Lunching with PG tips, GPs and Ambassadors.

A hard old life it is! I have to do all these lunches and people just keep on asking! Perhaps the highlight this week was at the Gherkin; that wonderful Norman Foster tower in the City. 180 metres high and 40 floors, the top 2 floors are a restaurant, bar and viewing platform with stunning views out across London.

See view here;








Good to look down on the Tower of London and remember my goodly ancestor Sir Edward Neville, beheaded by Henry VIII as an adherent to the Roman faith. Always useful to be reminded there are sometimes consequences for speaking truth to power!

But don't think I was just swanning around. I was meeting one of my members , Suzanne Boardman, who runs Twycross Zoo, together with Derek Bishop who as a leadership development consultant has been supporting her through turbulent times.




Photo of suzanne and derek.

Every so often you meet someone who renews your faith in how wonderful our sector can be. Suzanne is one of those third sector CEOs who combine incredible professionalism with a fiery determination to support her cause. In her case the protection of primates. This has led her into battle in gypsy camps in Greece as she rescued dancing bears. And in China. She runs Twycross Zoo which is the biggest collection of primates in the world.

The zoo has a fascinating history. Set up in 1963 by 2 ladies with business flare , Badham and Evans (Evans is still alive - 92- and involved in the Zoo Suzanne tells me). They started with just a few monkeys as pets but then got given more and started collecting. Their chimpanzees are the original PG Tips chimps- so they made enough money on royalties to buy a rectory and start the Zoo!

Suzanne faced a financial challenge from hell when she has started a bold new developement of a visitor and training centre. Then came the Lehman brothers collapse and their investments were decimated. But she reorganised and refinanced and survived. With true grit she said whatever happened she would not allow the collection of animals to be broken up and sent off to who knows what conditions. It's true that one of our distinguishing features is that strong and fierce commitment to our beneficiaries. A third sector CEO isn't just doing a job; they are on a mission. She also tells me she had a severe governance crisis which she survived and transformed.

Incidentally Suzanne tells me their new centre is ideal for board and staff awaydays. You can even have dinner with snow leopards watching you!

www .twycrosszoo.org

And yesterday was a double whammy. Lunch with my old Oxford friend the Irish Ambassador , at the Embassy , and then dinner at the Royal College of GPs. Neil Hunt is their CEO and a member and their Chair is my friend Clare Gerada (another dedicated and fiery woman!).

We need to develop strong links with GPs now they will have a stronger commissioning role. So with a group of my health members and a bunch of their leading GPs we talked about how to maximise links, enthuse GPs about our sector's potential for delivery and patient advocacy.

But this over lunching takes it toll. I was somewhat tired this morning. Hope my Chair is not too harsh on me at my supervision meeting this afternoon !

Oh come on Shirley!

Shirley Williams may be verging on a National treasure but she is totally wrong on competition in the Health Bill as reported in the Guardian yesterday ( so must be true? ) . She is arguing that the entire Part 3 of the Bill- all the competition clauses should be dropped.

This would be a disaster for the country's charities. Many of us are tired of the gross assumption that

# competition is only about the private sector.

# and that citizen choice is not important.

Whose side do the politicians want to be on? The producer or the citizen? Is it not ironic that a respected social democrat is pitching on behalf of a state monopoly against extending choice for the citizen?

Part 3 , as amended after my report on Choice and Competition is about giving life to the NHS Constitution promise of more choice. How do you get more choice unless you have a diversity of providers. Is it fair that the only choice you get is what you are given?

My group spent 3 months reviewing the choice and competition clauses in the Bill. We made a number of important changes which the Government implemented. We said we did not want the entire section 3 of the Bill dropped. We said that there would be advantage in properly managed competition as a means of ensuring diversity and so choice. Trying to go back on all the work of the Future Forum is very frustrating to those of us who spent this time examining this in detail.

So those who support removing "competition" clauses , answer this please. Do you think it is right that when the majority of people at the end of their life want to die at home or in a hospice , they die in a hospital bed ( and at greater cost to the NHS ! ).

Why are we not creating new markets for long term conditions to encourage more charities to expand the work they do supporting and advising citizens to manage their condition? We need integrated services and commissioning to achieve the best

I'm tired of the way this debate is characterised as all about the private sector. I'm fed up that respected politicians who effectively ignore our sector and promote actions that will damage it and the services we provide for patients and citizens.

Let's hope Shirley has been misquoted!

Competition is not a disease.

GIVE MORE

I'm not a morning person. Like my Hound I like a lie in , usually with the Today programme to keep me company! So it was a stretch to make the launch of " Give More" this morning at 8.30 ( and no breakfast- it's not Lent yet is it? ).

This is a brilliant new 12 month initiative to get people to make public commitments to give more time , money and energy in 2012. And to get everyone to talk more about giving.

And as we met a slogan was unveiled on the top of the Post Office Tower just up the way which says , " GIVE MORE".

I was hoping to see Bob Diamond there. If only one of our top bankers made a public statement that they were donating a good chunk of their bonus top support those Communities who are bearing the brunt of our recession. Perhaps the British Bankers Association might like to publicise the campaign? Get their members to talk about their giving.

See their website: http://www.givemore.org.uk/


And I shall be doing that myself!

Mutuals and all that...

A rather good lunch yesterday ( in the sense of food for thought rather than sustenance as it was only boring old sanis! ) at Reform. Reform is one of my favourite think tanks because they promote public service reform with zeal and vigour. And goodness knows that is needed! And of course led by the splendid Nick Seddon.

They had gathered together a strong bunch of thinkers and advocates to discuss mutuals. We had Julian Le Grand to discuss where and why and where we have got to with Government. I was busy taking notes till he mentioned he had done a blog so I thought I'd give you some exited highlights from that. Always good to promote fellow bloggers.

He blogged ,

" We are moving into an era where public services are provided by an increasingly diverse range of providers. Social enterprises, charities, mutuals of various kinds, private firms and professional partnerships: all are of growing importance in delivering social and other services, sometimes alongside, but more often instead of, old-style public monopoly providers. It is therefore important to think about what kind of provider is the most appropriate to entrust with the delivery of public services. A key issue here is one of motivation – or beliefs about motivation. If one believes that everyone in the private sector is what David Hume termed a knave – an egoist concerned only with promoting their own well-being – while also believing that everyone in the public or charitable sectors is a knight – a professional altruist imbued with the public service ethos - then one would prefer public services to be delivered by a public sector, or perhaps a charitable, organisation, for the knavish private sector, driven by the selfish concerns of shareholders and managers, will exploit the informational and other provider advantages inherent in many public sector services to the detriment of the service user.

If, on the other hand, one believes that everyone, whether they work in the public, private or charitable sectors, is fundamentally knavish, then one would be most reluctant to let a public service be delivered by a monopoly of any kind. Rather, it would be better to rely upon a competitive market where each individual's self-interest can be harnessed byAdam Smith's 'invisible hand' to serve the public good. In fact, as we know, in the real world motivations are complex. Everyone, whether in the public, private, charitable or social enterprise sectors, is a mixture of knight and knave – although the balance may vary between the sectors.

So the trick is to harness this complex structure of motivation so as to deliver a high quality service: to construct what elsewhere I have called a 'robust' incentive structure, one with knights and knaves pulling in the same direction to deliver a service that benefits both the users of the service and those who work within it.".

And it goes without saying which side I am on. After all , I'm a knight by definition as well as being on the side of the angels.

Incidentally , a tip to all those who believe champagne is life's finest medicine ( as Napolean said ," in victory I deserve it , in defeat I need it!" ). Tesco have their premier cru on offer for half price. It's a great dry champagne and at a very reasonable price , such that even a third sector CEO could get one! No sponsorship was involved in this Blog!!! Though I'd be open to offers , especially if you drop your promotion of the health lottery and push the National Lottery !

And I opened one for dinner last night at home as I was entertaining Seb Elsworth ( fellow brixton resident).

Europe, women and fire

There is something deeply worrying about the situation in Greece. Is the EU moving in a profoundly undemocratic direction. We should all feel uncomfortable at a democratically elected government being ordered around by undemocratic institutions to protect a currency! There was even a debate on Today with someone suggesting that the government may need to be removed. We have already seen one country ditch its elected government in favour of "technocrats" , whatever they are. Just because they had a clown as a PM there has been less fuss but the point is the same.

Whilst we rightly argue about the bonus culture in the city , the bigger problem is the way in which the EU is moving to put the protection of the single currency above the rights of the people of Greece.

There has been much criticism of Cameron and his stance on women in the boardroom following his Scandinavian visit. I don't share it. It was a welcome intervention. It drew attention to the progress made in Norway since the introduction of quotas.

" There is clear evidence that putting an end to Britain's male dominated business culture would improve performance" he said. He has said an option of a 30% quota may be an option if companies fail to increase representation.

The UK performs badly compared to other countries in the EU. The proportion of women in FTSE 100 is only 15%. One in ten of Britain's biggest companies have an all male board!

In Norway , where they introduced a 40% quota the proportion is now 42%.

Companies could do worse than looking at our sector where a wealth of talent of top national charity CEOs awaits; my starter list for ten are;

Clare Tickell, Fiona Reynolds, Lesley-Anne Alexander, Jackie Ballard, Sue Sayer, Lucy de Groot, Jane Slowey, Barbara Frost, Loretta Mingela, Ruth Turner , Virginia Beardshaw and Anne-Marie Carrie. And there are plenty on others!!!

So head hunters. Get cracking! Happy to put you in touch.

But let's face it, we have seen how resistant finance and top businesses are to reform of top pay and bonuses, do we seriously think they will voluntarily increase diversity in the boardroom. It's time to be bold. Even if we were to adopt a voluntary quota scheme; with naming and shaming the backward lads that would be an improvement. The good progressive companies would set a trend.

And finally , sad news from Charlbury. Our beautiful Parish church of St Mary's had a fire yesterday. Fortunately only in part of one of the side aisles but of course all the heating and electrics are damaged so no services for a while. Perhaps someone in sympathy with the poor old Greeks!

Finally 2 lovely pictures from the snow:

A programme for Europe we can like!

Rupert Evenett , former investment banker and recent Chair of BTCV is also a colleague on the Board of the Social Investment Business. He has recently written an article on the role of social finance for a european journal. I thought it was worth reproducing here.

" Across Europe thousands of social entrepreneurs are combining social values and motivations with business acumen. They are using enterprise as a sustainable platform for effective social intervention. They are active often in large and growing areas where private enterprise can lack the appropriate values fit, for example in community health care and social care or in skills and training for the young. They are innovative and create a public good for the often most vulnerable fellow citizens that they help. And by avoiding the need for subsequent (bigger, more expensive, less effective...) critical and institutionalised action by the state they save money for the public finances – precisely through improving the life opportunities and capabilities of the citizens concerned at the same time.

A “triple bottom line” in the jargon – and good news for empowering citizens in anyone’s language, especially at a time of economic and social fragility.

Of course social enterprise is partly vintage wine in new bottles. Cooperative and other enterprising associations have always been with us. But it’s getting new life from a new generation of social entrepreneurs who are creating a new and exciting prospectus for social investment – and just need access to capital to achieve so much more.

People like Chris Manze of Stone Soup in Nottingham who used an initial £0.5million of scale-up social investment to build what is now a large and broadly spread social enterprise covering social care, training and employment services. People like Jolanta Lacosta of AmbitiousAboutAutism who used £5million of social loan investment to turn a group of portacabins into an innovative leading school for autistic children and is now innovating again with a model for post-school university level education to create richer opportunities for real progression for them. People like Rachel Talbot of Cambridge Citizens Advice Bureau who by creating a social enterprise hub of advice through a £1 million social loan has given a blood transfusion to the idea of civic advice, practically helping individual citizens secure their rights.

And what’s really exciting is that this new wave of social enterprise and social investment has passed a threshold. Not just an idea though still in its infancy, over the past ten years it has become an existing practice with a growing track record. A growing track record of social enterprises showing they have viable business models and, more importantly, the ability to execute them. And a growing track record of risk and return working – of social investors investing in these enterprises and finding the risks are manageable and not as great as you might think. In the UK, social investment loans from different providers yield 5-6% (and payment-for-success innovations like social impact bonds have the potential to pay higher equity-like returns). In the US, funds like the Calvert Foundation’s Community Investment Notes yield individual investors up to 2%. The acceptability of such returns suggests that the risks (and blended returns) of social investment are getting better understood and are no bar to investment.

In short, social investment is now an Emerging Market, with the opportunity like many an emerging market before it, actually to emerge and become a significant economic and social force. And the classification as an emerging market is important because it identifies what needs to be done in a very un-rocket science way. It just needs to be able to keep going in building a track record of successful investment and acceptable risk. Like successful emerged markets before, by demonstrating its risk and return characteristics, social investment can start attracting mainstream investment capital and by taking the “exotic” out of the social can establish itself as a viable if still alternative investment class. Hedge funds followed this route – wouldn’t it be nice to see social investment make better use of the same roadmap?

Still with lots to prove and fragile as well as exciting? Of course. What new entrepreneurial market worth its salt isn’t? This is about entrepreneurs creating something new with all that that entails. And it could be big – in fact needs to be big to address the scale of public need while also diversifying the financing of public good at a time of public financial constraint.

Let’s look at some figures. Bank J P Morgan in its social finance research has suggested social enterprise and charity already contributes 1.5% or £24billion to the UK GDP alone. Their December 2011 survey suggested an expected funds flow globally into social investment of US$4billion. A comparison with private equity and hedge funds suggests a target for social investment of 1-2% of mainstream investors’ portfolios is reasonable (with some aspirationally projecting 5-10% on a ten year view). This is big stuff.

Yet history of course is full of good ideas that deserved to but didn’t flourish. What can we all do to help this social investment market build on early success?

The European Commission has already done a lot to catalyse social investment (look at the creation of the European Investment Fund’s social investment facility) and the UK’s creation of Big Society Capital, for example have an important ongoing role.

But much of what is needed immediately is technical. We need the financial risk and return data across the field of social investment to be collected in aggregate and on a comparable basis – it is this data and not just the individual investment experiences that will finally transform social investment into being an investible alternative asset class. This needs a trade body or government sponsored body to take the work in this area of innovators like the Global Impact Investing Network and apply it tailored to a more regional and local basis. We need social investors to experiment with retail investment products for high and medium high net worth individual investors and with stock exchange listed collective investment vehicles for social investment. And therefore we need the financial regulators across different European markets to acquire the relevant social investment sector expertise (especially if a European passport for social investment comes in) so they are effective regulators but not excessive brakes on this needed experimentation.

We need existing charitable foundations (and crucially their regulators) in different markets to embrace the multiplier benefits of so-called “mission related investing” – incorporating social investment as initially a small percentage of their core investment programmes for their endowments and not just as part of their grant giving – a move which would really catalyse social investment. And we need banks and other mainstream financial investors to see the long term benefits of dipping a toe into this growth investment market that is so different both from established corporate social responsibility grant-giving and from ethically-screened investing.

Returns that are a blend of financial and social returns will be attractive to investors on a financial basis alone in our current low interest rate, yield hungry environment and with social returns - or a public good narrative – on top, the appeal to retail investors is very marketable. Who said good has to be uncommercial?

And this is also an opportunity for Europe to take a leadership role in the new global growth market of “Impact Investing”. If Europe’s financial markets don’t take a lead in this, others will. In Brussels,Commissioner Barnier’s recent conference on social enterprise gave important and forward looking leadership. The time is right. Let’s take our lead from the entrepreneurs themselves and roll our sleeves up to carry on with what is now a practical job of continuing to build this market. "

Healthy lunch!

Today with Phil Collins, the Deputy Editor of The Times. Always a fun thing to do and not just because we were in a splendid Italian restaurant Quirinale in Westminster. Phil is a great wordsmith and brilliant purveyor of anecdote and debunker of political posturing.

As it happens he had a trenchant Op Ed in the Times this morning, " the guardian angels of the NHS are killing it". A useful reminder that some organisations so loudly supporting the NHS were once violently opposed to it. I talk, of course of the BMA who voted by 86 % against the creation of the NHS in 1945. As Phil writes,

" Its worth noting that the NHS is full to bursting with business people already. They work for themselves and buy and sell their practices on the open market. We know them as GPs ".

The saddest aspect of the current row about the Bill is how it distracts from the real challenges the NHS faces. These are;

#How do we extend real choice to citizens and patients?

# How do we empower patients to manage health and care; especially for the 18milliopn people with long term conditions?

# How do radically boost resources to prevent ill health?

#How do we move resources from hospitals to the community ?


And why is this debate being conducted by people who believe that the NHS belongs to the staff who work in it rather than the citizens who pay for it ?

To quote Phil again,

" It is ignorant to suggest that increasing competition or allowing patients more choice is the beginning of the end of the NHS ".

There are thousands of strong charities and social enterprises gagging top play a bigger role. Hospices who want to take people from expensive hospital beds and provide better care for people at the end of their lives. Bodies like Diabetes UK or Macmillan Cancer Care or Asthma UK and Age UK who are gagging to play a bigger role in providing care and support where it is needed most - in the community or at home. And what are we doing. Expanding their role? Encouraging them? No. We are cutting their funding and abusing them by inaccurate attacks on " marketisation ".

The core principle of a universal service free at the point of use if not being challenged.

As I pointed out in my report, the true defenders of a free universal service are those arguing for reform and for a bigger role for alternative providers because the financial challenge is such that, unless tackled now, in a decade we will be forced to debate an insurance based system as the current arrangements begin to collapse. That is the real danger we face, not allowing many more independent providers of health services. Many , like the third sector charities and social enterprises who offer better value for money and a more client based service.

And now for a healthy weekend walking the Hound. Good job she likes the snow!