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Trust, Risk and Health Care Reform

Taylor-Gooby, Peter (2006) Trust, Risk and Health Care Reform. Health, Risk & Society, 8 (2). pp. 93-103. ISSN 1369-8575. (doi:10.1080/13698570600677092) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:6684)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided.
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Across the developed world, governments face severe challenges in health care reform as demand rises

and resource constraints grow more stringent. In the UK, the current government is devoting

considerable resources to welfare state reform and (arguably) achieving real improvements in services

such as the NHS and education. Despite this, the reforms remain highly controversial and there is

considerable concern about lack of trust in the new welfare policies. A decline in trust may undermine

the public acceptability of the reforms and threaten the ability of government to gain electoral support

for them. Recent work in sociology, political science and psychology indicates that rational deliberative

and non-rational valued-based or affective factors contribute to trust in institutions. At the same time,

theoretical arguments suggest an increasing need for public trust. Trust facilitates the co-ordination of

complex enterprises under conditions of uncertainty, especially valuable at a time when rising demand

and intensifying pressures for spending constraint provide a continuing impetus for reform. One

possibility is that policies designed within a rational actor framework may erode the non-rational

aspects of trust, so that the service improves but trust in it declines, with consequences for the political

sustainability of reformed health care systems. Risk research in health care has a good opportunity to

consider issues of institutional trust and to build inter-disciplinary links in doing so.

Item Type: Article
DOI/Identification number: 10.1080/13698570600677092
Projects: SCARR
Uncontrolled keywords: Trust, risk, rationality, interdisciplinarity, NHS, reform
Subjects: H Social Sciences > HV Social pathology. Social and public welfare
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research
Funders: Economic and Social Research Council (
Depositing User: Peter Taylor-Gooby
Date Deposited: 01 Sep 2008 13:24 UTC
Last Modified: 12 Jul 2022 10:38 UTC
Resource URI: (The current URI for this page, for reference purposes)

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