Abstract
The UK government is setting up a new kind of organisation as part of the National Health Service, the foundation trust. Foundation trusts will be more distanced from government than existing NHS bodies, and will have closer community links. In this paper I identify the importance of legitimacy in health care and explore the potential situation of foundation trusts in terms of the bases of their legitimacy as organisations. Relationships with community, stakeholders and government are all considered as sources of legitimacy for foundation hospitals, and comparisons are made with other organisations, state, voluntary and private. I conclude that the blueprint of the foundation hospital creates a set of relationships which are incoherent and mutually conflicting, and conceals a crucial relationship with the state. I argue that these problems are likely to weaken the legitimacy of the foundation trust.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Argandona, A. (1998) The Stakeholder Theory and the Common Good. Journal of Business Ethics 17, 1093–1102.
Brummer, J. (1991) Corporate Responsibility and Legitimacy. Westport, CT: Greenwood Press.
Cormier, D., and Gordon, I. (2001) An Examination of Social and Environmental Reporting Strategies. Accounting, Auditing and Accountability Journal 14, 587–616.
Deegan, C. (2002) Introduction: The Legitimising Effect of Social and Environmental Disclosures—A Theoretical Foundation. Accounting, Auditing and Accountability Journal 15, 282–311.
Department of Health. (2002) A Guide to NHS Foundation Trusts. London: Department of Health.
Department of Health. (2004) NHS Foundation Trusts.A Guide to Developing Governance Arrangements. Available from http://www.doh.uk/nhsfoundationtrusts/governancesourcebook.pdf
Friedman, M. (1970, September 13) The Social Responsibility of Business is to Increase Its Profits. New York Times Magazine.
Gibson, K. (2000) The Moral Basis of Stakeholder Theory. Journal of Business Ethics 26, 245–257.
Habermas, H. J. (1976) Legitimation Crisis. London: Heinemann.
Hansmann, H. (1996) The Ownership of Enterprise. Cambridge, MA: Harvard University Press.
Husted, B. (1998) Organizational Justice and the Managment of Stakeholder Relations. Journal of Business Ethics 17, 643–651.
Jensen, M. (1998) Foundations of Organizational Strategy. Cambridge, MA: Harvard University Press.
Loughlin, M. (1996) Legality and Locality: The Role of Law in Central-Local Government Relations. Oxford: Clarendon.
Mays, N. (2000) Legitimate Decision-Making: The Achilles Heel of Solidaristic Health Care. Journal of Health Service Research and Policy 5, 122–126.
Stryker, R. (2000) Legitimacy Processes as Institutional Politics: Implications for Theory and Research in the Sociology of Organisations. In S. Bacharach and E. Lawler (Eds.), Organisational Politics (pp. 179–224). Stamford, CT: JAI Press.
Toynbee, P. (2003, May 2) The Rebels Have Won. Guardian.
Turnbull, S. (1997) Stakeholder Cooperation Journal of Cooperative Studies 29,18–52.
Warren, R. (2003) The Evolution of Business Legitimacy. European Business Review 15, 153–163.
Weber, M. (1978) Economy and Society. Berkeley, CA: University of California Press
Wilmot, S. (2001) Corporate Moral Responsibility: What Can We Infer From Our Understanding of Organizations? Journal of Business Ethics 30, 161–169.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wilmot, S. Foundation Trusts and the Problem of Legitimacy. Health Care Analysis 12, 157–169 (2004). https://doi.org/10.1023/B:HCAN.0000041188.79809.05
Issue Date:
DOI: https://doi.org/10.1023/B:HCAN.0000041188.79809.05