"NGOs act̨ within the framework of the law in force in a democratic state, influencing its improvement through democratic procedures. Organisations participating in the lawmaking process must make clear in which capacity they act̨ - as advocates of the public interest, on behalf of specific groups at risk of exclusion, or in the name of̨ other interests".
This is one of the principles - Legalism - of the ten-point Charter of Principles for the Activities of Non-Governmental Organisations, which quietly and unnoticed "turns" 25 in 2021. The Charter, originally a seven-point charter, was adopted at the First National Forum for Non-Governmental Initiatives in 1996, when many of today's organisations, and sometimes even their leaders, were not yet around. The current Charter, having been renewed and refreshed and already ten-pointed, is a document to which all organisations wishing to become members of the All-Poland Federation of Non-Governmental Organisations must declare adherence.
Patient organisations in the Coalition for Health are also developing their own set of ethical principles, the Charter of Good Governance, as a binding document for organisations wishing to cooperate within the health system. Do patient organisations need charters and coalitions, since many of them are doing very well on their own?
According to the research "Image of NGOs" conducted by KLON/JAWOR in 2017, as many as 26% Poles are distrustful of NGOs, 42% think that there is a lot of money to be made in organisations, 45% think that organisations waste some of the money they receive, and as many as 49% think that there is often privatisation and abuse in organisations. And while we all know perfectly well that this is a picture that has little to do with the reality as we ourselves know it from our own work in an organisation, it is hard to get over how badly we fare in the eyes of those we want to encourage to support us financially or get involved in volunteering. We can explain to ourselves - and this is actually true - that this distorted image is the result of media coverage of scandals and scandals, and that these are still marginal, but we cannot thus completely absolve ourselves of responsibility for consciously and consistently building the image we would like to have in the eyes of the public. Adopting, publicising and adhering to a charter of principles - any charter, let it even be an internal code of ethics - is precisely one of the elements of rebuilding/maintaining the image of NGOs as entities working for the common good, with respect for the resources entrusted to them and the public trust.
Having conducted (together with Piotr Frączak) audits of selected organisations as part of the Coalition for Health project, which were so open as to allow sometimes difficult questions to be asked, I want to draw the particular attention of patient organisations to a few principles from the NGO Charter of Principles for Action that are particularly important to them - and often their Achilles' heel - and encourage them to be involved in any future discussion on the development and implementation of a sectoral charter.
Independence. NGOs are self-governing and independent. The rules of their activities are determined by internal self-regulatory mechanisms both at the level of individual organisations and branches. Independence - both from sources of funding and from political centres of power - is a fundamental challenge for organisations.
Sometimes an organisation which is formally independent, to a large - too large - extent shapes its activities not on the basis of the needs and expectations of its members and beneficiaries, but on the basis of the needs and expectations of those who decide whether or not to allocate funds for its activities. Sometimes an independent organisation is more of a client than a partner of an authority or a sponsor, and may not realise to what extent what it does ultimately depends not on what the expectations and needs of all members are (and this is, after all, the highest authority in the association), but on what sponsors and funders are willing to fund. Of course, in most cases these may coincide and the organisation, by fulfilling the expectations of the sponsor/granter/decision-maker, fulfils the needs of its members/beneficiaries, but it happens that this is not the case at all - the members/beneficiaries do not object to the way the organisation works, but only because they do not have the opportunity - nobody asked them. Sometimes an organisation's biggest problem is not even that it is too dependent on external factors, but that it is too independent of its own mission, members, beneficiaries. So it is good to ask ourselves from time to time, who is leading the organisation in the direction it is going? Sponsors/grantors - disastrously. Presidents - not ideally, because even the best are not infallible. Members - the rarest and most difficult, but in the long term this is the only way to build an organisation that will last beyond the support of sponsors or the tenure of a leader. How often do you ask yourself who and what drives your organisation?
Openness. The substantive and financial activities of non-governmental organisations are public activities because of the special care they take with regard to the public funds they hold or which have been entrusted to them by private individuals. The transparency of an organisation's finances must allow an external evaluation of the reasonableness and rationality of its expenditure..
Patient organisations, or pro-health organisations more broadly, rely heavily on public generosity, and corporate support. Looking through the websites of organisations working in the field of health (but not only), I have noticed that the intensity and creativity in asking for support does not always translate into equally open reporting on the support already raised and how it has been used. The websites of organisations lack information about the amount of funds raised and how they were used, and organisations rarely publish factual and financial reports, allowing one to form an opinion about their effectiveness, not only financial. Gentlemen don't talk about money, organisations do. Not only when they need it, but also when they can boast about how they spent it. This may sound strange, especially in the context of the vast amount of good that patient organisations do, but one of the drawbacks is the inability to brag about it. And this is, after all, key to building your own credibility and attracting more donors. How often do you publicly boast about what your organisation has already achieved?
Division of powers. When creating its organisational structures, each NGO should at least distinguish between management and supervisory functions in its statutes. The supervisory body should have programme and control functions as appropriate. The members of the collegial supervisory body are required to be impartial, reliable and committed to the organisation's activities.
Patient organisations most often arise out of the need of the moment, out of necessity, as an attempt to collectively address the problems of a group of people who are united by illness. The founders and leaders are sometimes people who never had a career as an NGO manager in mind, but life decided otherwise and they became leaders because someone had to, and the organisation itself is simply a tool to achieve a common goal. So it happens that both the way the organisation's affairs are arranged internally and the style of leadership is a product of the character of the leader(s), rather than a conscious and participatory chosen way of running the common affairs. From my own experience in organisations, I know all too well that sometimes there is not at all a surfeit of competent people willing to take over leadership in an organisation, which, apart from the satisfaction of carrying out important and necessary activities, involves a lot of bureaucratic responsibilities and a difficult responsibility to bear. In the practice of NGOs, management is more a necessity and a duty than a pleasure and a privilege, especially if the leader does not have real support in the other members of the board of directors, in the audit committee or, finally, in the members, staff and volunteers. The weakest link of many organisations is their oversight body - the audit committee in an association, or the foundation board (if there is one at all) in a foundation. The haphazardness of the selection of the composition of the control body and its façade can be seen especially in associations, where - unlike in foundations - this body has to be and happens to be for everyone (including its members themselves) a formality without any real meaning and without any attempt to use the after all important control competence. Meanwhile, a well-chosen, competent, active and inquisitive supervisory body is not at all an "internal policeman" looking over the board's shoulders, but a support for the board in the proper execution of its duties. A well-functioning control body helps to prevent mistakes (which are not difficult to make in a convoluted legal system), to rectify those already made and to testify to other members/employees/volunteers/donors about the organisation's honesty, integrity and economy. How often does your organisation's audit body actually inspect day-to-day operations?
Material for the Institute for Patients' Rights and Health Education was prepared by Katarzyna Sadło (Projectionist), as part of the 'Network for Health' project.
The Network for Health project is implemented with a grant from the Active Citizens Programme - National Fund financed by Iceland, Liechtenstein and Norway through the EEA Funds..