Tuesday, 18 April 2017

Tweaking Governance Incentives

Societies’ need for the work of charities is complex. It is affected by the social and political systems, the economy, population growth, government policy, private sector’s social responsibility, and climate & environment, to name a few. 

Charitable endeavour is likewise affected by need itself, as well as levels of donations, professionalism, governance, public opinion, government policy & relations, voluntarism, and philanthropy. 

There are lively debates in the third sector on fundraising practices, on the use of Randomised Control Trials, the best ways to demonstrate impact, and the nature and practice of individual altruism.  There has also been some focus on governance itself, as displayed in the House of Lords Select Committee on Charities’ recent report: Stronger Charities for a Stronger Society.

Rather than propose a big shock-and-awe intervention in governance, this blog is an attempt to think through the incentives and disincentives that affect those engaged in it. There is no silver bullet for fixing charity governance, no easy-to-follow formula. A board can have a diverse set of talented people who meet at appropriate intervals with adequate information – they can look  perfect on paper – and still fail the charity they are meant to steward. Likewise a board that by description sounds chaotic can, with devotion and passion, steer a charity to robust growth. As we know from experience, governance is both about good process and strong dynamics in the organisation. 

We know that weak governance can cause serious problems for charities, and that boards which just keep a charity ticking along, without effectively challenging and stimulating the executive team, fail in their duty to help their charge be the best it can be for beneficiaries. We also know that if the relationship between a Chair and a CEO is bad then this will affect delivery and effectiveness. 

One way to think about this is to go back to basics, at least so far as management studies and behavioural economics would say: what are the incentives and disincentives for people becoming trustees and doing their duty as well as possible? 

Once we’ve established those, we can look at suggesting tweaks to the system to minimise the deterrents and boost the encouraging factors.

The list below is far from exhaustive and we’d welcome more suggestions. The list does not assign weight to each factor, so more items in a column doesn’t mean we think that column is overall more compelling. The factors certainly don’t all apply to all boards equally, or at all.

-         Belief in charity’s purpose, goals and work
-         Interpersonal reasons (favour for friend/family)
-         Warm glow/ advancement of spiritual enlightenment/ faith 
-         Enjoyment of the trustee role
-         Social status/acclaim
-         Social expectation (those of high standing; religious obligation)
-         Career advancement (looks good on CV; builds experience; contacts & prestige)
-         Good relationship between board and senior team

-         Time commitment (including holiday days taken up, evenings reading, fundraising events; opportunity cost over leisure or earning)
-         Weight of responsibility and tough board choices (even if you vote against)
-         Pecuniary liability if things go wrong
-         Legal and regulatory scrutiny (and related stress)
-         Risk of media and moral hazard, community distrust
-         Costs of travel, sundry expenses
-         Learning strain (trusteeship training or self-education) or feeling out of depth
-         Boredom/diverts from passion of frontline volunteering
-         Competition from other non executive posts that offer remuneration

This prompts a few simple ideas to minimise the latter column. They would not revolutionise charity governance by any stretch, but taken together, could increase diversity, attendance, enthusiasm and confidence.

A. Volunteer days in law
If the state made employers offer 3-4 days, or even half-days, as paid leave specifically for volunteering this would free up countless individuals who would like to join boards but cannot justify taking so much time off. The third sector often discusses the personal growth benefits to serving on a board – these could be useful to the trustee’s main employer too, so volunteer time should not be seen simply as holiday, but as a form of constructive training. 
The flip side would be: hold all board meetings outside work/study hours. This presents travel problems but is often the easiest solution…

B. Normalise travel costs being paid by the charity
The cost of travelling to and from board meetings is a barrier to entry for some potential trustees. Charities are already encouraged to expand their capacity for holding meetings using digital communications technology, but this too presents affordability challenges (laptop, microphone, broadband line). Charities that can should consider normalising the cost of travel (and other similar expenses) to and from board meetings – many already do.

C. Recruiting and paying trustees
As discussed by New Philanthropy Capitalit may be appropriate to consider paying trustees in more cases than we currently see. Recruitment should also be open (at least on the charity’s website and social media if not through an HR firm) to avoid any accusation of bubble-headedness or cronyism. Payment need not be shockingly high or comparable to a salary, but could compensate those who really can’t give up working time, however much they’d like.  This is often a constraint for having proper beneficiary/service user representation on a board and should be considered deeply as a matter of diversity – only with genuine diversity rather than tokenism can a board fulfil its proper function of testing and challenging the executive. Modest payment also allows a charity to demand adequate time from its board to take appropriate reading and training/development steps if available.

Some argue that this changes the dynamic of what volunteering is about, what board service means. Is this really a problem? Are we willing to accept less-than-optimal governance for the sake of a vague Victorian sense that voluntarism is inherently noble, to the detriment of those unable to work for free?

Of course there are myriad other suggestions that would affect governance, and hopefully have a knock-on effect in charities’ impact – reform and support for and from the Commission; a public better educated in the realities of fundraising and charity action; better training and resources for boards of all stripes – but these are fuzzy, indistinct. The improvements suggested above are simple, and B & C can be done by charities tomorrow, without any long legislative process. Idea A can be supported by individual employers tomorrow, again, if the private sector sees what it can do to help (and to promote its employees’ responsibility and skills). The ideas explored here could apply equally to social enterprise directors, small charity boards or global research foundations.

Sir Stephen Bubb

Wednesday, 22 February 2017

The fantasy of a well-supported charity: Spontaneous Combustion Support

Imagine a fictional charity, Spontaneous Combustion Support (SCS). This charity, as the name implies, provides advice, preventative care services, and post combustion family counselling, for sufferers of the grave affliction. The most visible work it does is sending volunteers and medical professionals to identify suspected sufferers displaying early symptoms (wisps of smoke escaping from the nostrils, high fever, insatiable desire for curry) and chill their cores, then monitor their ongoing progress.

SCS operates along typical charity lines. Its workforce and volunteer pool are highly motivated, well intentioned, and generally good at what they do. The charity is always struggling for funds and often has to dip into reserves to keep delivering its vital services. Its IT systems are nearly a decade old and often freeze, while the scanners that their volunteers used to identify especially hot individuals in public places tend to break down or identify those puffing tobacco.

The charity has a couple of good researchers but their efforts to develop better cures and diagnosis tools are limited by the need for them to also act as coordinators for SCS personnel on the ground. The company’s logistics a poor: emergency teams often scramble to rescue those who are either already piles of ash, or perfectly healthy but standing near radiators. Staff salaries are below those of the public sector and completely out of sight of comparable private sector positions.

The charity has no budget to train its senior leaders, to help its board bond and learn to support and challenge the executives appropriately, nor does it have nonrestricted money for raising funds. Its efforts to alert people to the dangers and early warning signs of spontaneous combustion are limited to free social media platforms and simple infographics on its website. In some areas the NHS welcomes its help, in others the reception is frosty.

In short it is a worthy charity providing an important service, surviving but not thriving.
One day tragedy strikes. The daughter of a prominent businessman taking a refreshing walk along the Thames is healthy one moment then seen with smoke billowing from her ears the next. When the affliction hits she is a mere 20 minutes from a trained SCS volunteer who could help. However, the public is not aware either of the disease or of the charity’s ability to cure it. She is first ignored, assumed to be a poor example of performance art, then finally an ambulance is called, but it takes her to a general hospital without dampening and chilling facilities. By the time a staff nurse alerts SCS, Alicia Postlethwaite is alight. A charity volunteer team exerts themselves to put out the blaze but is too late.

Alicia’s father, once recovered from his grief, decides to hold a fundraiser for SCS with the vow that nobody else should perish from such a preventable disease. Mr Postlethwaite consequently holds The Businesspeople’s Big Bucks for Back Office Bash, inviting all of his besuited friends for a glitzy four course meal and auction of pledges. His associates and colleagues are well aware of the importance of supply chain, upstream facilitation, quality logistics and coordination, and proactive governance. They see an opportunity not only to help SCS and make something good of Mr Postlethwaite’s grief, but to provide a new model for the charity sector. This fundraiser is unique: not a penny raised is ringfenced for the front line. The businesspeople compete in largesse to support all aspects of the SCS engine room.

The charity is turned around in a matter of months. It becomes the Google/Twitter/John Lewis of the charity world, with fantastic facilities, state of the art technology, trendsetting best practice project management. A chief executive is brought in from a FTSE 100 outsourcing conglomerate. SCS offers fun diversions for staff, great pay and CV potential, training and development budgets. The best of the best compete to work there - even if not all are strictly motivated by altruism or charitable feeling. Its comms are efficient, frontline staff are sent where they need to go when they need to be there, research is joined up and coordinates with other charities and the private sector & universities.

Writers from the FT and Economist run articles on SCS’ innovative restructuring. Management finds it can collaborate with local spontaneous combustion charities such as Cornwall Against Combustion and Burnley Burn-Not, combining its medical expertise with their greater knowledge and links with chronic sufferers. The public learn how to spot the first signs of the disease and know who to call. Soon spontaneous combustion is little more than a myth used to scare naughty children.

In summary, far more SC sufferers are treated and saved than would have been if Mr Postlethwaite had demanded that all the money he raised be spent on paramedics and body-fridges.

The question is: would this be bad? From the description above Spontaneous Combustion Support no longer sounds much like a charity – it sounds like a typical private sector company that happens to run on donations. 
Is that a problem? It is very much meeting its charitable purposes after all.
More to the point, why is the story above so unbelievable? Fictional disease aside, it does not seem unrealistic that those many in society who understand the importance of back-office and business process should be motivated to donate to charities in a sophisticated manner.

They should frankly be annoyed by calls for every penny to go on the front line, for overheads to be minimised, for accounting acrobatics or actual austerity to create misleading ratios between giving and direct charitable effect spending. It is understandable that many in the public view charities with suspicion, but given the sector’s progress in transparency and accounting openness, why is there no support among those whose own businesses are run with proper infrastructure, for the voluntary sector to have the same bedrock?


Thursday, 19 January 2017

Is there a science of charity, and would we want one?

A few months ago Joe Saxton, Driver of Ideas at nfpSynergy, wrote a thought-provoking blog challenging our sector’s enthusiasm for randomised control trials. Joe’s article and the debate started in the comments, were fascinating and deserve a read. But it prompted consideration of the question one step removed – before we look at charities borrowing science’s tools, is it appropriate to compare charitable and scientific worlds?

Randomised control trials are the current highest point of evidence collection in the scientific method, a method whose genesis is hundreds of years old and whose structure is supported by countless examples of error, trial, error, improvement. When scientists operate, their experiments rest not just on the shoulders of giants, but on the backs of a pyramid of giants, trolls, charlatans and visionaries. Science learns from itself, from its mistakes, around the globe and across the centuries.

The scientific method demands that results be replicable, and expects an important experiment will be run by entirely different people time and again. Science has operated for decades within the infrastructure of the academic world, with a host of peer review journals and challenging conventions, allowing distant practitioners to test the validity of claims and build on success. Rivals and successors pore over datasets, read failed experiments and negative results, perfect techniques. The world has far more STEM graduates than experts in charitable operation or social policy research. The sector’s main notable academic journal is that of the Wellcome Trust, Wellcome Open Research. It is excellent, and it is, of course, a science journal.
This is not the only difference. Science and technology are wedded more firmly to economic progress. 

Shareholders, government, hospital directors and the public take note of new drugs, stem cell breakthroughs, rumours of groundbreaking green energy generators. Charity practitioners have nowhere near this level of awareness – not because we are lazy or intellectually inferior, but because we have no such support structure or history of sharing. Too often in the charity sector, it is not just a case of one hand not knowing what the other hand is doing: it is two fingers on the same hand each reaching out to grasp the same object and still failing join up.

In the corporate world, certainly in the boardrooms of pharmaceutical and tech companies, directors are inquisitive and acquisitive. There are aware of all their competitors’ projects, what newcomers try, innovation springing up in far-flung corners, blossoming SMEs. They are not only concerned with keeping their own company afloat but with exploring expansion on the frontier. They have teams of researchers comparing clusters of studies and meta-analyses to scope opportunity. They are supported by both the academic literature and by business media – the Financial Times and rolling TV news. Likewise they have a worldwide network of business schools, economics departments, management courses, decades of theories on effective leadership and proactive governance.

There are of course a great number of collaboration efforts in the charity sector, from the Good Exchange to the concept of “generous leadership”, from joint initiatives between funder organisations and umbrella bodies to local projects in the same town or village. One of Charity Futures’ ambitions is to compile a directory of these, listing free and paid resources on charity academia, leadership and governance training, and emergency support. Hopefully by signposting both collaborations and smaller ventures, even more efficient partnerships can be forged. This could grow in utility by adding neutral reviews and learning aids, so a bewildered new board member could easily find out the different tools available to help her.

The other difference between science and voluntary worlds is simply that a lot of charities do not operate in a manner with quantifiable results. The goal of some is to enable a sport to be played, or to make a group’s life more tolerable, hopefully enjoyable. There are sector activities which suit social science measurements, like helping ex-prisoners reintegrate or educating children, but a host of important charitable activities are little to do with numbers. Has enough thought been devoted to testing an ethical component, are quality-adjusted life years enough?

Trying to get a picture of impact by asking beneficiaries to rate their experiences feels like missing the point, even if methodologies were sound enough that they could be compared across location and type – which they aren’t. Some of the largest management consultancies have been trying for years to set out a standardised system to rate charity effectiveness and each model sinks on its flaws. What the voluntary sector does brilliantly is use hard science evidence in campaigning – against smoking near children for example – and funds investigation of this type. But that does not contribute to a central corpus on how charities themselves campaign.

The question of randomised control trials speaks to the charity bubble’s current focus on, possibly even obsession with, transparency and impact. You get the sense that many charity leaders believe that if we could only display our accounts and give hard numbers on how many people we’re helping, then the public and press would return to treating all charities as angelic.

This is a limp hope. Few people have the time or inclination to check the accounts and annual statements that charities painstakingly polished, even fewer compare different possible donations in such detail. Even if they do, they may not have the statistical grounding to make informed decisions, or may leave with the wrong message, that all the charities they compared spend too much on staffing, premises, IT and training. Certainly the sector should not retreat on transparency, but nor should it slog on under the delusion that once we reach a certain crystal-clear level, the public will fall in love.

Another difference charities may be more happy about. The sector is far less regulated, and while the Charity Commission comes down hard on some charities and may be seen as too bureaucratic, it pales in comparison to pharmaceutical watchdogs. We have nothing that functions like the FDA/MHRA testing and delaying new drugs for years. The Charity Commission does not review every new project, grant or intervention that a charity plans, not even very large experiments. Likewise most donors or funders would not be able to block a charity functioning.

Try as we might we cannot create a ready-made academic milieu for the voluntary sector, with the centuries of history, the international network of journals, the expectation of challenge, refinement and peer review. Multi-institutional multi-national collaborations do not spring up overnight, but after years of relationship building, sharing techniques and ethics, agreeing shared goals. But this is certainly a goal to have in mind: through thought leadership, debate, seminars and working with the university sector across disciplines, we must strive to introduce higher standards of intellectual rigour and collective progress.

This article first appeared in Third Sector magazine, here

Sir Stephen Bubb is Director of Charity Futures. Jonathan Lindsell is the Research & Programme Manager of Charity Futures.

Wednesday, 26 October 2016

What would the National Trustees body do?

The national survey of trustees conducted by the Charity Futures programme, Third Sector, and nfpSynergy indicated strong support for a new national trustees body. It follows that we should consider what such a body should actually do. It should have clear aims and a distinct role not already covered by NCVO, ACEVO, or the Association of Chairs. NCVO already has a governance department, and ACEVO ran a governance review service: there is also the Governance Hub, which produces the Code of Good Governance, which includes input from a whole host of bodies.

Many sector commentators already complain that there are too many infrastructure bodies. Only with a very defined purpose, funding structure, and place in the conversation would a trustees body enjoy wides support. It is not jumping the gun to hypothesise what role such a body should take. Fully 25% of our respondents thought that “a national body supporting trustees” would be “very useful”, while another 36% thought it would be “useful”.

The question did not imagine what that support might consist of. Different respondents likely interpreted it in different ways, projecting their own ideas about infrastructure support onto the question. Such a body could do any number of things, and the questions we had posed just prior to the one concerning trustees bodies probably affected what respondents were thinking: they included online training, better general training, trustee handbooks, and a trustee e-newsletter or group. There was most supports, 82% positive responses, to the generic idea of “Better training for trustees”, which doesn’t get us far.

How would such training be delivered? Seminars, workshops, awaydays, off-line courses? Would we have online video lecture series, mentorship programs, a grand centre delivering cutting-edge governance literature? How much extra time are trustees willing to devote to self-improvement? Would it be useful to have more governance appraisal services, provided at an affordable rate? Would funders and philanthropists have a more contributory role? Can charity boards learn from the composition and practices of the private and public sectors? If such a body did spring into being, how would it communicate with the public what it was trying to do, and assess whether it bolstered third sector leadership?

All of the ideas above feel worthwhile but uninspiring. A few hours of tuition or a quickly forgotten best practice document won’t have the impact we want. We need a body that is seen, unlike the Charity Commission, as a mentor, not a monitor. Perhaps there are many more innovations to come, or perhaps a carefully crafted mixture of the options above is the best that can be done.

The weighty challenge of governance demands joined-up big thinking. Marginal improvements and small scale initiatives on their own won’t be enough. They need to be set in this wider context, or small-fry thinking might become a habit. It would be a disaster if the mentality that can only justify minor interventions seeps into how foundations fund capacity. So the answer may well lie outside the sector and certainly may be about big philanthropy.

Trustee concerns reflect our sector’s broader problem themes. There remains a tendency to think too narrowly, e.g. contemplating governance simply as a question of trustees and processes, failing to recognise that it is as much to do with values and cultures – about how organisations are governed. That governing covers executive and staff behaviour, not just board meetings. Governance geeks, who just focus on the minutiae of process, are not only wrong; they are dangerous. They risk driving out the passionate spirit which (alongside professionalism) should be the sector’s hallmark. 

These are all issues that will need to be mulled over, indeed considered in great detail, before anyone dives ahead. But this work can be really valuable if we arrive at the right answer, or even as an answer that is mostly right. If we improve whole sector governance by a small margin in back-office, unsexy ways, this would translate into an imperceptible rise in quality of our whole sector’s operations. Intervening upstream to avert another Kids Company, pre-empt an Age UK or resolve a Terence Higgins Trust situation before it became an emergency: that would be a great boon to the sector. More, helping each board that had been merely muddling along, keeping their charity afloat, to really strive and explore how to deliver the very best: that is worth spending time to work out.

This is why, without any doubt, Charity Futures is now shaping up to be more than a two year journey - Woodford Investment and I are in this longer term. But perhaps our most important contribution – at least in the early years - will be to encourage others to join us in asking these questions and looking for answers. We will become clearer with time, and this gives us our best chance of delivering something meaningful.

Thursday, 20 October 2016

Surveying the landscape: how do trustees feel?

For all the talk about charity leadership and governance, we actually know very little about what board volunteers think, what their training and backgrounds are, how they experience their roles. Past attempts to reinforce the quality of those guiding our sector have, in effect, been crafted half-blind. No wonder they have not always had the hoped-for impact.
That is why, with nfpSynergy and Third Sector magazine, Charity Futures has run the first comprehensive national trustees survey. We’ve been asking board members how confident they are in their own groups’ skills, what challenges they face, what support they receive and what are the best new ideas for support they’ll actually use.  By using social media, Third Sector’s readership and ACEVO’s member list, we’ve achieved a good snapshot of charities large and small, wealthy and modest, old and new.
Our results – together with choice commentary from yours truly - will be out next Wednesday. The survey promises to push the charity leadership conversation forwards and help us beef up the back office.
And on 22 November, we are holding a seminar with a range of sector experts on governance to help us digest these results and look at next steps. This is all part of our efforts to discuss widely with people and organisations to get their views on what an initiative in governance might look like and how it might work (and indeed who might fund it!) 

Wednesday, 19 October 2016

Speaking truth to power, part II

As I have blogged just recently, it is often said that one of the core duties of a charity is "to speak truth to power". It’s a phrase that originated with the Quakers in the 18th century. The charge that they were given to speak was threefold:
  • To those who hold high places in our national life and bear the terrible responsibility of making decisions for war or peace,
  • To the  people who are the final reservoir of power in this country and whose values and expectations set the limits for those who exercise authority,
  • To the idea of Power itself, and its impact on life.
There is an obvious link between the work of the Church and faith groups, and the work of charities in acting as the moral conscience of the country and a thorn in the side of the powerful on behalf of the poor and disenfranchised.

Of course this sometimes means we are both attacked by Governments and politicians who argue we have no business playing politics. Former Archbishop Williams has talked of the "illiteracy" of many politicians about our role and this is but an example of that. If Christ turfed the money changers from the Temple, would the Churches not be failing in their duty if they did not point to the gap between the wealthiest in our society and the poorest? Is that not true for charities?

It is sometimes argued that charities should "stick to the knitting". In other words we should run soup kitchens or food banks for the poor but keep our mouths shut about the causes of poverty. Fortunately neither the Church nor charities will cease from these essential roles; both delivering services to vulnerable people and the most damaged communities and holding those in power to account. 
Cardinal Nichols' trenchant criticism of the effects on communities of welfare changes is a powerful example of the role Church leaders can play and one to be applauded. The work of churches of all denominations and other faiths is also a great example of community cohesion. Our Muslim communities have a strong and abiding charitable tradition that mirrors that of the Christian tradition. So the example being set by Archbishop Longley and other faith groups in Birmingham offering the Muslim community solidarity is another example of the role Churches can play in fostering stronger communities.

Historically the link between faith and charity is strong and continues to be binding. Charitable giving is one of the core duties of a Christian. From early times the Church has encouraged and supported charities. Indeed many of the earliest charities were run directly by the Church. One of ACEVO’s members, the CEO of St. John's Hospital in Bath, is running an institution set up by the monks and which, as they say, "through centuries of change (…) has remained true to its purpose. Founded in the 12th century it is still providing comfort in old age for those in need." Pope Innocent III in 1215 gave a letter of authorisation for the collection of alms, writing, "with works of great mercy and for the sake of things eternal so sow on earth what we should gather in heaven, The Lord returning it with increased fruit."

Many of our great national charities have their roots deep in the founding impetus of the Church; the children’s charities: Barnado’s, the Children’s Society and Action for Children are cases in point. One of the earliest hospices in the country, St Joseph’s in Hackney, was founded by the Sisters of the Poor. The work of the great international NGOs such as Caritas, Cafod and Christian Aid is sustained by the faithful and not simply through giving but through active support for their campaigning role; to mention just one example of that, "Make Poverty History".
So, at a time when the gap between the rich and the poor remains so large, we need a renewed sense of purpose between the Churches and charities in our common goal of giving voice to the voiceless. Similarly faith groups and charities continue their work in providing care and welfare services for those in need. Our role is growing as the State draws back from provision. Often this is because of an increasing understanding of the role of citizen and community focused charities, but also because the deep funding cuts demanded by austerity have eaten significantly into the safety net of our welfare state. That role will continue to grow and with it the much greater responsibilities that entailed. And as Archbishop Longley reminded ACEVO members in his speech to us, poverty encompasses so much more than just worldly goods. As he said, "poverty includes isolation, loneliness, fear in one's environment, being deprived of opportunities and lacking a voice". So we have that common purpose in delivering basic support and care as well as speaking out.

When the translators of the King James Bible were examining the Latin texts for the famous injunction of 1 Corinthians 13.13, there was much debate on the term "caritas". Modern translations use "love" but the King James scholars stuck to charity. Just a few years before they were deliberating, there was also debate on the role of charities which led to the great 1601 Statute of Elizabeth on Charitable Uses. I like to think they eschewed the use of "love" for charity as it is in charitable actions and approaches that we demonstrate the love we must have for one another and for God.
"And there abideth faith, hope, charity; these three, but the greatest of these is charity"

Tuesday, 18 October 2016

Speaking truth to power - or whispering?

Our sector is supposed to pride itself on its ability to "speak truth to power" but frankly at the moment you would be hard pressed to see many examples of it.

I was proud to be part of the marvellous coalition of organisations that fought the Lobbying Act and made such a change to it. We also worked closely with our colleagues to fight the nonsense of the contract gagging clauses that still lurk around Rob Wilson's in tray. But the reality is that the real threat to the sector is our own self-censorship. 

In the big debates of the moment you would need to look hard to find the charity leaders’ voice. On Brexit for example we took a craven line in the referendum debate and now are failing to effectively challenge the rise of xenophobia and hate crime. There are honourable exceptions of course, and the organisations promoting the cause of migrants and refugees is a great one, but by and large we have failed to come together to promote the tolerance and inclusivity that our sector espouses. Where for example was the voice of the sector denouncing the appalling "foreigner employees" speech of Amber Rudd? 

Then we come to the horrendous crisis in our health and social care system. This strikes at the heart of where our sector has traditionally been active. Many, many third sector bodies are prominent in service delivery and advocacy. What is happening with the care of the frail elderly in hospitals around the country is scandalous. I have seen this at first hand with my father who has just spent over two months in hospital, where I have seen the strains on the system. 

Chris Hopson, who speaks for NHS providers, has been a great example of someone prepared to tell the truth publicly about the crisis. On Monday we had Jeremy Hunt on the radio denying there is a problem and insisting that the planned cuts – so-called efficiency savings – will go ahead. This is disastrous, and anyone who knows what is happening in A&E or in the care system realises the need for more resources. 

But where are the sector leaders in the media pointing out the crisis we face? Demanding action? There is a curious silence when we need a voice. Sometimes leaders think you work behind the scenes to get action and don't use the media. This is a wrong approach. 

The media is an essential ally and a great negotiating tool. The media is not a nasty thing you wheel out when all else has failed. Politicians respond when they feel there is public pressure and concern.  Thinking you can make change through discussion and meetings alone can be a flawed approach. A judicious use of media to give voice to genuine concern, to articulate what beneficiaries are experiencing and to demand action, is part of the process of getting action. Hopson has brilliantly shown how this is done by exploiting media on behalf of his NHS provider members whilst engaging seriously with them on solutions. Politicians and ministers, and therefore officials, respond when there is a crisis and you are there both demanding action publicly, and there to offer a solution. But they also need to fear you. A charity leader uses media to extract change because people trust us and listen to us and that is something many politicians don't have.
But there is a second and perhaps more fundamental reason why we need the media.  A charity is not there simply to deliver a service or act as an agent of the State.  Our beneficiaries want someone to champion them and articulate their concerns and demand change. They want to hear that. They want to see it.  We are not simply there to work behind the scenes, necessary though that is as well, but to speak truth to power in a way that reassures our beneficiaries that we are on the case. 

I'm afraid Theresa May is deeply unengaged in the current crisis and will not until she starts hearing us on Today or the front page of the Mail or top of the news. The NHS didn't do the pilots in A&E two years ago simply because I presented Government with a neat paper. They did it because they feared the damage a winter crisis could do. We have failed to capitalise on that. Never fall for the trap governments set when they tell you won't get anywhere if you go to the press. That secures compliance, not action. 

I'm reflecting what I am seeing in the media and also on 15 years of working with politicians and getting results. When the Blair government wanted to make a major policy impact on charities, Number 10 was able to ignore many sector leaders. Those that were consulted – myself included – were those whose public backing was vital to success, and whose public opposition in the press could have been a serious thorn in the side. A charity leader needs to be in a position where they are too dangerous to ignore, and they can provide answers to sort major problems.

Bob Kerslake, former chief of the Home Civil Service, was quoted in Civil Society last week, pointing to the power of the sector and to remember we are more powerful than politicians. He sums up my position brilliantly:

"You have to stand apart and have an independent voice, and in my experience in government they respect those who stand up and challenge even if they don’t like it. The worst thing you can be seen to do is cower in front of government because, eventually, they will get you.”