My Mother rang this morning with sad news. A very close member of the family, my Father's life long friend, John Hughes, died last night. John and his family were always a part of our lives and both he and his friendship with Dad were legendary. They were both characters that lived life to the full. John was the local vet, my dad the GP and their kindly ministries just about covered the needs of the village. When I was about Katie’s age, I remember them staying up all night to attend to my guinea pigs that had been attacked by the neighbour’s dog. This was, of course, the perfect excuse for them to drink all night, but when I awoke in the morning to news of Posy’s death (Rosie made it), having them both there made all the difference. Funnily enough I was thinking about John last night whilst listening to my friend Stephen Bubb, of acevo and Martin Brookes of New Pilanthropy Capital, slugging it out on Radio 4. Martin reckoned people should make moral judgements about how they give their money with children taking precedence, over say, ballet. Stephen talked of his 98 year old Auntie, fond of giving to animal charities, who would take a very dim view of being lectured to do otherwise. I thought of Val, John’s lovely wife who died 4 years ago and who requested that instead of flowers we all gave to her favourite donkey sanctuary. John and Val really loved animals, living in a veritable Noah’s Ark for most of their lives. Each to their own ehh?
The dreary thing about age is the accumulation of goodbye’s in contrast to the diminishing hello's. This process is supposed to make us wiser and kinder but it doesn’t alway work. Listening to people talk of the Big Society or the Good Society, I think of my upbringing. My father, Dr Bill Ogden dedicated his whole life to public service. As a GP he was not brilliantly well paid and worked extraordinarily long hours, doing night duty for the majority of his 50 year career. He was still doing visits on the day he died, aged 76. The services he provided included over 1000 homebirths, helping those less able to keep up with their paper work so that they could maintain independent lives, performing minor operations at the local cottage hospital and always, always taking responsibility. In retirement he moved to an urban London practice to teach, which he loved, but he did not agree with the increasingly risk averse culture that saw GP’s referring minor ops, like ingrown toenails, and felt that the move away from GP home visits increased the distance between doctor and patient.
I wonder what Dad would make of social enterprise in health care? I think he would like it as he preferred models that prioritised responsibility and enabled medical practitioners to make real connections to patients. Today we have a really good piece in Social Enterprise with Francis Maude Minister to the Cabinet Office visiting Central Surrey Health. They are a great social enterprise who have innovated health care and offer a cost effective service. Francis is quoted as saying he wants to see the majority of health services delivered in that way in 10 to 15 years time and if the Government can support the transition so that neither patients nor staff lose out, (pensions, commissioning etc) I think he may get his wish.
Our latest contribution to this debate is Transitions, which as Third Sector reports this week is flying out the door with over 4000 going out and agencies like the National Audit Office loading it up to their data base. I am off now to meet yet another local authority CEO, my 3rd this week, to look at Transitions and see where they can use it within the council strategy to meet the demands of austerity and outsourcing. Some think we are advocating privatisation and I am quite clear that we are not. At present local authorities have two stark choices, cut and kill or privatise. The social enterprise lobby are offering a third possibility, that of outsourcing to a staff led/owned entity that maximises social value, looks and feels like a public service but offers value for money and a significant degree of mutual independence. I think of Dad, pouring John a scotch just about now, and I think he’d approve.