Speaking Volumes

February 28, 1997

Tessa Blackstone on Richard Titmuss's The Gift Relationship

In 1966 I was appointed temporary assistant lecturer on a one-year contract in the department of social administration at the London School of Economics. I was 24, expecting my second child, who was born two weeks before the start of the term, and I had not yet finished my PhD. I also had the haziest understanding of what the study of social policy and administration was. Graduating in sociology two years earlier, I had taken a degree which was devoid of any courses on the social structure of Britain, let alone on social policy; I had perversely chosen to take two papers on medieval political and economic structures, because I was interested in history and, I suspect, because I wanted to be different. Fortunately my degree did include compulsory papers in economics at the end of the second year, which proved to be useful to me in my new department. It must, however, have been a bit of a risk to appoint me. Some might have thought it an act of folly. Hired to teach the sociology courses in a new broadly based social policy degree, my reading focused on social theory and on British social structures and institutions. There was also the unfinished PhD to do. When my colleagues discussed housing policy or social security provision or forms of health care, I was out of my depth. What I knew about them could be written on the back of the proverbial postage stamp. But initially I had too little time to do much about it; and I only had a temporary contract and supposed that if I got a permanent job, it would be in a mainstream sociology department.

When I was offered a permanent job in the social administration department, I had to address my ignorance about my colleagues' work. I began by developing a specialist interest in education policy, building on my postgraduate studies in the sociology of education. I turned then to general theories of the welfare state and to the classic studies of the main forms of social provision that make up the welfare state. It was engrossing information gathering rather than an exciting intellectual experience.

Then two or three years into this reading, Richard Titmuss's The Gift Relationship was published. As a junior colleague, I had known that he was working on a comparative study of the supply of blood in Britain and America.

At the time it struck me as a strange subject to study in such depth and to write about at such length. What I was not prepared for was the brilliant eclecticism of Titmuss's approach in which he combined philosophical, psychological and anthropological insight in analysing two sharply contrasting forms of provision: one based on the purchase of blood in the market in which mainly poor people and sometimes drug-addicted and sick people sold their blood for the use of relatively richer people in a health care system in which the ability to pay for treatment played an important part; the other based on the altruistic giving of blood in which there was no direct reciprocity in a system where access to treatment including blood transfusions was based on medical need. Dazzling in its deep thinking about welfare systems and its use of empirical evidence to demonstrate the flawed nature of the market in the provision of public goods, the book affected me profoundly. It helped to shape my growing interest in the use of the social sciences to study public policy and to draw prescriptions from the conclusions. It confirmed my view that much as there is to admire about the United States, the European model of welfare is better than the American one.

The book is a masterpiece - flawed perhaps - but all students of the social sciences should still read it.

Tessa Blackstone is master, Birkbeck College, London.

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