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Introduction
Healthcare has become an increasingly complex and intricate policy area and the recent responses precipitated by the COVID-19 outbreak have strained health systems worldwide, raising concerns about the capacity of public health systems to respond to the virus. Reassuringly, we have also witnessed a wave of solidarity, mutual aid, and collaborative efforts initiated by civil society actors and grassroots innovators to generate community-based responses, such as producing locally made hand sanitizers and supporting local workers and families most affected by the virus. A global health emergency like the COVID-19 pandemic has revealed an urgent need for a profound re-examination of the ways in which health and healthcare are organised and managed, involving the public, private and third sectors to tackle health and social care issues. Under these circumstances, New Public Governance (NPG), which has highlighted the increasing involvement and engagement of civil society actors in policy and service delivery (Jenson, 2017; Mendell, 2010), has become an important lens through which the management of public services, in the era of collaborative governance, can be understood (Osborne, 2010; Lindsay et al., 2014).
In recent years, there has been an increasing interest in the role of social enterprises 1 – a type of enterprise that seeks to create public benefits (e.g. Chandra and Paras, 2020; Defourny and Nyssens, 2010; Kerlin, 2013; Mendell, 2010; Roy et al., 2013) using business strategies. While social enterprises operate in various fields of work, they have played an increasingly significant role in the provision of healthcare services (Mazzei et al., 2019; Miller et al., 2012). In this article, we use the term healthcare social enterprises (HCSEs) to refer to those social enterprises that work primarily in the provision of healthcare. With an increasing emphasis on inter-organisational relations in policy delivery embedded within the NPG approach, HCSE has been framed as an ideal civil society business model that can provide alternative and effective ways to deliver healthcare services and, in places where the state has traditionally provided the majority of healthcare services, can compensate for the withdrawal of the state somewhat from direct welfare provision through community-based action (Macaulay et al., 2018).
However, despite an increasing interest in the promise of HCSEs in engaging a collaborative approach to...