Social Care

ACCHOs are primary health services governed and operated by Aboriginal communities for Aboriginal communities. Starting with the first service in Redfern (1971), the sector has grown to 140+ organisations delivering culturally safe healthcare across Australia. Community control means Aboriginal people determine priorities, employ Aboriginal staff, and deliver holistic care addressing social determinants. ACCHOs demonstrate that community governance creates better health outcomes for marginalised populations than mainstream services.

• 140+ community-controlled services
• Aboriginal governance and employment
• Culturally safe care model

Buurtzorg ('neighbourhood care') revolutionised Dutch home healthcare by eliminating management hierarchy. Self-managing teams of 10-12 nurses have full autonomy over scheduling, care decisions, and administration. The result: 40% lower costs, higher patient satisfaction, and happier nurses. The model proves a counterintuitive point: decoupling from management hierarchy (Δ) actually increases alignment (Λ) because nurses can respond directly to patient needs. It's PSC applied to organisational architecture.

• Self-managing teams of 10-12 nurses
• No management hierarchy
• 40% lower costs than traditional care

Kids Company supported 36,000 vulnerable children in London under charismatic founder Camila Batmanghelidjh. Despite £42M in government funding and celebrity backing, it collapsed in 2015 within days of a final £3M grant. Investigations revealed chronic overspending, governance failures, and complete dependency on founder's relationships. Kids Company shows that charismatic leadership without structural governance creates extreme fragility—when the founder faltered, the entire system collapsed.

• 36,000 children supported (claimed)
• £42M government funding received
• Charismatic founder-dependent

The Peterborough SIB was the world's first social impact bond, targeting prisoner reoffending. Investors funded rehabilitation services; if reoffending fell, government paid returns. Results were mixed: reoffending fell 9% vs control (triggering partial payment), but the program was terminated early when government launched a national scheme. The Peterborough SIB proved the concept but revealed challenges: complex measurement, political interference, and questions about whether market mechanisms suit social problems.

• World's first social impact bond
• Target: reduce prisoner reoffending
• 9% reduction vs control group

The UK pioneered Social Impact Bonds (now called Social Outcomes Contracts) in 2010 with the Peterborough Prison project. The model: philanthropic and private capital funds social interventions; government pays only if outcomes are achieved; capital recycles into new projects. The UK has now run 100+ contracts across homelessness, employment, children's services, and health. It's proof that outcome-linked capital can create regenerative cycles—successful interventions generate returns that fund the next intervention.

• 100+ social outcomes contracts
• Risk-layered capital structures
• Payment for outcomes, not activities