Abstract
During the 1980s and 1990s, nine hospitals in England transferred out of the National Health Service (NHS) and into charitable control. By exploring 30 years of financial records, annual reports, and contemporary materials, this paper examines how these hospitals have evolved since their transfer. Framing insights using Resource Dependence Theory, connections are identified between how these organisations are resourced and their development: these hospitals’ funding sources have shaped their organisational mission, scale and scope of services, and building developments. The institutional change from NHS to charity hospital appears more on paper than in practice: public funding continues to be their dominant source of income and, despite no longer being subject to NHS restrictions over the use of charitable funds, these hospitals continue to mainly use charity to fund ‘extras’ rather than core services. Findings question the public benefits of funding these hospitals outside the NHS.