Am I the only one who feels a bit queasy every time I see a poster in a shop window promoting the Health Lottery? Not, until recently, because of any opinions about the rival claims of this organisation and the National Lottery (in fact, I have only just realised that there are different operations going on here).
It just seems to highlight everything that is wrong, and probably going to get worse, about our national health service. If you Google for NHS lottery, you will get a mixed bag of results, some relating to the aforementioned game of chance, others to the variable health service available, depending on where you live.
To save us all the trouble of finding out for ourselves, the government has produced an NHS Atlas of Variation. If you assumed that someone with dementia would have access to the same treatment in Kent as Lancashire, you would be wrong. NHS funding for a care home place for someone who requires continuing care? Much less likely in the West Country than Northumberland. If you need bariatric surgery, the East Midlands is a better bet than East Anglia. These are just a few highlights. The analysis was based on 71 key indicators, including hospital admission rates, treatments that Primary Care Trusts choose to fund, mental health provisions, cancer treatments, etc, and it shows wide differences that cannot be explained by variations in patient illness or patient preferences.
Add to this recent stories in the media highlighting poorer treatment received from the NHS by people with learning disabilities, with dementia, and those with physical disabilities, and "health lottery" really does seem to sum it up.
During the past week, organisations representing nurses and midwives joined doctors in confirming their opposition to the proposed changes to the NHS: people at the sharp end seem unanimous in fearing that however well-intentioned, expecting GPs to take on commissioning of health services will make outcomes even more variable. As funding available for the NHS continues to be squeezed, and the private sector is allowed to take over those areas where they see scope for turning a profit, again, it will be the patients who pay the real price. Expect the recent spat between private cosmetic surgery clinics and the government about responsibility for putting right dodgy breast implants to be repeated multiple times, as entrepreneurial set-ups find the cost of dealing with unforeseen consequences unacceptably high.
Health Lottery indeed. Incidentally, the other Health Lottery is either a clever collaboration between 51 community interest companies (CICs) intended to generate more funds from the public for health-related causes, or an attempt to persuade people away from the National Lottery - which apparently gives a higher percentage of the ticket price to the causes it supports - thus reducing the amount of money available to good causes in general. There is some debate about the ethics of the situation, amongst MPs, third sector organisations, and other interested parties, including the Gambling Commission.
The bottom line, though, is that we all have a choice about which, if either, of the lotteries we choose to support. When it comes to the NHS, there is only one, and when we need its services, we really have very little choice in the matter.
Showing posts with label third sector. Show all posts
Showing posts with label third sector. Show all posts
23 January 2012
16 November 2009
Charities shouldn't need to pay huge salaries
Everybody seems to be looking over their shoulder at everybody else's pay packet at the moment, and I've been inspired to join in, having read about the number of charity bosses being paid large six-figure salaries. The trade union Unite, which represents 60,000 people working in the not-for-profit sector, has highlighted examples such as Age Concern, Anchor Trust and Riverside Housing Group, where the chief executive's salary is more than the £197,000 earned annually by the Prime Minister.
They are concerned that over-generous remuneration is corrupting the ethos of the charity sector. The justification from apologists for those in receipt of these big salaries is that you need to pay a lot to somebody who is running a complex business, and that they could in any case earn even more in other areas.
Which appears to me to contain an inherent contradiction. If money really is the only motivator, as they seem to be suggesting, then everybody will no doubt rush off to become a big cheese in finance, where obscenely big pay packets are still de rigueur, in spite of the desperate necessity for taxpayer support just a few months ago. In reality, though, most people evaluate their employment on a range of measures, one of the most important of which (once you are fortunate enough to be earning enough to cover your outgoings) is the amount of satisfaction gained from doing the job. Being privileged to work at something where what you do really makes a difference to other people's lives should weigh considerably more than knowing that you are at the top of the premiership when it comes to earning power.
So I don't think charities need to beguile potential chief execs with huge pay packets - they are actually offering something much more important, or should be, if they are true to the charitable purposes for which they were first established. On the other hand, if charities really have become just another big business as I suggested in an earlier blog posting, and are more focused on commercial activities than philanthropy, then perhaps they will need to offer pay packets like big businesses, competing for the services of people who do only measure their success in terms of money. Because they will have lost their unique appeal, and that will be a loss for all of us.
25 November 2008
Is charity just another big business?
"Some big charities are more commercial than many traditional businesses, and are exploiting their charitable status as an unfair competitive advantage."
It is a bold statement - and reflects what an increasing number of smaller businesses are saying in private, if not in public. Casting aspersions on organisations such as Help the Aged, Red Cross, the RNID and RNIB, which are generally held in such high regard, is risky; not least because adverse comments are likely to be misinterpreted as an attack on the charities themselves, when in fact it is their trading activities that are causing the rumbles of concern.
This website provides information about products and services to help with living independently. Although what we do may be considered a valuable social service, we are not a charity, but are funded by subscriptions from reputable suppliers. Over the last few years, we have become increasingly aware of powerfully marketed product ranges emanating from charities such as those mentioned above.
There is a growing trend for charities to become involved in business. The government encourages this, having recognised the valuable contribution that can be made to delivery of social and healthcare services by not-for-profit organisations. The "third sector" is flourishing, with more than 55,000 social enterprises across the UK investing most of their profits in socially beneficial activities, rather than turning them to the benefit of shareholders or business owners. Charities who seek grants are advised that they are more likely to be successful if they set up a trading arm: grant-making trusts regard those with a business generating income as a safer bet than charities which rely on more traditional methods of raising money.
So charities are definitely part of the business environment, and they are not going away. It is perhaps not surprising that the leviathans of the sector have decided to exploit their brand recognition to market products to the public. These brands have been built up through decades of charitable work. Consumers may well be more inclined to buy from Help the Aged or British Red Cross because they know the name in a philanthropic context. Their purchase also becomes a charitable donation; nobody feels that they are doing good to anyone but themselves when they buy a hearing aid or a stairlift - but if it comes from the RNID or Help the Aged? And in some respects, their activities have been beneficial: for example, their concern to protect their brand gives them a powerful interest in ensuring that the products and services provided in their name are of the highest quality.
But there is so much confusion about what is charity and what is business that I don't find it at all surprising that many business people are suspicious of and threatened by the charities' commercial activities. Charities enjoy exemption from corporation tax, some VAT exemptions, and rates relief of at least 80 percent. Whilst the trading arms and any independent companies which run their businesses for them do not, the lines between the different areas are often very blurred. For example, from personal experience, charities expect (fruitlessly) to receive at no charge a subscriber page on Independent Living for which the companies they are competing with have paid the full price. They don't say: "We are the trading arm of charity x, so of course we understand that we should be treated like any other business." Rather, they tend towards: "We are a charity, so you should be donating your services to us." Or they request a link as a charitable organisation, but then direct that link towards their online shop. If they are not honest about what they are doing, how can they expect their customers or their competitors to understand what is going on? Charity shops selling new goods are already a powerful presence on the high street, undermining many small retail enterprises with a combination of big business-style purchasing power and charity-style tax breaks. 'Charity muggers' who ambush you with a hard sell designed to persuade you to commit to a regular donation are probably paid workers, rather than the volunteers they often claim to be.
The overwhelming advantage enjoyed by charities is their name and reputation. A traditional company selling goods in our market, however well-run and ethical it may be, will always be on the back foot when competing with them. But as they become ever-more closely aligned with the world of business, they should not be surprised if their carefully nurtured brands lose some of their lustre through the association.
It is a bold statement - and reflects what an increasing number of smaller businesses are saying in private, if not in public. Casting aspersions on organisations such as Help the Aged, Red Cross, the RNID and RNIB, which are generally held in such high regard, is risky; not least because adverse comments are likely to be misinterpreted as an attack on the charities themselves, when in fact it is their trading activities that are causing the rumbles of concern.
This website provides information about products and services to help with living independently. Although what we do may be considered a valuable social service, we are not a charity, but are funded by subscriptions from reputable suppliers. Over the last few years, we have become increasingly aware of powerfully marketed product ranges emanating from charities such as those mentioned above.
There is a growing trend for charities to become involved in business. The government encourages this, having recognised the valuable contribution that can be made to delivery of social and healthcare services by not-for-profit organisations. The "third sector" is flourishing, with more than 55,000 social enterprises across the UK investing most of their profits in socially beneficial activities, rather than turning them to the benefit of shareholders or business owners. Charities who seek grants are advised that they are more likely to be successful if they set up a trading arm: grant-making trusts regard those with a business generating income as a safer bet than charities which rely on more traditional methods of raising money.
So charities are definitely part of the business environment, and they are not going away. It is perhaps not surprising that the leviathans of the sector have decided to exploit their brand recognition to market products to the public. These brands have been built up through decades of charitable work. Consumers may well be more inclined to buy from Help the Aged or British Red Cross because they know the name in a philanthropic context. Their purchase also becomes a charitable donation; nobody feels that they are doing good to anyone but themselves when they buy a hearing aid or a stairlift - but if it comes from the RNID or Help the Aged? And in some respects, their activities have been beneficial: for example, their concern to protect their brand gives them a powerful interest in ensuring that the products and services provided in their name are of the highest quality.
But there is so much confusion about what is charity and what is business that I don't find it at all surprising that many business people are suspicious of and threatened by the charities' commercial activities. Charities enjoy exemption from corporation tax, some VAT exemptions, and rates relief of at least 80 percent. Whilst the trading arms and any independent companies which run their businesses for them do not, the lines between the different areas are often very blurred. For example, from personal experience, charities expect (fruitlessly) to receive at no charge a subscriber page on Independent Living for which the companies they are competing with have paid the full price. They don't say: "We are the trading arm of charity x, so of course we understand that we should be treated like any other business." Rather, they tend towards: "We are a charity, so you should be donating your services to us." Or they request a link as a charitable organisation, but then direct that link towards their online shop. If they are not honest about what they are doing, how can they expect their customers or their competitors to understand what is going on? Charity shops selling new goods are already a powerful presence on the high street, undermining many small retail enterprises with a combination of big business-style purchasing power and charity-style tax breaks. 'Charity muggers' who ambush you with a hard sell designed to persuade you to commit to a regular donation are probably paid workers, rather than the volunteers they often claim to be.
The overwhelming advantage enjoyed by charities is their name and reputation. A traditional company selling goods in our market, however well-run and ethical it may be, will always be on the back foot when competing with them. But as they become ever-more closely aligned with the world of business, they should not be surprised if their carefully nurtured brands lose some of their lustre through the association.
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