Co-operative identity in the world of health care

In November, Turkey staged the Global Conference of the International Co-operative Alliance. Within the context of the gathering, the delegates celebrated the 120th anniversary of the Alliance, while Ms Leroux was democratically elected as the new President of the organisation that represents the global co-operative movement. One of the key issues at the conference was the publication of the Guidance Notes on the Co-operative Principles, as a tool contributing to a co-operative promotional campaign under the slogan “Co-operatives for a better world”.

These guidelines are based on the Statement on the Co-operative Identity approved by the Alliance in 1995, and ratified by the General Assembly of the United Nations in 2001, and by a recommendation of the International Labour Organization in 2002, thereby giving a particular and essential status to the co-operative enterprise.

The example of SCIAS

The declaration mentioned above contains the definition of a co-operative, the values on which co-operatives are based and the principles through which they operate in practice. These principles are divided into seven subsections and are precisely explained in the guidance notes, accompanied by some considerations that will need to be taken into account in the future. The lengthy document Guidance Notes on the Co-operative Principles is illustrated by means of a number of examples of different co-operatives, one of which is the SCIAS co-operative, with a photograph of some of the facilities of Barcelona Hospital.

The co-operative, which belongs to the Assistència Group in Barcelona and is one of the constituent parts of the Espriu Foundation, is a clear example of the fulfilment of the principles of co-operative identity in the world of healthcare. SCIAS, the owner and manager of Barcelona Hospital, has demonstrated over a track record of more than 40 years that it is a co-operative reality in the health sector here.

SCIAS and Barcelona Hospital, together with Autogestió Sanitària Societat Cooperativa, the owner of the insurer Assistència Sanitària, make up the Assistència Group, comprising a jigsaw of different legal entities that, directly or indirectly dependent on one of these co-operatives, undertake their operations and fulfil their objectives, taking into account at all times the co-operative identity of their parent institution within the group.

At the Assistència Group, membership of the SCIAS and Autogestió co-operatives is voluntary and unrestricted, with no discrimination of any kind, as stated in the first point of the Statement on the Co-operative Identity.

The second point of the SCI is likewise fulfilled, indicating that the governance structures of the group’s co-operatives are participatory and democratic. At the annual general assemblies, the supreme body of governance, all members of the co-operative are invited to attend, and the votes apply the principle of equal participation rights: one member, one vote. Furthermore, all the members who make up the governing councils are selected or ratified democratically at the assemblies.

Economic autonomy

The members of each co-operative have an equal stake in its capital, which is subject to precise democratic control on the part of the governing bodies. The co-operatives of the group operate on a non-profit basis, with any surplus being allocated mostly to investments intended for the development of the company, reserves and co-operative training, following the margins indicated by the legislation in force. This thus serves to fulfil the third point of the SCI.

The Assistència Group is an economically autonomous group that receives no outside resources for its activities that are not provided by its own members and affiliates. Those members of the society democratically appointed to the governing council act in their individual position as members, rather than as the representatives of any public law entity or political group. In short, the group is autonomous and independent, as proclaimed in the fourth point of the SCI.

Regarding education, training and information, the fifth point of the SCI, it should be mentioned that, for example, SCIAS-Barcelona Hospital undertakes a range of annual internal and external training programmes that are allotted a budget periodically adjusted by the institution’s education commission. Meanwhile, the Autogestió co-operative and the insurer Assistència Sanitària likewise offer a series of annual training bursaries for professionals in the field of healthcare. Both co-operatives periodically publish a series of documents recording the activities of their different societies, and a joint annual report setting out the group’s main activities.

Strategic alliance

Co-operation among co-operatives is one of the fundamental features of the Assistència Group, and one of the keys to its success. Autogestió Sanitària, the doctors’ co-operative, and its health insurance instrument Assistència Sanitària, operate in a “strategic alliance” with the SCIAS users’ co-operative and their Barcelona Hospital. Under the permanent management of an inter-cooperative commission known as the Group Commission, the activities of both of the parent co-operatives are supervised and managed, along with the other societies in the group. This alliance among co-operatives, which is essential for the proper functioning of this co-operative group, demonstrates absolute fulfilment of the sixth point of the SCI.

Service vocation

The seventh and final point of the SCI links co-operatives with the concept of “concern for community”. This concept represents the essence of the thinking of Dr Espriu (1914-2002), the founder and promoter of the co-operatives of the Assistència Group, who began in the 1970s to discover in the co-operative movement the material expression of his ideals and his vision for the organisation of a health care system capable of resolving collective needs in the world of health, for both professionals and users who, through their respective co-operatives, work with one another and organise themselves on a free, self-managed basis to satisfy the needs of both sides. Within the group, all the organisations focus on service, and not commercial profit.

In short, the Assistència Group and its co-operatives are a shining example of the fulfilment of the principles of the SCI within the world of healthcare here.