Future Project Events


Border Crossings: Charity, the State, and Health Care Since 1948

Event date: 24th-25th October 2024

Location: Central London

Call For Papers:

We warmly welcome submissions to a two-day conference in association with our Wellcome Trust Collaborative Award on charity and voluntarism in Britain’s mixed economy of health care since 1948.  

On 30 April, 1946, the Minister of Health for England and Wales, Aneurin Bevan, condemned the extent to which a significant part of the UK’s hospital system was dependent on the ‘caprice of private charity’.  However charity – and voluntarism more generally – have continued to play a significant role in the development of healthcare within the UK’s National Health Service. During the pandemic, the remarkable impact of NHS Charities Together’s Urgent COVID-19 Appeal demonstrated the continuing relevance of charitable money in the NHS today.  

We invite abstract submissions for papers from academic researchers, policy-makers and practitioners which actively engage with questions about the role of charity in health-care systems. Although our own project has focused on developments within the UK, we also welcome papers which address these issues from a more international perspective. Papers might address questions including (but not limited to): 

1. What ethical issues are generated by charitable finance in health-care, and how might present-day organisations respond to the dilemmas these pose?

Charitable finance can include donations from ‘questionable’ sources. For example, many former voluntary hospitals in the UK received significant donations derived from the profits of slavery. How much is known about these donations, to what extent are healthcare organisations continuing to derive benefit from them, and what ethical issues does this pose for contemporary policy and practice?  To what extent have hospitals received funds from other ‘questionable’ sources and what dilemmas do these pose? 

2. Who defines the aspects of healthcare provision that are ‘essential’, or are ‘nice-to-have’? 

At its establishment,it was expected that the state would take responsibility for the financing of all ‘essential’ health services through the NHS, and a Government Minister suggested that any continuing role for charity would be limited to the provision of ‘trimmings’.  However, the boundary between ‘trimmings’ and ‘necessities’ has remained elusive in both policy and practice. How has this boundary been defined, tested, and shifted by different actors over the decades of the NHS? How (if at all) is this distinction relevant in other healthcare systems?  

3. To what extent has charity played a particular role either in pioneering the development of new services or directing attention to the needs of so-called ‘Cinderella’ services? 

The discretionary nature of charitable funding means it has potential either to channel resources towards ‘unfashionable’ areas of provision or, alternatively, to pioneer new forms of social intervention. To what extent have charity and philanthropy succeeded in focusing attention, either on more ‘disadvantaged’ aspects of health service provision, such as mental health or the provision of support for older people, or in supporting the development of new initiatives in different times and places? 

4. How have attitudes to fundraising, and fundraising practices in healthcare, changed over the years? 

Modalities of healthcare fundraising have transformed since the establishment of the NHS, both in response to policy shifts (for example, Government efforts to limit hospital staff from fundraising in the early years of the NHS) and to technological change (for example, the rise of crowdfunding platforms and ‘viral’ social media campaigns). How have these changes affected fundraising in the NHS? 

5. What role has charity played in ‘embedding’ healthcare facilities within their communities, and what role does it continue to play? 

The importance of fundraising to relationships between hospitals and their communities was reinforced during the establishment of the NHS, when critics argued that efforts to ‘nationalise’ voluntary hospital endowments would undermine this sense of local identification and engagement.  While local fundraising persists, recent years have also seen more attention paid to larger scale appeals, and even to  national fundraising efforts. To what extent are local NHS charities competing with each other for scarce resources? What can these debates tell us about the relationship between charity, healthcare and locality?  

6. What roles have businesses and corporations played in relation to NHS finance? 

During the late-1980s and early-1990s, policymakers began to focus particular attention on the extent to which corporate and ‘high-value’ donors could contribute to the financing of health care.  How have such individuals and organisations supported health service provision?  What are the incentives for them to do so, and what challenges might this pose for the provision of public health services? 

7. What impact has charity had within broader patterns of health-care expenditure? 

Although charity makes quite a small contribution to the overall financing of the NHS, there have been many debates about the ways in which it has influenced service provision, both directly and indirectly.  To what extent have charitable gifts reinforced existing inequalities in spending between health services and localities?  How has charitable finance interacted with other income streams, including patient charging? What can be learned from the experience of countries where the role of charity and philanthropy is greater? 

8. What can debates about the role of charity within health care reveal about the attitudes of different political parties towards the role of voluntarism? 

Within the UK, it has often been assumed that support for health-care voluntarism is greater on the right of the political spectrum than the left.  This was reflected in some of the debates between the Labour and Conservative parties during the debates over the establishment of the National Health Service in the 1940s but how have these views interacted with more recent party political shifts in health policy? 

The conference will take place in central London on 24 and 25 October 2024. Abstract submissions (up to 500 words) for papers should be emailed to h.s.bodenhamchilton@bham.ac.uk by 10 May 2024. 

A limited number of travel bursaries will be available for those without other funding: please indicate when submitting your abstract if you would like to be considered for this.