“We very often fail to think as carefully about helping others as we could, mistakenly believing that applying data and rationality to a charitable endeavour robs the act of virtue.”
William MacAskill
Charities are information-rich and income-poor. They have deep knowledge of the people they serve, highly developed networks with experts and extensive relationships with donors. However, their mechanisms for raising funds, based on gifts or grants, frequently constrain their scale and impact. This article outlines an alternative approach, proposing that charities should act as catalysts for change. They should combine their knowledge of the needs of the people they serve with information from experts to create new services. As an example, a charity in the healthcare sector could develop a cancer treatment recovery service delivered at home using a combination of remotely delivered medical expertise, AI-driven care management and easy to use low cost diagnostics tools. Such services could be developed and provided by charities through a combination of gifts: donations of time and expertise, together with financial payments: governments buying the service or commercial healthcare organisations paying royalties to use the service. The article also argues that charities will require a new mindset to become catalysts for change. They will need to apply “data and rationality” to charitable endeavours and give up the idea that blurring the line between gifts and transactions, between charity and business, robs “the act of virtue”.
Process
In the example of home-delivered cancer care, the charity could look at potential demand (almost 3.5 million people in the UK are living with cancer) and could draw on its relationships with patients and carers to understand their needs (based on lived experience). This could be augmented by information from the charity’s employees and volunteers, gained from years of experience (domain expertise). Then the charity could collaborate with its extensive network of medical practitioners, scientists and regulators to design a high-level proposition to deliver improved outcomes, enhanced patient experience, and more efficiently. The charity, with its ability to ‘convene’ patients, practitioners, scientists and health policy makers, could then build and evaluate prototype solutions. The participants could contribute to these solutions by sharing experience and knowledge, and giving equipment, funds and feedback. With the prototype proven, it could then be rolled out regionally, nationally or even internationally. In the rollout phase, the charity’s credibility and authenticity could be used to build high levels of engagement and buy-in. With the new service widely adopted, options would then emerge for ongoing delivery and financing from public sector health providers or private sector insurance companies. These funds could be used to improve the service, provide royalties to the charity and deliver returns to investors.
Benefits
A charity has four key information assets: lived experience, domain expertise, the power to ‘convene’ and authenticity. In this approach, the charity could use these assets to build services to deliver measurable improvements to patients. These services go beyond conventional charity programmes, providing training, accreditation standards and toolkits to directly deliver better outcomes in the field. Furthermore, the approach benefits all the participants in the healthcare system. For charities, the main advantage is the ability to operate at scale and to help more people. The approach creates a standardised and transferable service, which can be used extensively and continually updated and improved. The resulting royalties provide income and reduce dependence on donations and grants. With patients and carers, the approach, by directly leveraging their experience, improves the quality of the service provided. It also gives patients agency and a greater sense of worth. The approach enables medical practitioners and scientists to broaden the delivery of best practices and increase access to hard-to-reach populations. With healthcare providers, it helps build deeper partnerships with charities to jointly develop more effective services, more quickly and with greater acceptance. As importantly, it could build a reinforcing set of relationships between participants from across the entire healthcare system.
Challenges
However, for charities to adopt this approach, there will need to be a mindset change. For some charities, it will mean a transition, as MacAskill stated, to a more rational approach. For others, it will necessitate a willingness to accept closer links with commercial entities and an acceptance that gifts and financial transactions can be combined to serve the needs of the people the charities were set up to serve. To achieve this shift, it will be useful to draw on the work of the political activist Saul Alinsky. His approach is to constantly ask the question “does it work?” and to avoid overemphasising ideological purity, “He who sacrifices the mass good for his personal conscience has a peculiar definition of ‘personal salvation.’”
With the new mindset, there are still practical challenges that need to be addressed. A charity’s trustees will always be concerned about liabilities. As a result, most charities will want a separate trading subsidiary for their commercial activity. The definition of Intellectual Property (IP) ownership and the distribution of royalties are always sensitive issues and can prevent the development and application of this type of approach. As a result, it is essential to develop an IP register, an inventory of the contributions made during the development of the service. The split of royalties needs to be clear and publicly stated. These arrangements should be set by the trustees, reviewed annually, and communicated in a trustees’ report.
Transiting to this catalytic approach to develop new services would enable charities to maintain their unique relationships with the people they serve while building scale and significantly increasing their impact. Surely, this is a worthy objective, one that robs no one of their virtue.
The Archive of Free Thinking 
Leave a comment