Border Crossings: Charity and Voluntarism in Britain’s mixed economy of health care since 1948


The NHS is famously a state-run health service, yet it has always made space for some charitable activities. These include some of the wealthiest charities in the country. The boundaries between state-run and charitably-run activities have shifted over the decades. What difference do these unusual charitable actors make, and how should policy manage them in the future?

In our research programme, we will study how health policy has understood, and sought to change, the role of charities in the NHS. We will analyse the amount and distribution of charitable fundraising for NHS charities. Finally, we will study a selection of NHS charities, both historically, and in the present day. Together, we will develop a collective account of the effects, both positive and problematic, of these organisations in the UK health system. This will change understandings of the NHS, and inform suggestions for the future of charities in the NHS.

This project is extremely timely. Resource pressures have repeatedly stimulated debate about the potential contribution of charity to health services, but claims about the positive and negative aspects of charitable effort are often partisan and lacking in evidence. Our comprehensive and original programme of research will provide an essential dispassionate analysis, and its results will be highly relevant to stakeholders in the NHS, charities and their supporters, politicians, and all with an interest in informed debate about the contribution of charitable initiative in the welfare state.

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This research has been funded by a Wellcome Trust Collaborative Award in Humanities and Social Science (£1.4 million). It will run from 2020 – 2024.

The team is comprised of Professor John Mohan (University of Birmingham), Dr Ellen Stewart (University of Edinburgh), Professor Martin Gorsky (London School of Hygiene & Tropical Medicine), and Professor Bernard Harris (University of Strathclyde).

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Getting back to the Archives by Gareth Millward

As the country begins to open up, so are the nation’s archives. While not every library, county records office, museum or any other form of heritage centre is fully accessible yet, many have been running controlled opening hours for months. I decided to take advantage. I joined the Border Crossings project in May, working on…

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‘Social democracy redistributes for the benefit of health, education, social housing, and the needy. Market liberalism pays for privatized health, education, pensions, and housing. It recycles debt into more and higher debt. It funds charity and substitutes it for entitlement. … Both social democracy and market liberalism are currently in crisis.’ Avner Offer, ‘The market turn: from social democracy to market liberalism’,

Economic History Review, 70, 4 (2017), pp. 1051, 1066-7.