Mutuality in Scottish healthcare: Leading for public good

Abstract

This paper offers an alternative paradigm to healthcare, and its delivery, by introducing the concepts of mutuality and empowerment into the existing NHS model of a public health system. In this paper, we will: revisit what is meant by mutuality; advance the meaning of the ‘public interest’ in this context; explore empowerment and community empowerment and their relationship to health; and introduce leading for the public good, which links these concepts and terms together via a dual development approach. It is suggested that this dual development approach will enable policy makers, practitioners in the NHS, and citizens to explore and evolve ways of leading and managing a mutual NHS, with public interest fora becoming the engines that will lead the development of mutuality. Our approach has not been taken from an observation of practice as such; rather, we suggest it as something to pursue as a consequence of theoretical reasoning applied to observations of practice in terms of policy ideas and outcomes of varied healthcare models that suggest inadequacies with existing approaches. It is hoped that this analysis will help researchers and practitioners alike to appreciate further the important concept of mutuality, and to suggest the importance of empowerment and leadership into the existing public health system paradigm.