The NHS as "Civil Association"


13th-14th April, British School of Osteopathy, 275 Borough High Street, London, SE1 1JE

Since its conception in the 1940s, the nature and purpose of the UK welfare has state been interpreted in two complementary ways. 

On the one hand, the welfare state may be understood as a set of institutions justified by their contribution to the efficiency of the UK economy. On such a view, the NHS addresses the need to care for workers: curing, repairing and returning them to productive activity should they fall ill or be injured.

On the other, it can be seen as an expression of communal solidarity, expressing a sense of moral obligation that citizens feel for each other. As such, it is more than simply a contract between citizens; it is an expression of a sense of collective identity – in the words of the British philosopher Michael Oakeshott (1901-1990) a “civil association”.

The 6th event organised by the Think About Health network, in association with Cardiff University’s Centre for Applied Ethics, explored this tension, and in particular to address the dangers that arise when instrumental or economic justifications of the NHS come to be dominant. 

Through a series of talks and small group work, the conference sought to explore our understanding of the NHS and how that understanding shapes our day to day practice as medical professionals, as patients and potential patients, and as concerned members of the public.

Topics for discussion included:

• Health Care after the Health and Social Care Bill
• Dignity and care
• NHS and asylum seekers
• Health care as a commodity

A full programme of talks, together with audio files, will soon be available - watch this space!

For more on the NHS as a "Civil Association", click here for a paper by Think About Health's convenor, Andrew Edgar of Cardiff University.

To read Robert Macdonald's paper "The Psychiatric Hospital: phenomenological, spatial and architectural experience of mental illness", please click here.

To read David Taylor-Gooby's paper "A Community Ethic in Relation to Health", please click here.