Originally posted on the VAHS blog on 25 February 2013
I gave a seminar at Glasgow Caledonian University last week, which gave me a chance to return to some of my doctoral research into the voluntary hospitals that provided around one-third of Britain’s hospital beds before they were nationalised in the new National Health Service in 1948. A major focus of my research has been on the issue of payment. These institutions were charities, founded to care for the ‘sick poor’ who couldn’t afford doctors’ fees or nursing home costs. The early-twentieth century was a time of change for them, with new technologies and increasing demand, and against this backdrop various types of payment were introduced – something I’ve written about elsewhere. I don’t want to rehash that here, so much as flag up the central question that has occurred to me whilst researching this topic, which is: what is the meaning of payment?
Business History is a dynamic field, but there is surprisingly little written on payment. This is striking when compared to the long-running historical discussion on gifting, drawing upon the anthropological works of Marcel Mauss and many others. The ‘gift exchange’ has been an important conceptual tool for historians wanting to explore alternatives to (and question the ubiquitous logic of) the modern capitalist market. The ritual of gifting, the myriad meanings put on display by the choice of gift and the power imbalance within reciprocal relationship created have all been debated by historians. So why is the meaning of payment left simply as a matter for practical management and business studies? When the act of payment is so well-engrained in our daily lives, so intimately woven in to the tapestry of our society, why do we not treat it as a revealing matter for us to consider?
A social and cultural history of payment is something I’d very much like to see, but it will be the work of more than one academic. My contribution is to interrogate the boundary between gifting and payment. Nowhere can this be more clearly seen than in the work of charities, many of whom do charge for services. This is not necessarily a problem for charities in demonstrating their work is of ‘public benefit’ (as this Charity Commission guidance document makes clear). The arguments for and against charging might include that it helps to make clear the value of the service provided as well as bring in cash or that it threatens the charitable ethos of the organisation. This is a real debate for the voluntary sector as well as for historians.