How to Improve NHS Healthcare
Improving healthcare has been the subject of much discussion for the past decade. An Oxford report on how to encourage employee engagement and increased public benefits in the NHS adds new substance to the debate.
The Centre for Mutual and Employee-Owned Business (MEOB), based at Kellogg College, Oxford, released a report of a parliamentary seminar held on 18 December, 2009. Entitled A Mutual Health Service,’ the report looks at the Foundation Trust model for hospitals, whereby hospitals effectively become mutual businesses owned and governed by stakeholders including patients, the local community and employees. The report’s lead authors are Professor Jonathan Michie, Director of the Department for Continuing Education at Oxford and director of MEOB, Professor Chris Ham of the University of Birmingham, and Cliff Mills, a solicitor and an associate of MEOB.
The NHS is Europe’s biggest employer, with around 1.3 million staff. The report looks at key issues including how to develop the mutual model to better engage this vast workforce. Foundation Trust hospitals are one type of mutual organisation, with patients and the local community having representation and a voice, as well as employees - but the report says more needs to be done to make the most of this type of structure.
The report’s recommendations deal with the twin issues of providing greater involvement for hospital stakeholders such as employees on the one hand, and ensuring pay correlated to performance without a financial-sector-style bonus culture on the other. Its key recommendations included the call for political parties to commit to greater use of mutuality and employee ownership to better connect public services with their users, as well as a reform of the current pension system, which makes it difficult for mutuals to hire new staff with any protected pension provisions.
The report says that greater use of mutuality and employee ownership within the NHS would enhance employee engagement and provide better services to patients. This cannot happen without support from the government, however, and none of the political parties have specifically addressed this key provision yet. David Cameron has pledged support for 'John Lewis' style delivery of public services, but the report states it is important for users such as patients to have a stake, not just employees such as doctors.
Professor Michie said: ‘Mutuals and employee-owned organisations are answerable to their customers and employees, rather than to external shareholders. Is this the way forward for delivering public services? Perhaps, but it won't happen unless support is given. And it's no good creating “John Lewis” style organisations that don't engage with the users of the services.'
Political parties support the idea of health workers forming mutuals to deliver services, the report notes, but it recommends the provision of legal and other advice, which could be provided by the sort of unit that advises football supporters’ trusts on taking ownership stakes in their clubs.
The Centre for Mutual and Employee-Owned Business runs educational programmes focused around the area of mutual and co-owned business enterprise, with its emphasis on corporate ethics, community responsibility and long-term sustainable strategy.
Read the full report of A Mutual Health Service.