If Virgin is the answer, it's the wrong question

Prime Minister David Cameron and Cabinet Office Minister Francis Maude welcome Big Society Award winners Central Surrey Health to No. 10. 22 November 2010; Crown copyright

The flagship social enterprise, Central Surrey Health (CSH) has been in the news this week. Having pitched for a £500 million contract, it lost out to Assura Healthcare Ltd, a private company that is 75% owned by Virgin. CSH is considered an exemplary social enterprise for very many good reasons and not just because Cabinet Office Minister Francis Maude has called it his 'pin-up' mutual. It is incredibly well run, innovative, forward looking and inspirational. From the very start, the company was all about being No. 1 at giving the very best nurse-led, caring healthcare to the community. In its journey, CSH has developed numerous innovations in community healthcare and the Government has even gone out of its way to support its progress, including bestowing a Big Society Award in November last year. And so we are all gobsmacked that it has lost out to a big, new, private sector provider.

My friend Patrick Butler, the Guardian's Society Editor, has written an excellent blog http://www.guardian.co.uk/society/patrick-butler-cuts-blog/2011/sep/19/social-enterprise-big-society-gets-reality-check?INTCMP=SRCH  that outlines the issues and I urge you to read it. So I shall not repeat the debate, but I do have something to add.

Today, via Twitter and the Transition Institute (the body we set up with Nesta to promote public sector spin-outs that maximise social value, and which I chair), the debate seems to be swinging between the why bother? camp and the what's all the fuss about? lot. I agree that some social enterprise failure was bound to happen and that not all social businesses were going to win contracts. Fair enough, but this was a top notch social enterprise up for doing what it does best. So what was the question posed by Surrey Health Authority that Virgin could answer better than CSH? Without having all the facts, I am inclined to speculate that if Virgin had the right answer, it was the wrong question.

I hope these issues are debated at the Labour and Conservative party conferences, but I also hope people avoid drawing the conclusion that this means social enterprises or social spin-outs can't cut it. The truth is they can do the job, they can deliver value, but the system of commissioning has not caught up with the new choices and innovations. Until commissioners start asking the right questions, we will get these sort of howlers that are no good for anyone's health, much less vulnerable patients.