Read aloud or translate

What’s the biggest question facing the next government?

Jonathan Senker, Chief Executive 31 May 2024

Our Chief Executive, Jonathan Senker asks how can we build state institutions which are trustworthy? 

This question looms large as a general election is called at the height of the inquiry into the Post Office scandal. This was just 3 days after the infected blood inquiry demonstrated the most far-reaching, appalling and callous disregard for the lives of citizens in the deeply scarred history of the NHS.

Despite the incredible work of so many in public service, appalling shortcomings in the duty of the state to the individual — followed up by denial and cover-up — feel at times to be the norm under numerous governments rather than the exceptions; from Hillsborough, to the Windrush scandal and Grenfell, to these most recent exposures.

The issues imprint themselves on us, as no matter the layers of explanation, we’re confronted with the fact that they tell the stories of the lives of individuals — and all too frequently the lives lost — of people like us.

Of course, it’s about financial investment, which is a huge issue as the two largest parties jostle to demonstrate who can be clearer that they will not raise taxes. Both leaving instead a growing spectre of major cuts in public services.

But it’s about far more than funds. It’s about culture, leadership, integrity, and trust. And how to rebuild these after what feels like decades in which they have become increasingly damaged.

Laughing Boy

This was driven home to me last week when I saw the amazing play Laughing Boy. For those of you who are not aware of it, this tells the story of the life and death, by neglect in an NHS assessment and treatment unit, of 18-year-old Connor Sparrowhawk.

It’s the story of an intense, loving, sweary, grieving family. At its heart, it’s about a phenomenal young man who loved trucks, buses, winding people up, and life. It’s also the story of the devastating power of the state to crush individuals and then to hide, lie and deceive in the attempt to cover this up.

Finally, it’s the story of the power of his family, with his mother, Sara Ryan, pressing for justice at its centre.


The issue of trust in state institutions has salience for us as we see it in our own lives and those of people we care about. The ambulance we can no longer rely on coming in time, the sense of getting increasingly unwell while being on a waiting list, the damp social housing un-repaired.

Here, at VoiceAbility, as in many organisations, we see it in our work with people who draw on public services. Time and time again, I’ve met people who cannot understand the basis for the decisions made about them by state institutions.

From the young refugee who is pressing to live with the people he calls family, to the older person who does not agree they must live the rest of their life in a care home, to the person who does not agree with the medication they’re told they must take.

Our work, and those of organisations which share our objectives, are vital in ensuring these people have a voice, can understand their situation, and are supported to affect change. It ensures people are not powerless and not alone. It acts as a bulwark against excessive state power, ensures accountability and enables health, social care, and social security professionals to hear and respond to people’s voices.

Influencing for change

Alongside this, we shine a spotlight on systemic injustice and propose solutions to address these — as we are doing with our Use Your Power campaign and our advocacy on the Mental Health Act reforms, both of which we will continue into the next government’s term.

By combining our individual work and influencing, we can be most effective in supporting people in an unfair world and addressing that problem at the source. At the heart of all this are the insights of people who draw on our services.

We are hugely fortunate to live in a relatively wealthy country where it’s possible for the state we contribute to, to act reasonably and support us in return. 

If delivered equitably and well, the NHS and social care can enable people to live a far better life than would otherwise be possible. Yet the shortcomings are all too apparent.

Irrespective of who forms the next government, we’ll be working to ensure that more people are supported to understand their rights, know they are not alone, and help their voices be heard.

Together, with other people and organisations, we’ll be highlighting the problems and enabling people to push for the changes which matter in their lives and the lives of others.

I would love to hear your views and discuss how we can work together for change.