What should we scale when “scaling up”?

 

This week, Professor Cam Donaldson, Principal Investigator of the CommonHealth project, shares his thoughts on scaling-upeyeball-155174_640

As an economist, I often find myself thinking and saying things that recipients of my utterances might think contradictory to my parent academic discipline. A general example of this is that “we don’t have to put a monetary value on everything that might count within a cost-benefit analysis”. Within the context of our commonhealth research programme, my latest bugbear is going to some meeting on social enterprise and hearing some smart-arse make a comment about scaling up! This is usually a negative comment about the lack of ability of social enterprise to scale up, supported by a statement or implication that scaling up is necessary. It may even be accompanied by a smug look, reflecting on a controversial point well-made (given the audience) as the social enterprise love-in is stopped in its tracks.

Me? I just tend to copy the antics of an animated colleague of mine when such points are made – I roll my eyes!

First of all, not only is the point an easy (even lazy) one to make, but also it is factually wrong. There are plenty of examples of very large social enterprises out there; moreover, many of these entities have scaled up whilst staying true to their original missions and principles. They are not hard to find – so just make sure you go to meetings armed with a couple of examples in case the scaling-up bogey person is there.

Second, you might, if there is time, venture into a more philosophical and evidence-based debate with said bogey person. This could go along several lines such as:

  • Dismissing the point by arguing that many social enterprises, by their very nature, are local. In many respects, this is the essence of social enterprise, is it not? We know, for example, that things like social capital and social connectedness are positively related to health and well-being. Perhaps these things can only be generated by the more-intensive, community-based and local nature of social enterprises. It is these kinds of relationships that commonhealth is trying to tease out. As a result, and I am afraid to say, I do not really find myself thinking too much about issues of scale, in its conventional sense, in any of commonhealth’s eight projects. To me, it is a second order issue. Context is everything. So, if a well-functioning and socially-productive social enterprise can scale up without losing the essence of what it does, then, of course, more of this good stuff should be spread throughout society.
  • But, a further note of caution might centre on the argument that that attempting to scale-up social enterprises in terms of trying to impact positively on public health could lead to exacerbating the very same problems that we are trying to fix. Might it be that the NHS monolith is incapable of responding to differing health needs across the UK, thus leaving places with differing health needs (e.g. Glasgow and remote-rural populations respectively) underserved? So, the scale of the NHS, arguably one of the very things for which it is revered, may restrict its success through its lack of ability to get upstream in the ways that social enterprise can.
  • Returning to the issue of still wanting to spread the good stuff around, this brings another question into play – what is it that we want to scale up? There is a much more interesting discussion to be had here beyond just thinking about scaling up in some sort of financial or economic-growth terms. Can we apply thinking about scaling up to other dimensions of social enterprise and what might be the implications of this? For example, it might be that what we need to discover are answers to questions such as how we scale up social capital and connectivity. If the evidence shows that we do indeed want to do these things, the implications then become very interesting, and involve things like trying to create the right environments for economies based on principles of mutuality and reciprocity to flourish. Such flourishing might involve lots of small (social enterprise?) entities operating in their natural (localised) settings. Some, too, might still grow in the conventional manner of scaling up, because that is what is appropriate for them – and we also know that the scale of social problems in some parts of the world (e.g. Bangladesh) are so vast that thinking of scaling up in more conventional ways is more important than, perhaps, the scaling down that might be required in parts of the UK (health) economy. Context, once again, is everything.

The next time scaling up is mentioned, if there is time for the debate to go along some or any of these lines, my eyes will stop rolling and be firmly fixed on the prize!

 

Professor Cam Donaldson