Purpose – The aim of this chapter is to explore the current trend for new ‘mutual’ models of public service delivery as part of a process of personalisation and commodification of health and social care design and service delivery.

Design/methodology/approach – The authors use the thesis of commodification and the concept of value to explore, with the aid of three examples from previous research, the complexity of transfer of large-scale services from local government and health bodies and the potential contribution of co-operatives and mutuals to this agenda.

Findings – Mutuals may provide an alternative to the supposedly inevitable progression to wholly commodified health and social care provision. However, a top-down push to encourage employee-owned enterprises may fail to take account of significant issues: high capital and labour costs; transfer of risk to consumers purchasing services; quality of care assurance; scope and scale of services; and enabling policies and structures to support democratic ownership and control of enterprises.

Research implications/limitations – Although the chapter focuses on Welsh experience, there are implications for the future provision of public services more generally.

Originality/value – This chapter contributes to a growing discourse and critical awareness of co-operatives and mutuals as potential public service providers. In particular, the nature of democratic engagement and involvement; models of co-ownership and co-construction of public services and the role of the State in promoting alternative non-marketised systems of design and delivery for the public good as well as maintaining accountability through local and national democratic processes.

You do not currently have access to this chapter.
Don't already have an account? Register

Purchased this content as a guest? Enter your email address to restore access.

Please enter valid email address.
Email address must be 94 characters or fewer.