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NHS, Early Intervention & Social Impact Bonds

Posted: 22/02/2012 15:37

Copious ink is being spilt in the social networks and newspapers of the land on the Tories' NHS reforms. Rightly so. They remind us of not only the gut wrenching impotence of opposition, but of the dangers of on the one hand mindless, on the other purely ideologically driven (and hatred of) public services, and race for profit in the increasing privatisation of precious public services.

It is easy in these circumstances to enter into a mind-set of opposition to all Coalition policies, regardless of their merits. While this may appear tempting, particularly in light of some of the disastrous decisions being made, it would be ill-advised.

Does this mean I am in any remote way an apologist or have a modicum of sympathy for Her Majesty's government? Unequivocally not. However as Rafael Behr rightly reminded us last week; both David Cameron and Ed Miliband have yet to clearly define a benign remedy for the nation's ills.

Canvassing voter's opinions on the doorstep is proving informative with four particular aspects that stand out. First I am not finding an endemic love of the Tories, second there is a widespread mirth and hilarity should the words "Clegg" or "Lib Dems" be brought into the conversation.

Unsurprisingly (and thirdly) voters are wanting Labour to offer viable and credible specific alternatives, but what fourthly is increasingly being said in the doorstep is "stop squabbling and sort this mess out, stop blaming each other, and where a Coalition policy is ok, don't simply oppose".

One coalition policy that I would argue merits deeper consideration is that of social impact bonds. The idea takes the very best aspects of the private sector, with social enterprises providing advance funding to support schemes created and administered by organisations such as prisons and local councils.
In Merseyside, Triodos Bank, Greater Merseyside Connexions Partnership (GMCP) and Business in the Community (BITC) are working together to help young people who are facing social disadvantage. While ventures such as this may end up costing the taxpayer more money if they prove successful, they provide an excellent barometer of success while helping eliminate waste.

But this is about more than saving money and improving efficiency. Early intervention works. The Coalition is stealing our clothes here. We know this from Labour's achievements on Sure Start, investment in nursery provision, Child Trust Funds and other progressive measures the Coalition are busy dismantling. Recipients of early intervention enjoy not only better opportunities, but more of them. It prevents crime, raises education standards and eases pressure on public services that would have had to attempt to deal with the issues that may have befallen those who are most in need.

Not only do social impact bonds help those most in need, they also fit comfortably into Labour's attempt to reclaim the localism agenda. And it is in this manner that the party can differentiate itself over the policy. Currently, it is local organisations, such as social enterprises and philanthropists that provide the funding. But what if we were to be brave, and encourage local business to carry some of the burden. The policy could be tweaked so that targets were more short term and rewarded with tax breaks. Businesses would be allowed to use the schemes as ways of engaging with the local community (and therefore their customers), creating an advertising space that was potentially profitable even before a scheme was a success.

This step would have the advantage of easing the burden on the relatively narrow, and already heavily called upon, sector of social enterprise. It would also lower the schemes' costs, with tax breaks requiring less administrative duties than a repayment through other means.

This idea, of reward for positive social behaviour, can already be seen in carbon trading and in proposals for tax breaks for employers who may a living wage. While the relative merits of these policies are widely debated, offering financial incentive for positive social conduct is a proven tool.

The NHS Bill struggles on, and we will continue to fight it with every last sinew. But not everything this government will do will be as toxic, with the party or the people. We must learn to compartmentalise our vitriol and encourage those policies we know may do some good, improving them, and claiming the credit along the way. It may be the only way we salvage our good work previously in government. Then indeed we start to outline our vision of a Good Society, but that's a discussion for another time.

 

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