download this article: What is the role of the governors of a foundation trust

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. The Government has committed greatly increased funding to the NHS on the basis that it is accompanied by thorough modernisation and reform. If the aim is to improve the health and well-being of people in England, the health service needs to be designed in a way which is most likely to deliver this objective.

To date, it seems that the reforms embrace both a consumerist and a citizenship approach. The consumerist approach, making use of familiar tools and techniques of the market, has played an increasing part in public sector reform over recent decades, in an endeavour to improve efficiency. Such an approach in the long-term will not result in a system designed for the best interests of patients, nor will it be in the wider interests of communities.

This paper suggests that the citizenship approach is the more appropriate basis for reform of the NHS for the twenty-first century, and that it is more likely to provide a platform to change attitudes towards health issues, and encourage greater responsibility for personal health.

Please feel free to download this article: NHS Reform: Consumerism or Citizenship