The Silver Bullet?
So what does health and social care devolution mean for local VCSE (voluntary, community and social enterprise) organisations? Even more importantly, what does voluntary and community action and enterprise mean for devolution? I think it is probably the silver bullet everyone is seeking. But we are a long way off firing it with any likelihood of hitting the target.
Discussion in Greater Manchester is about devolved leadership to local institutions, people and communities. It’s acknowledged that the public sector can’t solve everything, and there’s appetite for a more equal relationship with an independent voluntary sector. This is very heartening.
The theory is that if people and communities can take on more responsibility for themselves and each other, and if local services are better organised, there will be less demand for acute services and greater levels of positive health, as well as reductions in inequalities, unemployment and poverty. This is good in theory. But we have not yet adequately explored the details of this.
It seems plain to me that this will require voluntary action on a grand scale – if we define voluntary action as “people doing things for themselves and others, by organising into groups with a common purpose”.
There’s certainly great potential, and we can build on considerable strength. The local VCSE sector is already active in health and social care and related areas. Of the 15,000 or so registered organisations in Greater Manchester, about 5,000 are working in health and wellbeing, and a similar number in community development; there’s also a big sports and leisure sector of about 4,000. Our most recent surveys showed that over 90% are keen to help and 58% believe they have the capacity to work in partnership with the state and the market towards common goals.
In Greater Manchester our sector is already grappling with the withdrawal of the state from territory it has occupied for decades. The pillars of the welfare state – universal access to education, healthcare and justice, along with “social security” – are wobbling. Ninety percent of VCSE organisations in Greater Manchester are already experiencing increasing demand and/or identifying new needs they cannot meet. Larger charities and social enterprises have been hard hit by spending cuts.
And we may not have the VCSE sector we need. In parts of the country where affluence is greater and people live longer, the nature of the VCSE sector is different. Research published this week by nfpSynergy http://tinyurl.com/jsunzfg also illustrates a clear linear relationship: the more wealthy the area, the more charities registered. This suggests that in more deprived areas, voluntary action is less structured and less visible – and there may be less voluntary action. That correlates with GMCVO information.
There are three crucial functions for the local VCSE sector in devolved health and social care:
- We have the ability to reach out and engage widely with people and communities, including people whom others might struggle to talk to. 97% of existing organisations say they have the capacity to do this.
- Service providers from the VCSE sector typically offer huge additional social value and will be keen to be involved in the new local care organisations. These organisations are bringing considerable resources of their own to the table. We must be taken seriously as providers.
The third function is least well understood by the public sector, but by far the most important.
- Voluntary and community action and volunteering are hugely significant in creating strong communities. Involvement in them also increases positive health and wellbeing in individuals.
But this kind of citizen-led action is least well-resourced in our most deprived areas, and is everywhere poorly connected to public and private sectors. We are missing a big trick.
We all need to start to think differently.
Firstly, we need to stop operating in “partnerships” and start to understand ourselves as a single system. What if we were to radically renegotiate the relationships between public, private and voluntary sectors, tackling our “wicked” socio-economic problems together with each sector playing to their strengths?
Secondly, we need to acknowledge the need for transformation within the VCSE sector itself. What if we were to take a really strategic approach to developing a stronger VCSE sector, based on emerging understanding and evidence of how to do this?
As a VCSE sector I believe we have a moral obligation to rise to the devolution challenge. That means non-profits need to move into socio-economic development at neighbourhood level, using social enterprise methodologies and collaborating across “sectors”. We need more plain old charity, offering a safety net in times of crisis. More public money, including public giving and business pro bono must be invested systematically in grassroots voluntary and community action. Importantly, this is not “them and us”: all residents should be both actors and beneficiaries; all local institutions should play a part.
Alex Whinnom, Chief Executive, Greater Manchester Centre for Voluntary Organisation