In late July, Michelle Mitchell was preparing to take her first holiday since becoming head of the MS Society 10 months earlier. Her spare time is spent with her children and she says she has no hobbies. It's this sort of singular focus that led her, at the age of 41, to become one of the youngest chief executives of a major charity. She joined halfway through its 2011-2015 strategy, but she wasn't content to implement someone else's plans. The strategy was, in effect, torn up.
"I am not someone who comes into organisations and continues with the status quo," she says. "There are two broad areas in which I excel: one is change and major realignment; the other is running excellent organisations." The MS Society brought her in to do both.
The results so far have been a new target for income growth in 2014 of between 8 and 10 per cent, and a shake-up of the executive team. The charity – which supports and campaigns for people with multiple sclerosis and funds research into the condition – asked nearly 3,000 people who are affected by it what they thought the charity's priorities should be. The feedback from this exercise forms the backbone of a new 10-year strategy, which will be unveiled in September at the charity's annual general meeting.
Mitchell has never taken the easy route. She grew up in Ellesmere Port, Cheshire, and was the first in her family to go to university. Her first job after studying in Manchester was as assistant and adviser to the late MP Donald Dewar when he was Labour's shadow social security minister and then chief whip. This threw her in at the deep end; but, not content with learning to swim, she used her evenings to study for an MA in political and public administration.
Her next move in 1997 was to the political campaign group Charter 88, where she worked on influencing the Devolution Bill, House of Lords reform and the Freedom of Information Act. A career in politics seemed obvious – but, instead, the charity sector beckoned.
"For me, it's about finding the best way to bring about change", she says. "Charter 88 enabled me to step back from party politics and parliament to look at how to build a broader consensus for change. That helped to give me a wider perspective on media campaigns and policy."
She was a government affairs adviser at the NSPCC for two years and then, in 2002, moved to be head of public affairs at Age Concern. "I've never had a career plan," she says. "I've just followed the things that I am interested in and passionate about: social justice, poverty issues, equality, health and social care. In all of those areas I have sought to give a voice to people whose voice has not been as strong as it could be."
Ironing out the detail
As communications director of Age Concern, she played a crucial role in its merger with Help The Aged to form Age UK in 2009. "In both organisations there had been a lot of internal resistance to the merger," she says. "But the potential benefits meant the rationale behind it was overwhelming. I personally, as a director in one of those organisations, was very supportive of it."
She attributes the success of the union to having two very far-sighted chairs and a small merger team, of which she was part, which was dedicated to ironing out the detail. She says: "We planned the merger and the restructure, launched a new organisation, built a brand, persuaded 169 organisations to come with us and then built the new strategy for Age UK." She pauses, then laughs ironically: "She says, in under one minute!"
Mitchell thinks there is a strong argument for further consolidation in the charity sector. "You have one criterion: does this benefit your beneficiaries?" she says. "If it does, in whatever environment you are operating, you have to build the case for change and take people with you." The Age UK merger saved "the equivalent of about £10m a year, which we could invest in income growth and front-line services".
Some of that £10m came from 300 jobs losses. But despite being an architect of the restructure, Mitchell says her own job was by no means guaranteed. "Everybody had to apply for new roles. I had to be re-interviewed with a new board, a new set of trustees and a chief executive I hadn't met because I had been on maternity leave. It was a competitive process, and rightly so."
Not everyone from Age Concern was so lucky. Some had been tainted by the ill-fated, now infamous, Heyday membership scheme for people nearing retirement. It was launched with big fanfare and even greater cost. Aiming for 300,000 members paying £26 a year, it attracted only 45,000 and incurred £22m of losses, including a £6.7m IT system that didn't work. The Charity Commission even questioned whether its objects were charitable. An investigation by Sir Christopher Kelly concluded it was "a significant failure of governance" and was "almost bound to fail".
The 'H' word is clearly not one Mitchell likes to hear, even now. "The idea itself wasn't wrong, but Age Concern confused its charitable and its commercial purposes," she says. "In the end it tried to create something for which there wasn't a demand. It was corporately slow to respond to the signs that it wasn't working. I won't give my personal opinion on it, because I don't think that's particularly helpful."
She agrees that she learned a lot at that time, but argues that she has gained even more from her successes. She says: "I've worked on 11 major campaigns over seven years that have delivered huge changes for people, whether it was latterly reducing the age that the state pension increased, the campaign on introducing a universal state pension, putting malnutrition and dignity in care on the map or abolishing the mandatory retirement age. That is real, transformational change that affects people. I am extremely proud of that."
Investment in research
Change is what Mitchell intends for the MS Society too. Investment in research is to double over the coming decade. Research expenditure in 2013 was up to £5.6m from £4.2m in 2012 (or 19.9 per cent of total expenditure, compared with 15.3 per cent). A major research-focused national appeal, headed by the charity's new appeals director, Emma Whitcombe, is being planned – although the details are under wraps for now.
It's not a choice of research at the expense of other things – it's a question of finding new ways of raising money
"Our members, people with MS and our board want us to spend more on research," says Mitchell. "But it's not a choice of research at the expense of other things – it's a question of finding new ways of raising money."
Traditionally, income has come from legacies, individual giving and community fundraising, which accounted for the bulk of the £24.1m raised in 2013. "But we haven't necessarily attracted significant amounts of money from grants, trusts, foundations, corporates or high-net-worth individuals," says Mitchell. They will now be courted. She doesn't want to reveal the details, but she says her team is putting together compelling proposals.
She stresses the urgency of this work. The provision of health and care is a very mixed picture for people with MS. Eleven licensed drugs for relapsing-remitting MS and three symptom relief treatments have recently come on stream. At least two – Lemtrada and Botox – were the result of research funded by the MS Society.
"For those who get the drugs, there's a significant improvement", says Mitchell. But not everyone gets them. A report for the European Federation of Pharmaceutical Industry Associations found that the UK had one of the lowest rates in Europe of prescribing MS drugs. "Only 40 per cent of those who are eligible are getting these treatments," says Mitchell. "It comes down to multiple failure: low levels of awareness, GPs not diagnosing and referring early enough and variations in the numbers of MS nurses and neurologists in different regions across the country."
But her greatest ire is reserved for cuts to welfare and care provision. "People with MS are no longer accessing social care," she says. "You have growing demand at a time when resources are going down. Local authorities are responding to austerity cuts by tightening the eligibility criteria. That means people are not getting help with everyday essentials of living – help with getting out of the shower, cooking food, perhaps just being seen for 15 minutes a day. That's pretty brutal."
Assessments for Personal Independence Payment, the coalition government's more restrictive replacement for the Disability Living Allowance, are also a huge concern. "About 40,000 people with MS will have to go through a PIP assessment," she says. "It puts them under great stress because MS is a fluctuating condition – one day you might be able to walk more than 20 metres, the next day you might not. That will affect whether they can access benefits or not."
Bringing about change
This comes back to why Mitchell entered the third sector – to give people a voice. "We don't have the time, I believe, to sit back and reflect on these things," she says. "We have to be the movement that is bringing about change now."
The idea that the big society can step in and fill the gaps left by retreating state provision is derisible, she says: "We have nearly 9,000 volunteers who run 286 branches, provide services, support and friendship – they are already stepping in. Of course, there's a role for individuals and charities, and that is likely to grow. But we also need to look at the many ways in which there is incredible inefficiency and ineffectiveness in the cost and provision of services.
"If people with MS don't get the right preventive support, their conditions can escalate. But a specialist MS nurse, for example, can be a wonderful broker in the system, making sure you get the right medication, the local charitable support, friendship and connection with peers."
Working on solutions that make a difference and being a vocal – sometimes angry – champion of the cause has been Mitchell's approach. "In all the jobs I've had, the critical thing for me has been to be focus on solutions, rather than just critiquing what's going wrong," she says.