Health care in public and private

Wellcome Trust Strategic Award (£100,000)

June 2010 - May 2014

Professor Steven King

This project is underpinned by more than 20 individual and collaborative projects, each looking at some combination of the following key questions:

• How and why have political, patient and professional perceptions and expectations of publicly versus privately funded health care developed? In particular, how have definitions of ‘public’ and ‘private’ responsibilities varied over time and place?
• How have the changing economics of health influenced perceptions, experiences and configurations of health care?
• For patients, how did the constellation of health care (and the respective locations of public and private), rights to treatment and health outcomes vary according to life-cycle stage, ethnicity or wealth?
• How has the role of philanthropy influenced the development and patient experience of the mixed economy of health care?
• How were the indistinct and porous boundaries between public, private and philanthropic health care experienced and negotiated by patients and practitioners in the past?
• What sorts of professionals and patients have populated the borderlands between the sectors in the past?
• What are the relationships between a particular configuring of public and private resources and the mainstreaming or marginalisation of groups of patients (eg. British paupers or black South Africans)?
• How did patients and professionals think about their rights and duties in differently configured mixed economies of health care? How, in particular, could patients seek to establish rights to health resources?
• How and why have public, private and philanthropic institutions developed and what was their role in differently configured systems?
• How has the transfer of theory and practice across sectoral boundaries influenced the experiences, perceptions and expectations of publicly, privately and philanthropically funded health care?
• How have public health care systems participated in knowledge creation, testing and innovation with private companies?
• How did public, private and philanthropic medicine come to be subverted by quasi-scientific ideologies such as eugenics?

Stretching to 2014, the project aims to fundamentally refigure the way in which ordinary people experienced and accessed healthcare between the seventeenth and twenty-first centuries.