Theresa May in Africa: cynical post-Brexit development agenda smacks of desperation

Theresa May in Africa: cynical post-Brexit development agenda smacks of desperation

Michael Jennings, SOAS, University of London

British ministers in 1948 discussed development investment needs for African colonial territories. The focus was not on the needs of those countries, but on how colonial development might best support the British economy. There was also a political calculation to be considered. Following the rebalancing of global power after 1945, ministers felt that only by strengthening Europe’s African empires could an emergent Western European bloc compete with the US and Soviet blocs. Now, 70 years on, “Africa” remains a shibboleth for British politicians, only this time as the solution to the problem of how Britain can maintain global power and influence following its departure from that Western European bloc under Brexit.

Theresa May’s much hyped and much reported visit to “Africa” (a trip encompassing South Africa, Kenya and Nigeria) has been sold as the means for deepening economic ties between Britain and the region. May announced aspirations for Britain to become the G7’s largest investor in Africa by 2022. There is to be an additional £4 billion in direct British government investment, to be matched by private sector investment (a relatively modest ambition). The prime minister pledged to defend the level of British aid (against conservative and media critics who wish to see it cut), while positing a reorientation of that aid spending to support the post-Brexit British economy.

May is the latest in a long line of prime ministers who have evoked the potential of “Africa” for their own political purposes. From Tony Blair and Gordon Brown, who saw international aid as a mechanism for highlighting British global moral leadership, to David Cameron’s 2011 visit (of which May’s is an echo), when he called for aid to be used to create future consumers for British goods and services.

What makes May’s visit and proclamations different is the smell of desperation. There are many good reasons for deepening trade links across the region, and for establishing better relationships between Britain and African governments. But presenting this as the solution to Britain’s likely post-Brexit economic woes seems misguided at best, deluded at worst.

May has been criticised for her promise to refocus aid in ways that are seen to reflect British domestic and diplomatic interests. She wants to downgrade short-term poverty alleviation in favour of job creation. She wants to increase security and support for fragile African states but her motive for doing so seems largely to be reducing migration to Europe and Britain. Now she is using aid as a tool for supporting the creation of trade deals with non-EU blocs.

Yet British aid has always been about British interests: political, economic and diplomatic. Indeed, the first act that established British aid, the 1929 Colonial Development Act, was passed as the world tipped into global economic crisis and depression. It was explicit in its aim to boost the British economy and jobs.

Aid for trade?

Subsequent iterations of British aid from the 1940s to the 1990s, under both Labour and Conservative governments, “tied” aid so that spending on equipment and experts was made in the UK. Aid has always been seen as a foreign policy tool as much as a moral obligation to help poorer world regions develop. Nor was Britain alone in this: “tied aid” requirements remain common despite their poor record in reducing poverty. Blair’s government made tied aid illegal in 2002, but it remained a core element in the UK’s diplomatic arsenal – a means to ensure global influence (helpful, for example, in defending Britain’s permanent membership of the UN Security Council).

In 2009, Hillary Clinton, then the incoming secretary of state under US president Barack Obama, reflected the use of aid as both a means for tackling poverty and insecurity in poor regions of the world as well as for protecting domestic interests when she announced development aid was to be a central pillar of US foreign policy. France is relatively overt in its linking of aid to promoting its own African interests.

Nor is May’s promised refocus really substantively new. Under the coalition government, aid was to be refocused on job creation, with a promise that this would be good for British business. Priti Patel, during her disastrous period at the helm of the Department for International Development, repeatedly asserted that the purpose of UK aid was to serve the UK’s national interest. She regularly linked aid spending to future trade relationships and deals.

May’s “new approach” is essentially the same policy wrapped in shiny new Brexit packaging. But as a mechanism for achieving a bright, post-Brexit future, it seems as convincing as her efforts at dancing.The Conversation

Michael Jennings, Head of department, SOAS, University of London

This article was originally published on The Conversation. Read the original article.

 

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What lessons does 70 years of the NHS have for universal access?

NHS at 70

Today , Britain celebrates 70 years of the National Health Service, born under Nye Bevan’s midwifery on 5th July, 1948, and even in today’s divided Britain, a rare point of unanimity in the respect with which it is held. The NHS has perhaps been one of the most successful legacies of that extraordinary period of restructuring of the state and public services that occurred in the late 1940s and early 1950s. It is a major factor in the substantial improvement in health that has occurred over the past seven decades: the continuing (albeit now slowing) increases in life-expectancy (over a decade in life added since 1948); and decline in child mortality (34 children died in every 1,000 live births in 1948 in England and Wales, 45 in Scotland: today that is around 5 per 1,000 births). And it is a testament to the idea of health care being universally accessible, driven by need not ability to pay.

But does the NHS at 70 hold any lessons for evolving health care and health systems in sub-Saharan Africa? Its funding model – paid for by general taxation rather than the social insurance model more common in other European welfare states – is enormously complex. Its size is immense. The financial sums it takes to run it (around £125 billion a year, and this is still seen as insufficient) are well beyond the capacity of all but the richest states. And the range and level of services available as a result of that funding may not be easily replicable (in the short-medium term at least) by low- and middle-income countries. But as the examples of countries like Cuba and Costa Rica have shown, good health outcomes are not just (or perhaps, even mostly) about funding, but about the way the system is designed, and its priorities.

But even if the NHS may not be the most appropriate (yet?) model for African states to emulate, there are some lessons that may be useful in moving towards universal access to health care.

 

  1. The right plan, led by the right person, at the right time

Political will and vision is essential: someone (or some people) with the political clout to push through reforms, to lay claim to national (and donor) resources, and to force competing parties to the table. Nye Bevan is quite rightly seen as the father of the NHS, pushing hard within the Labour government to get his vision of a universal healthcare system through cabinet (and resigning in 1951 when the government brought in prescription charges, and charges for glasses and dental treatment).

But the focus on Bevan can sometimes hide the importance of other factors: it isn’t just about an individual, but about an opportunity, a moment and a chance when the vision stands a greater chance of being put into action. Underlying the creation of the NHS was a constellation of factors coming together, which enabled Bevan’s argument to capture the public imagination, gain sufficient political support to push through the reforms, and the government to overcome external opposition (the British Medical Association continued to threaten to boycott the new system until months before the NHS was inaugurated). The need for reconstruction in the aftermath of the destruction of total war, a surge in public support for the government’s broader welfare agenda, and agreement on a direction of travel (including, ultimately, amongst medical professionals) allowed the plans for the NHS to navigate through potential pitfalls and obstacles.

There is a new wind of change in thinking about developing country national health systems today. A consensus has been built around the concept of universal access to health care: the idea that health systems should provide (affordable) health care to all citizens. Importantly, the World Bank has moved over the past decade to champion this concept. Importantly, even in low-income countries donors, international organisations and health specialists have coalesced around the belief that universal access to health is affordable (without the need to charge fees), logistically possible, and likely to be effective in low-income countries. This presents a golden opportunity to push for substantial reforms that could lead to the creation of truly national health systems, accessible to all, with no fees at the point of use. Ministers of health and other politicians should be using this moment to build grand coalitions around the creation of new, truly national, truly accessible health systems. There is ample evidence of the workings of community-based health insurance schemes (even those operating at a national level, as in Rwanda) to show how the financing of this can work. And with growing recognition of the failure of vertical planning and delivery, where funds and services were directed to individual diseases and sectors rather than investing in broad public health, donors are also more understanding of the need to improve and extend national health systems. The prospect for a substantial shift to universal access is very real, but it does require political will to push through the reforms and restructures that would be required.

  1. Build on what you have, and compromise

Although it is tempting to see the NHS sweeping away all that came before it, instituting a bright new age of entirely state-owned and run health services, the reality is more prosaic. Britain was no more able to escape historic path-dependencies than other countries, even at a time of grand renewal, and built upon existing structures and systems. This, inevitably, entailed compromise. Consultants were to be allowed to continue private practice alongside their NHS work (in the same institutions). GPs, the gatekeepers to medical services and treatment, remain mostly independent contractors to the NHS, not public employees as is mostly understood by that term. Private chemists provide the bulk of prescriptions. Nevertheless, by adopting a general taxation-funded model (rather than the social insurance model, which often have more mixed economies in delivery of medical services, the state was able to assert overwhelming dominance and control.

The lesson here is not to replicate the British model (more accurately, see below, the British models), but to think about the realities on the ground in constructing health systems. African biomedical health systems are characterised by a mixed economy of state actors, private (voluntary) and private (for-profit) ones, large-scale company medical services which are extended to local communities, as well as disease- and sector-specific services often funded by external donors and running in parallel with official public health systems.[1] As a result, governments do not have a blank slate, but must construct health systems from where they are now. Should governments have regulatory, funding and delivering roles? Or should they contract out actual delivery, subject to strict controls and oversight? What is the right balance between private versus public? There will not be one answer to this question, and no solution will be perfect. But no reform will work unless it is grounded in the realities and historical pathways of each individual context. The key is understanding what contributes to the principles of universal access and what obstructs it, and refusing to compromise on the latter.

  1. Endless change

Since the early 2000s, successive governments (from Labour, through Coalition, to the current Conservative) have been driven by a particular mantra of health reform. There have been two issues with the overall tenor of these reforms: the first is the direction of travel, towards increasing competition within the NHS and the growth of private-sector actors; and the second is in the top-down centralised process of planning and implementing those reforms.

African countries looking to develop their own systems should take note of both. The introduction of competition has been disastrous. Successful health systems are marked by collaboration, not competition. Different parts of that system need to work together, supporting the overall health objectives of the country, not acting as internal markets with one part bidding against another. Of course costs have to be kept down as much as is reasonable, but the introduction of competition has not led to this outcome. As suggested above, it is likely that private actors will remain a substantial part of any health system, given the current mix of providers and services. But adding internal competition will exacerbate the worst aspects of that, and fail to build cohesion and coherence, even with strong state control.

In respect of the top-down, centrist-driven nature of reforms, balance needs to be struck between a government ensuring its health objectives and priorities are implemented and achieved, and placing so much stress on the system through continual change that it begins to break down. Once a level of service is established, allowing individual units to better manage their own resources, and look to how improvements can be made, may allow for more effective reform, as well as for the emergence of data-driven best-practice models which others can adopt. Of course, to monitor against egregious failures and gross negligence, oversight needs to be strong and transparent, but there must be an effective balance between power at the centre and power further down the structures. The NHS is already decentralised to an extent. The Welsh, Scottish and English bodies all pursue slightly different directions, with different emphases and priorities. And this has been a good thing, allowing for experimentation and lessons to be shared across all three. Successive governments have been reluctant to allow for more bottom-up reform. To be fair, it takes a brave Minister for Health to let go control over the process, knowing they will be blamed for any mistakes, and can take only partial credit for successes. But making-use of the expertise on the wards, and the highly-localised data those wards can generate, can improve patient care and experience in a way that centrally-mandated change will always struggle to do. It will also give greater likelihood that reforms are built on experience from the ground, rather than political visions of those remote from the actual patients and medical professionals.

  1. Don’t neglect social care, especially care of the elderly

The health and care problems linked to longevity may appear someway distant in some countries, or of a lesser priority, but as we see the shift from infectious to chronic health conditions move ever more quickly across low- and middle-income countries, thinking about how to incorporate geriatric health care, and link social care to health care, is essential. Kicking it into the long grass as successive British governments have done will make later reform harder, more expensive, and politically more divisive.

Building a health system now that incorporates as much social care as possible, will ultimately save time, money and political will, making it easier to expand as it becomes more necessary, and more affordable to do so. Similarly, learn from the failures to incorporate mental health services: the (relative) paucity of provision in the UK is a lesson to make sure mental health is given a key place within whatever structures emerge. The data on the growth of mental health issues in sub-Saharan Africa (as well as its historic neglect) suggests that now is the time to think about it.

  1. Free-at-the-point-of-use

The key feature of Britain’s NHS is that it is free at the point of use. Whilst this is taken for granted by many who live here, it is actually quite unusual. Other rich-country systems have varying levels of charges for the initial consultation. The impact of charging fees to access health care at the point of use is to exacerbate health inequalities and hits the poorest hardest. In the 1980s, the World Bank recommended the introduction of user fees to help fund health systems. For around 150 million people, the consequence of user fees is financial catastrophe each year as a result of becoming unwell, with 100 million pushed below the poverty line. The promised waivers and exemptions simply didn’t work, were rarely granted and limited in nature. And they failed, too, as a revenue-raising tool, accounting for just 5-7% of health revenues. The NHS model – free at the point of use – is essential for ensuring universal coverage is meaningful, to ensure health inequalities can be addressed, and to reach the poorest (and those most in need of health services).

 

Injibara (new hospital)

New hospital being constructed in Injibara, Ethiopia

 

 

So let us say happy birthday not just to the NHS itself, but to the idea of which the NHS is an expression of: that everyone, regardless of where they live, of their social economic status, of their ethnicity, of their age, of their race deserves, indeed has a fundamental right to, the very best health care that a society can afford. And that only through a state committed to enacting that right through a health system driven by and dedicated to that objective, can these aspirations be met.

 

 

[1] If you are interested in reading about the historical creation of health systems in Tanzania, I have written two pieces on this, one focusing on the colonial period, ‘Common Counsel, Common Policy: Healthcare, Missions and the Rise of the Voluntary Sector in Colonial Tanzania’, Development and Change 44 (4) (2013), pp.939-963; and one on the early Independence period, ‘The Precariousness of the franchise state: voluntary sector health services and international NGOs in Tanzania, 1960s-1980s’. Social Science and Medicine 141 (2015), pp.1-8

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On gift horses, football and aid: Rwanda, Arsenal and British gammon-coloured outrage

As the Trojans know, gifts can be somewhat problematic. When they’re not hiding an invading army in their belly, gifts come with a whole set of obligations and expectations from the giver, the beneficiary required to use the gift in a way that the giver deems acceptable, limiting and setting boundaries around behaviour (this is why academics who work on gift economies are rarely invited to parties). That act of apparent generosity requires gratitude (expressed through appropriate behaviour of the recipient), and in doing so sets up and sustains a particular set of unequal power relations, all tied up with ribbons and pretty paper.

I was reminded of the obligations that come with gifts both as I was reminding one of my children to respond appropriately to all his birthday presents, whether he liked them or not, and also as the story about Rwanda’s decision to sponsor the Arsenal football team caused consternation and spluttering over the nation’s cornflake bowls. The usual newspapers decried the decision to spend “our aid money” on a north London football club; the usual politicians used the ‘scandal’ to once again seek to undermine UK aid budget commitments; and Radio 4 Today Programme’s John Humphries moved into full outrage-mode in his interview with CEO of the Rwandan Development Board, Clare Akamanzi (in what was a profoundly uncomfortable interview to listen to but that encapsulated perfectly the sense of British entitlement over the obligations of aid recipient governments).

I don’t know whether sponsoring a football team is a good marketing strategy or not. Nor, I expect, do many of the critics of Kagame and his government. But for me, what is more interesting is what the whole story tells us about the continuing neo-colonial and paternalistic assumptions that lie behind aid, often simmering quietly below the surface before occasionally bubbling over. Because more than the fault of a potentially frivolous expenditure, what Rwanda is clearly much more guilty of, is the sin of not behaving the way donors think it should as a recipient of their largesse.

In the 1990s and 2000s, aid relationships, and specifically the conditions attached to aid (where aid was provided in return for governments agreeing to implement a particular set of policies) were the subject of growing criticism within the donor community itself. Donors started to acknowledge the need for governments to be able to set their own priorities and be less subject to donor fiat. Conditionality was out(-ish), ‘recipient countries’ were to be re-labelled as ‘partners’, and ‘ownership’ of aid by these new partners was deemed to be central to how aid relationships should, and would in future, function. As part of the 2005 Paris Declaration donors committed to “respect partner country leadership and help strengthen their capacity to exercise it”, in order that recipient countries might “exercise effective leadership over their development policies”. The 2008 Accra Agenda for Action, building on the Paris principles, called on donors to respect priorities established by parliaments and citizens in those countries, rather than impose their own agendas (ironically, this at the height of the MDGs which possibly did even more to undermine sovereign power to set priorities than aid regimes).

But as events like Rwanda’s football team sponsorship story show us, this commitment to ownership  (slippery and problematic though that concept is), to the right of nations to set their own agendas whether they are aid recipients or not, to building up the capacity of states to make their own, independent decisions, was little more than rhetoric. The transactional nature of aid, bound by clearly defined conditions and expectations, was replaced with the gift of aid, with unstated, but fully understood and no less onerous obligations. The space in which aid recipient countries are to be allowed to spend is limited. Decisions are tolerated only as much as they fit with what donors think is acceptable. And seeking to act as a fully sovereign nation is permissible only to the extent that those boundaries are not crossed. Set up a space programme, as India did, or try to promote an economic sector with potential for huge growth in the wrong way, and you will be condemned and your aid receipts threatened. The ‘gift of aid’ (as opposed to the transactional relationship of aid) has effectively restored Victorian notions of not only responsible giving, but responsible receipt.

Of course, this paternalism is not just found in international aid relationships. It suffuses ideas around charity and giving in donor countries themselves. In the UK, we are encouraged by some charities not to give directly to the homeless, as they will make poor decisions with that money. Far better, we are told, to give to a charity which will make the right decisions for them. The ‘respectable’ and responsible poor are those who either do as expected, or are grateful for others who make decisions for them. Of course, it is completely different when the UK – a recipient of European Union funding for some of its poorer regions (Cornwall and West Wales in particular) – decides to spend around £50 billion on a very fast railway. Some countries are more able to spend on prestige projects whilst in receipt of aid than others, it appears.

The British government, much of its media, and many of its citizens, see ‘aid’ as a marker for generosity of spirit, rather than an obligation of rich countries, especially those which have built their economies on the back of many of those countries and world regions now in receipt of that aid. We are happy, it seems, to provide aid to the respectable poor, who use that gift responsibly and appropriately (in other words, doing things we think they should, even if we are no longer quite so direct and explicit in setting out the precise terms of what it is they should do). But if a country decides to move outside of that limited imaginary – whether on space programmes, presidential jets, or football shirts – then our (donor) gasp of outrage counts for more than any rhetorical commitment to more equal relationships.

As I said earlier, I have no idea whether Rwanda’s idea is genius or madness. Did it come from super Arsenal-fan Kagame himself, or from a team of marketing experts? If it is such a bad idea, why do companies and organisations sponsor football teams at all? A much more interesting story may have been to think about what the reaction was inside Rwanda itself. But I do wonder whether the outrage would have been quite so vociferous if Rwanda had spent a similar amount on a campaign of posters on the tube or London buses. A much more respectable way for a poor nation to demonstrate gratitude to its benefactors.

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Oxfam’s Crisis: abuse, accountability and trust

For any institution, trust is possibly one of the most important forms of capital it can possess. Trust can be one of the most enduring, strong and sticky types of capital. But that strength can mask its fragility, and it can vanish almost overnight once confidence in that institution is lost. In 2015, the Edelman Trust Barometer showed that NGOs were one of the most trusted of institutions: 63% of those surveyed trusted NGOs to do what was right, well ahead of business (57%), the media (51%) and government (just 48%). Two years later, following sustained attacks against NGOs and international development in the media and by some politicians (one of whom would go on to become the Minister for International Development), and after scandals about fundraising practices and engagement in politics, public trust had fallen dramatically. In the 2017 survey, not only had trust in NGOs fallen to 53%, but NGOs were no more trusted than the private sector.

The implications for Oxfam following the revelations about the terrible behaviour of some of its employees in Chad and Haiti are still unfolding, but it couldn’t be more serious for the charity. Penny Mordaunt, the new Minister for International Development, has suggested government money could be withdrawn, and yesterday the European Union issued a similar warning. The Charity Commission has launched a statutory inquiry into Oxfam’s response to allegations of sexual assault raised by whistle-blowers in Haiti. And surely many individual donors will be rethinking their direct debits. Whilst I think Oxfam retains enough residual strength and goodwill to survive this storm of (justified) outrage, it is far from certain. Much will depend on how open it has been, and continues to be, in the next few days and weeks. Trust in NGOs, especially as allegations about similar occurrences, and of abuses against employees and volunteers within aid agencies, spread throughout the sector, will fall again.

Falls in trust matter for NGOs, because the success of the NGO sector is largely built upon a set of assumptions that NGOs are a better form of actor: better in their global aspirations (helping the world’s most vulnerable), better in the things they actually do, and better in their impact. If we can’t trust NGOs to be better, why would we continue to support them over other types of development and humanitarian actors?

One of the pillars of that trust has been a defence of good intentions. Typically, when I and others have challenged and critiqued the idea that NGOs are inherently better in lectures or print, a standard response is that NGOs don’t mean to cause harm, they intend to do good, and criticisms are thus mean-spirited and damaging. Projects are started with good intentions, promises to deliver certain services are fully intended to be met. It’s true that many aid workers, most, do care about the wellbeing of those they are seeking to help, and agonise about the failures that occur. So how can we criticise such efforts?

That pillar is looking increasingly inadequate. The desire to do good is admirable. Good intentions do matter, of course. But what happens when those good intentions (in the case of Oxfam, those of the organisation itself) result in harm? Decisions made by NGOs, and the way systems and processes work (or don’t work, or don’t exist) can and do cause harm regularly. And the scope for harm is magnified considerably in the context of a humanitarian disaster where resources are limited, and the power held by aid agencies and actors is immense in comparison. Allowing the defence of good intentions is to downplay the harm experienced by those at the sharp end, those who are already vulnerable. It is to put the interests of those with more power first.

Sometimes that harm is limited and minimal; but as the scandal over the behaviour of some of Oxfam’s aid workers in Chad and Haiti has shown, it can be extremely serious in its consequences and impact on those affected. And good intentions offer no protection. Oxfam did not mean to cause harm in Chad and Haiti, but, through the actions of its employees, it did. That questions were raised about one of those involved in Chad before they were moved to Haiti adds to the seriousness of the charges against the NGO. The harm may have been  unintentional on the part of the organisation (this becomes harder to maintain if it turns out managers were aware of the allegations but failed to act), but if it happened, can we simply shrug our shoulders and say, ‘at least they meant well’? If a for-profit company failed to meet its commitments, if it was shown to have bid for work it was unable to cope with, would we excuse it, or hold it to account? Or if employees of a for-profit company engaged committed sexual assault or abuse, would be not ask why processes were not in place to stop that in the first place? And why would we do anything differently just because the organisation is a charitable one?

Underlying the scandal that has previously hit various UN organisations, has now affected Oxfam, and may well spread to other humanitarian organisations, is a failure of accountability. There are two forms of accountability here: one upwards, to the donors, and essential for creating trust amongst an NGO’s giving community; the other is downwards, accountability to affected communities, giving them the opportunity to challenge behaviour, decisions and poor outcomes.

Much of the focus of the current set of debates in response to this crisis has been on the former: what mechanisms can be put in place to reassure governments, individuals and other donors that an NGO is undertaking its work appropriately and is able to respond to breaches in a timely and effective manner. This is important. Strong processes for reporting, monitoring and acting will reduce harm as well as rebuild trust. Critics of aid spending often argue that too much money is ‘wasted’ on needless bureaucracy, regulation and administration. What happened in Chad and Haiti is a powerful reminder of why these matter and how they can (when in place and working well) act as vital parts of protection for the most vulnerable. It was the insufficient working of such processes that allowed a culture of impunity to flourish and continue amongst a small minority of staff.

But attention should also be paid to how NGOs and other humanitarian actors can be made more directly accountable to the affected communities with whom they work. As I have long argued, there is a serious accountability deficit in this area. When harm is caused, when there are concerns about behaviour or policy, how do individuals and communities complain or challenge decisions? The changes proposed by Oxfam and others keep power and accountability within the sector. Unless and until mechanisms exist for communities and affected individuals to directly hold NGOs to account for their actions, to report on abuses (and see action), NGOs will struggle to rebuild and maintain trust amongst perhaps its most important constituency: the communities and people they say they are working with to alleviate poverty, suffering and marginalisation.

Humanitarian crises are sites of profound inequalities and imbalances in power, perfect conditions for abuses and harm to flourish. Strong sectoral mechanisms for monitoring, reporting, and acting on allegations are essential. But so too are ways of empowering affected communities to hold humanitarian actors to account for the promises they make, and the things that they (or their employees) do or don’t do.

Oxfam has responded quite well to this scandal in the past week, assuming it is now being fully open about what happened, what it knew and when. It has been transparent, self-critical, acknowledged that its previous practices were not acceptable, and proposed significant changes to processes to help limit possibilities of similar behaviours in the future. Its Deputy Chief Executive, Penny Lawrence has resigned, taking responsibility for the organisation’s actions back then. Others may follow. Nor is it likely that Oxfam is the only organisation in which such failings occurred. That does not, of course, make what happened acceptable or excusable, and our focus must remain on the harm done to those affected.

Haiti has become a benchmark for poor practice in humanitarian work, but what happened in one of Britain’s oldest, most venerable and most widely respected of NGOs has added to the catalogue of failures by humanitarian actors in responding to it, and cast a long shadow over the sector. For humanitarian actors in general, as well as for Oxfam in particular, the challenge will be to make meaningful change, enact real and substantial accountability to all stakeholders, and hope that trust can gradually be built up again. For without trust, there will be no Oxfam.

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How clean is your money? The President’s Club and just saying no (thanks)

A couple of years ago, the big controversies rocking the charitable sector in the UK centred around unethical fund-raising practices. Following the scandal of the President’s Club fundraising evening in January 2018, there is a new question for charities to engage with: when should they say no to donations?

Most of the focus in the coverage and debates about that evening centred, quite rightly, on the behaviour of the attendees towards the ‘hostesses’ hired for that evening. (One thing we have learned is how widespread the problem of myopia is amongst the philanthropically-minded great and – as it turns out, not-so – good, given how few attendees saw anything going on). Prominent amongst the voices of condemnation were the intended beneficiaries of the evening’s largesse. Reflecting the views of many of those charities who were to receive donations from the President’s Club, Great Ormond Street Hospital (GOSH) said it would be returning all previous donations, adding “we would never knowingly accept donations raised in this way.”

One question that springs to mind is whether the charities involved should have known what was going on. After all, rumours had reached the FT of what was going on at these men-only events. Should charities accepting money have dug a little deeper into the nature of the fundraiser? Charities can’t check everything – what goes on in the charity auction evening at the Puddletown[1] Village Hall will probably stay there. But the President’s Club was a slightly different in reputation and size of donations it was able to make. What due diligence responsibilities do charities have? But even with effective due diligence procedures, the real question is how charities can decide when a donation is from an individual or organisation, or the result of a particular type of fundraising activity, that conflicts so profoundly with their ethical and moral standpoint, that they have no choice but to turn it down. How clean, in other words, does a donation have to be?

Just put the cheque back in the post?

As charities publicly indicated their intention to return previous, and refuse future donations from the President’s Club, the Charity Commission (the regulatory body for all charitable organisations), issued guidance to charities affected. In a statement issued in the days following the scandal, the Charity Commission advised charities that it was for trustees to decide whether to refuse a donation:

They must make this decision on the basis of the best interests of the charity. That will include weighing up any issues around how the funds were raised, which may include reputational concerns, against the financial impact on the charity of turning the donation down.

Charities are restricted in how and when they can refuse a donation, or return one already made (in the latter case, Charities in England and Wales must obtain approval from the Charity Commission, so just putting a cheque in the post with a polite thank-you-but-no-thanks acknowledgement isn’t going to work). Refusals or refunds can only occur where the donation (or donor) poses a threat to the reputation of best interests of the charity, or where a donation may negatively influence its work (for example, through the attachment of conditions to the donation). Regulations in England and Wales allow for this decision to take into account a moral dimension, whilst charities in Scotland are in principle not able to refuse solely on grounds of morality. Trustees, who are responsible for making such decisions, must demonstrate that refusing or returning a donation will lead to an actual ‘benefit’ accruing to the organisation; and this benefit must be a definite advantage rather than merely convenient.

Uneasiness about a particular donor based on the individual ethical standpoint of an individual trustee or member of the charity is not in itself sufficient. There must be tangible harm to the charity in keeping the money, or a tangible benefit (that outweighs the loss in income) from returning it. So GOSH must decide whether the reputational damage from accepting donations from the President’s Club is greater than the good which would come from that money. Seen in that light, the decision is a harder than it might at first appear. How do we judge damage to the charity (which has unequivocally condemned the evening and had no role in it whatsoever) against the potential benefits (in this case life-altering or saving) that could result from the donation? Whose interests should take priority in any decision: that of the charity with its ethical standpoint, or the needs of the individuals or community who are the ultimate beneficiaries? What may be poor-taste but within the bounds of acceptability for one set of trustees, might be seen as beyond the pale for another. Groping and sexual harassment are clearly unacceptable to all, but had that not occurred, would the other things that went on (the line ‘spice up your wife’, linked to an auction for plastic surgery, for example) at the men-only President’s Club fundraiser have been, if not acceptable, tolerable?

The Charity Commission recognised that in responding to the President’s Club scandal, the decision as to whether a charity could accept donations would differ from one organisation to another, and expressed the view that there was no single ‘legitimate’ response. The balance between harm and benefit is not always clear, and the ethical dilemma is about the good to which the money could be used, against the taint of its source. Should an environmental charity accept money from an oil company implicated in major environmental damage? Or a human rights charity (or university) accept a donation from a foundation run by a close relative of a dictator known for torturing those opposing the regime? Would a legacy from a convicted rapist be acceptable to a charity working with survivors of sexual violence? Perhaps if during their life the individual had accepted responsibility and indicated remorse, but what if not?

How clean does a donation have to be?

Charities are having to decide how clean donated money has to be, and where they draw the line between clean and dirty (clean here being used in a moral sense, not in relation to laundered proceeds of crime). One might take a utilitarian position, and say it is not the source of money that matters, but the good that is done through its use. But as GOSH and the other charities have found, the provenance of money does matter.

In deciding how clean money is, charities must decide where to draw the line. Not liking the politics of an individual or organisation is probably not sufficient grounds. In the unlikely event that Katie Hopkins made a large donation to a refugee charity, they should probably take that money without any qualms. But charities should certainly say no when a donation could influence behaviour through explicit attached conditions or an internalised fear of missing out on future funding (as may have been the case with Save the Children, who were accused of spiking critical stories about two corporate donors at a time when they were receiving funding from them). It is the murky in-between areas that are more difficult to judge, where the moral lens will lead to different judgements between organisations. And where different outcomes result, does this mean some charities are more unethical than others, or just that the benefit / cost analysis looks different across organisations?

Making the issue yet more complex is the question of how many washes it takes for money to become clean? Few would have qualms now about applying for and accepting a grant from the Rockefeller Foundation or the Mellon Foundation, despite the business ethics of their founders. At what point did we become to so easily distinguish the source of the wealth of these foundations, from the work those foundations have done since? And what of the modern-day Rockefellers? How long will it take for their money to become clean?

If money can become clean over time, it can also be easily tainted. To what extent should charities be expected to consider returning a donation, accepted in good faith, when the donor proves to have been less than they originally appeared? What is the statute of limitations for donations, beyond which they no longer carry the taint of their donor? This has been an issue for universities as well as charities. As the UK Higher Education sector increasingly looks to alumni and philanthropic donors for its endeavours, it is coming up against the realities of how to know what money to say yes to, and what to decline. In 2011, Howard Davies quit as Director of the LSE after the extent of donations from the Gaddafi family and contracts for work in Libya was revealed. The LSE was criticised for failing in due diligence and lack of proper oversight in Lord Chief Justice Lord Woolf’s official report. But there will have been many institutions holding their breath fearing their own past and current relationships with particular governments, ruling families and other significant international figures might be next to appear under the public gaze.

A few weeks on, and only one of those charities has formally applied for permission from the Charities Commission to do so: the Royal Academy of Music , which received £10,000 from the President’s Club at the end of 2017. Others are still in dialogue with the Charity Commission, or discussing what to do with their Boards of Trustees. It will be interesting to see whether the decisions of trustees match the early public statements of the charities once the bright gaze of public scrutiny has moved on.

Before the President’s Club can be formally closed, its assets must be put to charitable purposes. So presumably some charity or charities are going to benefit from the money raised by this organisation. Handily, the Charity Commission tends to make such dispersals discretely. It was surely right for all affected charities to say they would no longer accept future donations from the President’s Club. And the decision to return donations made from this organisation was probably wise too, despite the impact the loss of that money will have. But charities are increasingly finding themselves having to draw their lines in the sand in a much more public way than previously over the question of what counts as clean-enough. And one thing about sand, it tends to shift around quite a lot. The work of the due-diligence manager has become an awful lot more public in 2018.

[1] Not even in the top 10 of Dorset villages with funny names

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