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Blurring the lines - does the NHS need traditional charities?

Fundraising | Daniel Fletcher | 16 Nov 2009

Recent developments in health care help to further confuse traditional organisational boundaries, with potentially challenging consequences for fundraising.

PCT Provider Divestment, a catchy term that was the subject of a report from The King’s Fund in April 2009 is driving some of the change. Basically, Primary Care Trusts, that part of the NHS that up to now has run GPs, community nurses, sexual health clinics, etc, are splitting their roles in two. The PCT part is focussing on commissioning what care should be given, and the provider part is being separated off, in the form of a separate organisation. The theory being that it’s more accountable for the organisation with the money not to be the organisation that gets paid to do the job.

The interesting implication for civil society is that some of these provider arms are not going to be typical, statutory NHS organisations. Some, such as Central Surrey Health, and Your Healthcare in Kingston, are independent social enterprises. Hull PCT is currently working to hive off its provider arm into a CIC, a community interest company, to be creatively known as City Health Care Partnership.

To add to this splitting of traditional boundaries, both the Tories and Labour are touting proposals that health and education bodies should be run with local communities or local groups and charities involved in the control of services. This all harks back to a pre- NHS era, when a number of education and hospital charities were set up to improve their communities.

So, how does this trend analysis influence fundraising? I think it has to do with what the public understands by ‘charity’ - a concept that historically engenders great trust, and which acts as shorthand to persuade donors to give to a cause that resonates sufficiently. For example, hospital fundraisers will often use the proposition that a donor should give to their charity, so that it can provide the extras to help the NHS go one step beyond its statutory responsibility. But, what happens when the charity and the NHS provider are the same? Does it matter if the public don’t know whether an NHS lozenge means run by the state, run by a CIC or for that matter run by a private company? 

The same issue was newsworthy recently when the Department of Health tried to enforce an accounting rule for NHS charities’ accounts to be included with those of their respective hospital.

The question is - does it matter who runs an organisation, if it is doing a good job and spending money on a good cause?  Does it have to be a traditional charity, or does any old model work?

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