Professor John Mohan launches 'Border Crossings'

The establishment of the NHS in 1948 signalled an attempt by the state to “level up” the distribution of services, using central planning and public funding to iron out the historic pattern of services in which one’s chances of receiving treatment were very much a function of place of residence as a result of the capricious and uneven pattern of voluntary support.

Charitable funding did not, however, disappear, and the fate and fortunes of charity in the NHS is the subject of a major new study, funded by a £1.4Mn award from the Wellcome Trust as one of their collaborative awards in humanities and social sciences. The project is led by Professor John Mohan, Director of the Third Sector Research Centre, with coinvestigators Bernard Harris (Strathclyde), Ellen Stewart (Edinburgh) and Martin Gorsky (London School of Hygiene and Tropical Medicine).  They are supported by six postdoctoral researchers and our highly-skilled administrators, and they have recruited an expert advisory board to challenge and support our work.

The range of charitable institutions and activities the group will study is considerable. These range from some of the wealthiest charities in the country, such as the charities administering the endowments of the teaching hospitals, to several hundred Hospital Leagues of Friends, with annual incomes often of a few thousand pounds, which nevertheless play a vital role not just in the institutions they support but also in the communities they serve – not least by bringing people together as volunteers. The mobilisation of communities and the variations between communities in voluntary support are little-understood. The study will explore this and we are also interested in how institutions that were not nationalised in 1948 developed as charities subsequently (some developing a new role and being highly successful; others were less successful, closing as a result of various pressures).

A further theme is the successes, or otherwise, of parts of the NHS that have once again been transferred into charitable ownership. The boundaries between state-run and charitably-run activities have shifted back and forth over the decades – hence the title, Border Crossings. The study's projects will develop a collective account of the effects, both positive and problematic, of these organisations and fundraising efforts in the UK health system.

This project is extremely timely. Funding was received in January 2020 and the subject became immensely topical within months, thanks to the efforts of Captain Sir Tom Moore and many thousands of individuals who engaged in fundraising to support NHS staff and institutions through the Covid pandemic. The work has to a degree been “on hold” because much is based in archives, which have been off-limits, but the team has now been recruited and will move ahead rapidly from there.

Claims about the positive and negative aspects of charitable effort are often partisan and lacking in evidence. This comprehensive and original programme of research will provide results of great relevance 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.