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What is the Future for Mutual Providers in Healthcare?

What is the Future for Mutual Providers in Healthcare?. Mutuals Forum 2010. Chris Brophy, Partner Cliff Mills, Consultant. 4 November 2010. Before the NHS. National Health Insurance Voluntary Hospitals Local authority hospitals and sanatoria Mutual society provision. The NHS settlement.

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What is the Future for Mutual Providers in Healthcare?

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  1. What is the Future for Mutual Providers in Healthcare? Mutuals Forum 2010 Chris Brophy, Partner Cliff Mills, Consultant 4 November 2010

  2. Before the NHS • National Health Insurance • Voluntary Hospitals • Local authority hospitals and sanatoria • Mutual society provision

  3. The NHS settlement • Tripartite structure • Nationalised hospitals • General practice • Local authority provision • Permanent organisational challenges • Democratic deficit • “Hidden” funding system – mutual insurance

  4. How the NHS works

  5. Today’s challenges • The modern capability of medical science • Modern expectations of health and “performance” • Increased life expectancy • Self-management of health

  6. Coalition thinking • More NHS Trusts to become FTs • Remove restrictions from FTs • Abolish some arms-length bodies • Create more social enterprises • Create “the largest and most vibrant social enterprise sector in the world

  7. The big questions • Are we really talking about mutual or co-operative organisations? • Or is this just state-ownership or private ownership in disguise?

  8. Membership • What do you think is the relevance of membership both in the emerging social enterprises, but also in Foundation Trusts? • Is it real? • Changing the ownership of a business • But careful about the pace of change • New social enterprises and the unions • Clinicians and management • Membership ideas spreading to other bodies

  9. Elected representatives • Do elected representatives have a genuine role in governance, or is it all rather cosmetic? • Less attention than members and directors • Situations where governors have been crucial • Real contributions: Forward planning • Key in the new social enterprise

  10. The economic link • How can NHS healthcare providers really be a form of mutual body when there is no economic connection between individuals and the services they access, which is free at the point of delivery? • Greater staff and public involvement in providers • Personal budgets and choice • Any Willing Provider

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