Self Help in Health and Social Welfare by Stephen Humble Judith Unell

Author:Stephen Humble, Judith Unell [Stephen Humble, Judith Unell]
Language: eng
Format: epub
ISBN: 9781138607309
Barnesnoble:
Publisher: Taylor & Francis
Published: 2018-07-12T00:00:00+00:00

HEALTH RELATED RESEARCH AND THE GERMAN SCIENCE SYSTEM

To do evaluative research in health related self help issues does not only interfere in domains and vested interests of actors from health-related professions and service institutions. It might also affect the scientific background and knowledge about health-related issues. It might use up research sources, and it might come to question traditional theories and findings.

To describe the ‘gatekeepers’ of these resources and the ‘trend- or standard-setters’ for scientific inquiries is an important prerequisite for the understanding of possibilities and limits of evaluative research in this field.

In Germany, there is an extended overlapping area between the earlier mentioned actors of the medical system and the science system (including their funding). In all relevant decision-contexts, the medical profession plays a dominant role: in university based research, in the review of applications for research funds and in the setting up of state-initiated experimental models (and accompanying research). Although health-related issues could be partially a domain of social scientists, there is no (not yet any) substantive health-related research capacity in Germany which is not dependent on the ‘good will’ of the medical profession.

The subject areas of social medicine, epidemiology or medical sociology are mainly part of the medical faculties in German universities. An independent sociological research into health or even into medicine is almost impossible. There have been a few attempts by the Social Democratic party in the seventies to fund such research. It was ended after only a few years – and not only because of the change of the government in 1982. Sociological questions are since then (again) closely tied to illness-related research which is defined by the medical profession (see Forschung und Entwicklung im Dienst der Gesundheit 1983).

In the fundgiving institutions (DFG, Stiftung Volkswagenwerk, Boschstiftung – to name only a few important ones) the medical profession defines not only the topics but also the standards for scientific undertakings. It can be interpreted as an important strategy for the protection of domains in professional service production. The topic of self help (devalued as ‘bungling of laypeople’) and the idea of evaluation are not supported if they don’t follow the predefinitions of medical professionals.

Some interest in evaluative research exists on the side of the government, because the cost increase in the medical system is a permanent issue. Here, new models of health services are tested (by evaluative research) and/or some hopes about less expensive solutions to health problems via self help initiatives are put forward. The question of a better health status for the population or the general importance of the lay system are only of marginal interest. Only the idea of self help groups has received some attention. But the funds which are given to this field of concern are not even a measurable proportion of 1% of the research money given to clinical medical investigations. The same is true for the whole field of welfare services: not even a tenth part of 1% of the money spent in this system is given to (evaluative)

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