IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v322y2023ics0277953623001624.html
   My bibliography  Save this article

The place of charity in a public health service: Inequality and persistence in charitable support for NHS trusts in england

Author

Listed:
  • Bowles, James
  • Clifford, David
  • Mohan, John

Abstract

The British National Health Service (NHS) relies for the great bulk of its funding on direct taxation, but the contribution of charitable sources of income to the NHS is not well-understood. The few studies of charitable giving to the NHS to date have concentrated on aggregate levels of income and expenditure. However, to date there has been limited collective understanding about the extent to which different kinds of NHS Trusts benefit from charitable funding and about the persistence of inequalities between trusts in their access to these resources. This paper presents novel analyses of the distribution of NHS Trusts in terms of the proportion of their income that comes from charitable sources. We build a unique linked longitudinal dataset which follows through time the population of NHS Trusts, and the population of associated NHS charities, in England since 2000. The analysis illustrates intermediate levels of charitable support for acute hospital trusts compared with the much lower levels of charitable support for ambulance, community and mental health Trusts and, conversely, much higher levels of charitable support for Trusts providing specialist care. These results represent rare quantitative evidence relevant to theoretical discussions about the uneven nature of the voluntary sector's response to healthcare need. They provide important evidence for a key feature (and arguably weakness) of voluntary initiative, namely philanthropic particularism - the tendency for charitable support to focus on a restricted range of causes. We also show that this ‘philanthropic particularism’ – reflected in the very sizeable differences in charitable income between different sectors of NHS trusts - is becoming more marked over time, while spatial disparities, notably between elite institutions in London and other locations, are also substantial. The paper reflects on the implications of these inequalities for policy and planning within a public health care system.

Suggested Citation

  • Bowles, James & Clifford, David & Mohan, John, 2023. "The place of charity in a public health service: Inequality and persistence in charitable support for NHS trusts in england," Social Science & Medicine, Elsevier, vol. 322(C).
    • Handle: RePEc:eee:socmed:v:322:y:2023:i:c:s0277953623001624
    DOI: 10.1016/j.socscimed.2023.115805
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953623001624
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2023.115805?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Koenker,Roger, 2005. "Quantile Regression," Cambridge Books, Cambridge University Press, number 9780521845731.
    2. Kearns, Robin A. & Ross Barnett, J. & Newman, Daniel, 2003. "Placing private health care: reading Ascot hospital in the landscape of contemporary Auckland," Social Science & Medicine, Elsevier, vol. 56(11), pages 2303-2315, June.
    3. Peter Backus & David Clifford, 2013. "Are big charities becoming more dominant?: cross-sectional and longitudinal perspectives," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 176(3), pages 761-776, June.
    4. John Mohan;Martin Gorsky, 2001. "Don’t Look Back? Voluntary and Charitable Finance of Hospitals," Monograph 000469, Office of Health Economics.
    5. Papke, Leslie E & Wooldridge, Jeffrey M, 1996. "Econometric Methods for Fractional Response Variables with an Application to 401(K) Plan Participation Rates," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 11(6), pages 619-632, Nov.-Dec..
    6. Brown, Laurie & Barnett, J. Ross, 2004. "Is the corporate transformation of hospitals creating a new hybrid health care space? A case study of the impact of co-location of public and private hospitals in Australia," Social Science & Medicine, Elsevier, vol. 58(2), pages 427-444, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Bernard Harris & Rosemary Cresswell, 2024. "The legacy of voluntarism: Charitable funding in the early NHS," Economic History Review, Economic History Society, vol. 77(2), pages 554-583, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Nicola Orsini & Matteo Bottai, 2011. "Logistic quantile regression in Stata," Stata Journal, StataCorp LP, vol. 11(3), pages 327-344, September.
    2. Joachim Wagner, 2016. "From Estimation Results to Stylized Facts: Twelve Recommendations for Empirical Research in International Activities of Heterogeneous Firms," World Scientific Book Chapters, in: Microeconometrics of International Trade, chapter 15, pages 479-514, World Scientific Publishing Co. Pte. Ltd..
    3. Machado, José A.F. & Santos Silva, J.M.C. & Wei, Kehai, 2016. "Quantiles, corners, and the extensive margin of trade," European Economic Review, Elsevier, vol. 89(C), pages 73-84.
    4. Cavalcanti, Tiago & Guimaraes, Juliana & Sampaio, Breno, 2010. "Barriers to skill acquisition in Brazil: Public and private school students performance in a public university entrance exam," The Quarterly Review of Economics and Finance, Elsevier, vol. 50(4), pages 395-407, November.
    5. Jinsuk Yang & Qing Hao & Mahmut Yaşar, 2023. "Institutional investors and cross‐border mergers and acquisitions: The 2000–2018 period," International Review of Finance, International Review of Finance Ltd., vol. 23(3), pages 553-583, September.
    6. Alexander Klein & Karl Gunnar Persson & Paul Sharp, 2023. "Populism and the first wave of globalization: Evidence from the 1892 US presidential election," Rivista di storia economica, Società editrice il Mulino, issue 2, pages 163-202.
    7. Alperovych, Yan & Hübner, Georges & Lobet, Fabrice, 2015. "How does governmental versus private venture capital backing affect a firm's efficiency? Evidence from Belgium," Journal of Business Venturing, Elsevier, vol. 30(4), pages 508-525.
    8. Giuliani, Elisa & Martinelli, Arianna & Rabellotti, Roberta, 2016. "Is Co-Invention Expediting Technological Catch Up? A Study of Collaboration between Emerging Country Firms and EU Inventors," World Development, Elsevier, vol. 77(C), pages 192-205.
    9. Zhao, Zhibiao & Wu, Wei Biao, 2009. "Nonparametric inference of discretely sampled stable Lévy processes," Journal of Econometrics, Elsevier, vol. 153(1), pages 83-92, November.
    10. Alexandre Belloni & Victor Chernozhukov & Kengo Kato, 2019. "Valid Post-Selection Inference in High-Dimensional Approximately Sparse Quantile Regression Models," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 114(526), pages 749-758, April.
    11. Matthias Schmid & Florian Wickler & Kelly O Maloney & Richard Mitchell & Nora Fenske & Andreas Mayr, 2013. "Boosted Beta Regression," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-15, April.
    12. Neuwelt, Pat M. & Kearns, Robin A. & Browne, Annette J., 2015. "The place of receptionists in access to primary care: Challenges in the space between community and consultation," Social Science & Medicine, Elsevier, vol. 133(C), pages 287-295.
    13. Nguimkeu, Pierre & Zeufack, Albert, 2024. "Manufacturing in structural change in Africa," World Development, Elsevier, vol. 177(C).
    14. Christophe Hurlin & Jérémy Leymarie & Antoine Patin, 2018. "Loss functions for LGD model comparison," Working Papers halshs-01516147, HAL.
    15. Blackburn, McKinley L. & Vermilyea, Todd, 2012. "The prevalence and impact of misstated incomes on mortgage loan applications," Journal of Housing Economics, Elsevier, vol. 21(2), pages 151-168.
    16. Asongu, Simplice A. & Odhiambo, Nicholas M., 2021. "Inequality, finance and renewable energy consumption in Sub-Saharan Africa," Renewable Energy, Elsevier, vol. 165(P1), pages 678-688.
    17. de Rassenfosse, Gaétan, 2013. "Do firms face a trade-off between the quantity and the quality of their inventions?," Research Policy, Elsevier, vol. 42(5), pages 1072-1079.
    18. Ichimura, Hidehiko & Todd, Petra E., 2007. "Implementing Nonparametric and Semiparametric Estimators," Handbook of Econometrics, in: J.J. Heckman & E.E. Leamer (ed.), Handbook of Econometrics, edition 1, volume 6, chapter 74, Elsevier.
    19. Mazen Hassan & Sarah Mansour & Stefan Voigt & May Gadallah, 2022. "When Syria was in Egypt’s land: Egyptians cooperate with Syrians, but less with each other," Public Choice, Springer, vol. 191(3), pages 337-362, June.
    20. Benjamin Hofner & Andreas Mayr & Nikolay Robinzonov & Matthias Schmid, 2014. "Model-based boosting in R: a hands-on tutorial using the R package mboost," Computational Statistics, Springer, vol. 29(1), pages 3-35, February.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:322:y:2023:i:c:s0277953623001624. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.