comment: A big shift in attitude is key if the NHS and voluntary sector are to team up

Published: 03/06/2004, Volume II4, No. 5908 Page 15

The NHS view of the voluntary sector is still dominated by the 'coffee-morning culture' cliché, which presumes charities are amateurish, political and the cheap option. There may also be something in the collective memory that tells NHS managers they escaped from the voluntary sector in 1948 and do not want to return.

People's peer and chief executive of social care charity Turning Point Lord Adebowale believes there is an increasingly compelling reason for statutory bodies to accept a much larger role for organisations such as his (the HSJ Interview, pages 24-25). He gives the example of out-of-area placements, often for very expensive and specialised care, where PCT commissioning managers too often choose the short-term fix. A better way, he says, would be longer-term contracts with proper risk sharing, giving charities stability to go with their expertise and community engagement.

His idea of a voluntary finance initiative (and he apparently 'doesn't care' if some people think the private finance initiative brand has been tarnished) is not new. He has been talking about it for the past three years, on and off. But momentum does seem to be growing.

Former health secretary Alan Milburn has proved an enthusiast. One of his first big speeches after retiring to the back benches was on the subject. The Treasury will be looking carefully at a report on the subject due in September.

Lord Adebowale suggests that much of the NHS's reluctance to use charities is down to a simple lack of imagination. That may be so but trusts will have reasonable concerns. Are all, or even most, voluntary sector organisations as dynamic and well organised as Turning Point seems to be? The profit motive has its faults but ensures a consistency of management quality over time - can charities prove as stable?

And, as Lord Adebowale himself says, can charities overcome their characteristic competitiveness (all the fighting over short-term funds has an effect) and show they can collaborate as effectively as the private sector?