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Living Goods, a social enterprise based in San Francisco, has built a network of door-to-door salespeople in Uganda A dose of competition is sometimes what's required to get life-saving medicines and other needed products to urban slum dwellers and the rural poor. Drugs to treat malaria, for example, are a recurring necessity in towns like this one east of Kampala. Uganda has an estimated 478 cases of malaria per 1,000 people per year, one of the highest rates in the world. Infections are treatable with the right drugs, so-called artemisinin-based combination therapy, or ACT. But those drugs...

Allison Ogden-Newton fears that social enterprises with local knowledge will lose out to larger deliverers who can achieve scale The government's target of enabling over one million former public sector staff to achieve mutual status by 2015 echoes the aspirations of many in the public sector who want to carry on doing the job they love and are interested in more independence – but only if the deal is right. For them, the choice between moving, via the TUPE process, to work for a large listed company with a reputation for stacking it high and selling it cheap, or clubbing together with trusted...

Philip Greenhill, managing director of a social enterprise that provides NHS funded community health services, shares his proudest achievement and what keeps him awake at night Describe your role in one sentence I am managing director of a social enterprise that provides NHS funded community health services in east Surrey and parts of Sussex. Why did you want to work in healthcare? I wanted to work in a sector where I could contribute to addressing inequalities in our society. How do you want to see the sector change in the next five years? I would like to see much more integration across health...

Do the reforms create more opportunities, or more challenges, for social enterprises working in healthcare? More than 40 social enterprises have spun out from the NHS under the right to request legislation. With projected turnovers from £400,000 to close to £100m and from four members of staff to more than 2,000, covering single services through multiple complex community provision, this is a diverse and important group. Given this breadth and variety, the Health and Social Care Act 2012 will affect these organisations in many different ways, but the most significant effects have yet to be discovered...

As a private sector company gets set to take over £140m of community healthcare contracts, a local councillor explores what it will mean for patients in Suffolk NHS Suffolk recently announced that it has chosen Serco to run £140m of community healthcare contracts in Suffolk . This includes community hospitals, district nurses, specialist dentistry and a range of other non-acute services. Serco will be working with a variety of partners, among these South Essex Partnership University NHS foundation trust and Bedford Community Dentistry, a community interest company. In my role as a local councillor...

Community providers are being pushed aside as commissioners recognise only those with money, not their track record In any economy, let alone one in recession, capital is king, so it is a primary consideration when contemplating reform of public services. As both the chief executive of Social Enterprise London and chair of the Transition Institute , which supports public services, I am an advocate of those independent providers who offer affordable, quality services with social impact and real accountability. Today we are being asked how we stand on NHS reforms. Through the work we have done in...

There is a growing sense that social enterprises could be fighting a losing battle to gain the confidence of commissioners Public-sector social enterprise spin outs are trying to stay positive in light of last week's news that Assura Medical has beaten social enterprise Central Surrey Health (CSH), to win a £500m local community services contract. CSH, a nurse-led enterprise that spun out of the NHS in 2006, is to appeal against the decision. It currently has a £20m NHS contract in place locally. Assura, which is majority owned by Virgin, has been named preferred bidder for the five-year contract...

Reality lags behind the rhetoric of creating the 'largest social enterprise sector in the world', finds King's Fund report The coalition has pledged to create " the largest social enterprise sector in the world ". However, is the reality living up to this vision? The government has been keen to push the growth of social enterprises across the health sector. This fits with their big society vision and many people welcome the prospect of a greater role for social enterprises in a world where "any qualified provider" can deliver health care. Social enterprises are not...