A minister has insisted that more NHS employees are eager to ‘become their own bosses’ by running ‘mutuals’ – despite a stark warning that the policy ‘no legs’.
The ‘Big Society’ project – which the government is keen to expand into dentistry services – took a hammering in a report by a Commons select committee.
The £10 million plans would quickly run out of steam without greater Whitehall support, the communities and local government committee found.
Much more effort must be put into providing advice and guidance to those wanting to set up a staff-led mutual if they were to ‘flourish’, its report said.
There should also be more coordinated leadership by the Cabinet Office and banks needed to be better educated on lending to mutuals and co-operatives.
The verdict appeared to back up the BDA’s prediction that dentists would tread cautiously before pressing to delivering care as mutuals – outside the NHS.
At least projects involving dentistry – in Sheffield, Torbay, Northamptonshire and North and North-East Essex – are among the first mutuals given the go-ahead.
However, in an interview with the House magazine for MPs and peers, Francis Maude, the Cabinet office minister, insisted the existing 100-odd schemes were ‘just the beginning’.
Shrugging off the criticism, Mr Maude said: “One of the things which, I think, is going to be a big feature of public service in years ahead is the growth of the public service mutual movement.
‘Groups of public servants spin themselves out of the public sector and set up, in most cases, on their own, but, in some cases, in a joint venture with the private sector or another organisation.’
Mr Maude said people he had met who set up mutuals were determined to ‘never go back’, because of the freedom it offered.
He added that they told him: ‘We don’t have to go through a process, don’t have to get clearance – we just have a contractual obligation to deliver and we need to work.’
Mr Maude argued that the ‘productivity improvements in mutuals are staggering’, adding: ‘A massive boost – it’s very exciting.’
Mutuals run their own budget, lease NHS equipment and the premises where they provide treatment and decide how to organise care without requiring the go-ahead from managers.
Staff will retain their health service pension and – at the start, at least – will probably be able to offer services without tendering and competing for a contract.
Pilot schemes have been offered grants of between £50,000 and £450,000, for start-up costs, staff costs, capital expenditure and business development. Alternatively, 25-year loans are available.
By Rob Merrick, parliamentary correspondent