Rewarding altruism: addressing the issue of payments for volunteers in public health initiatives
South, J. Purcell, M.E. Gamsu, M. White, J.
South, J.
Purcell, M.E.
Gamsu, M.
White, J.
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2014-03
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Abstract
Lay involvement in public health programmes often occurs through formalised lay health worker (LHW) roles and other volunteer positions. Whether such participation should be supported�or even rewarded�through payment is a critical question. With reference to policy in England (UK), this paper argues that framing citizen involvement in health solely as time freely given fails to account for the complexities of practice and the intrinsic motivations involved.
The paper reports findings on payment drawn from a study of approaches to supporting lay people in public health roles, conducted in England between 2007 and 2009. The first phase of the study comprised a scoping review of 224 publications, three public hearings and a register of projects. Findings revealed a wide diversity of approaches to payment, as well as the contested nature of the topic. The second phase examined programme?support issues in five case studies of public health projects, selected primarily to reflect different role types. All five projects involved volunteers, and two used forms of payment to support engagement. Interviews were conducted with project staff, LHWs (both paid and unpaid), external partners and service users.
Drawing on both lay and professional perspectives, the paper explores how payment relates to social context and to the varied motivations for giving, receiving or declining financial support. The findings show that personal costs are not always absorbed, and that financial support�whether sessional payments or reimbursement of expenses�can conflict with welfare benefits. By identifying the advantages and disadvantages of payment, the paper highlights the complexity of an issue often treated superficially.
It concludes that supporting citizen involvement requires attention to fairness and value alongside the pragmatic demands of programme management. However, policy conflicts must be resolved to ensure that employment and welfare rights are protected.
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South J, Purcell ME, Branney P et al (2014) Rewarding altruism: addressing the issue of payments for volunteers in public health initiatives. Social Science & Medicine. 104: 80-87.
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