Social Policy and Society


A Review of the Evidence of Third Sector Performance and Its Relevance for a Universal Comprehensive Health System

Elke Heinsa1, David Pricea2, Allyson M. Pollocka2, Emma Millera3, John Mohana4 and Jean Shaoula5

a1 School of Social and Political Studies, University of Edinburgh E-mail: [email protected]

a2 Centre for International Public Health Policy, University of Edinburgh

a3 Glasgow School of Social Work, University of Strathclyde

a4 School of Social Sciences, University of Southampton

a5 Manchester Business School, University of Manchester


UK policy promotes third sector organisations as providers of NHS funded health and social care. We examine the evidence for this policy through a systematic literature review. Our results highlight several problems of studies comparing non-profits with other provider forms, questioning their usefulness for drawing lessons outside the place of study. Most studies deem contextual factors and the regulatory framework in which providers operate as much more important than ownership form. We conclude that the literature does not support the policy of a larger role for the third sector in healthcare, let alone a switch to a market-based system.