Wally Harbert: Who pays the price for change?

Resignations at the Pilgrims Hospice show the importance of public accountability for trustees and chief executives, writes our columnist

Wally Harbert
Wally Harbert

Resignations at the Pilgrims Hospice are a reminder that people power remains important in the third sector. Members of Parliament and local authority councillors can be deselected or voted out of office if they pursue unpopular policies; but it is unusual for expressions of public feeling to have a direct and visible impact on charity trustees and chief executives.

The story is simply told. Steve Auty, the chief executive, persuaded his trustees that their premises in Canterbury were no longer fit for purpose and should be closed with the savings used to develop more appropriate services, mainly in the homes of patients. After a public uproar the trustees changed their minds and he resigned, swiftly followed by the chairman.
The decision to keep the building open may or may not be in the interests of patients and their families – I am in no position to judge – but decisions of this kind are not about right and wrong. They are judgements that involve a trade off between the certainty of what now exists and doubts about the validity of what might take its place.
In the 1960’s and 70’s fierce battles were fought to replace nineteenth century workhouses by modern elderly persons homes. Residents, relatives and staff protested that the old institutions were wonderful and that residents wanted to sleep in dormitories. Staff brought their residents to grumble loudly in the public gallery at council meetings where decisions about closures were made.
Fifty years later no one argues for a return to dormitories but there can be no doubt of the sincerity of staff, relatives and residents at the time. They did not believe that the changes proposed would be of benefit. They were, of course right. Existing residents suffered an enormous upheaval at the end of their lives for changes which were of no benefit to them. Their needs and wishes were sacrificed so that future cohorts of older people could look forward to a higher standard of provision. Improvement comes at a price which is not always paid for by the beneficiary.
It is a big step to replace residential services by community-based provision. Not only is there still considerable scepticism about the benefits of community care but, in some instances, protesters rattled tins, wrote begging letters and sold raffle tickets to raise funds for the facilities now recommended for closure. Both intellectually and emotionally, they may have a strong attachment to services in their current form. 
In this instance it appears that decisions were made before all stakeholders understood the issues. Perhaps the chief executive should have consulted more widely or ensured that his trustees were aware of the public backlash that might follow a decision to close.
On the other hand, trustees had a responsibility to ensure they fully understood the issues before they took a decision. They may blame the chief executive but ultimately, it was their responsibility to satisfy themselves that they had all the relevant facts. There are lessons here about public accountability for third sector trustees and chief executives.
Wally Harbert is a former President of the Association of Directors of Social Services and UK Director of Help the Aged

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