# The gift relationship: from human blood to social policy

- Link: https://fundraising.co.uk/books/gift-relationship-human-blood-social-policy/
- Published: 2003-07-29T20:12:00+01:00
- Author: Howard Lake

**Richard M. Titmuss’s _The Gift Relationship_ has long been acknowledged as one
of the classic texts on social policy. **

When _The Gift Relationship_ was first published in 1970 by Allen & Unwin it was
named by the _New York Times_ as one of the ten most important books of the year.

Is it better to pay for blood, or to rely on people giving it freely? Richard Titmuss’s
answer to that question — published in 1970 and reissued in this Policy Press edition—
became one of the most celebrated arguments in British social policy. But _The Gift
Relationship_ is more than a study of blood donation: it is a profound meditation
on altruism, solidarity, and what holds societies together.

 * [**Buy the book**](https://www.amazon.co.uk/gp/product/1447349601?tag=219)

A seemingly straightforward comparative study of blood donating in the United States
and Britain, the book elegantly raises profound economic, political, and philosophical
questions. Titmuss contrasts the British system of reliance on voluntary donors 
to the American one in which the blood supply is largely in the hands of for-profit
enterprises and shows how a non-market system based on altruism is more effective
than one that treats human blood as another commodity.

By treating blood as a gift rather than a commodity, Britain had created a system
that generated higher quality, more reliable supply at lower cost, while simultaneously
binding citizens together in a relationship of mutual care.

For Titmuss, the blood supply was a case study in a much larger argument. Drawing
on Marcel Mauss’s concept of the gift and on his own lifelong commitment to the 
welfare state, he showed how the commodification of altruism — the reduction of 
giving to a market transaction — corrodes the social bonds that make collective 
life possible. The lesson was not merely about blood: it was about the NHS, about
social security, about the entire architecture of post-war welfare provision. And
it remains urgently relevant today, as successive governments have sought to introduce
market mechanisms into public services.

The book’s history lends it a particular poignancy. Titmuss wrote it in direct response
to a proposal from the Institute of Economic Affairs, the same think tank that underpinned
the Thatcher government’s privatisation agenda, to commercialise blood donation.
Despite his warnings, the voluntary system was run down and Britain purchased contaminated
blood from American commercial suppliers, much of it from prisoners and drug users
already infected with HIV.

The long-running public inquiry into the contaminated blood scandal has given _The
Gift Relationship_ a renewed and painful topicality.

## Updated edition

This updated edition contains the original text along with new chapters that:

 * consider the relevance of Titmuss’s arguments to the AIDS and current health 
   care crises;
 * outline recent developments in blood donation and transfusion systems;
 * examine the systems for human milk donation; and
 * assess the response to the original edition and make the case for its continuing
   relevance today.

At a time when health and welfare systems are under sustained attack from many quarters,
this new edition of _The Gift Relationship_ is essential reading for everyone interested
in social policy and the future of our society.

## About Richard Titmuss

Richard Titmuss (1907–1973) was Professor of Social Administration at the London
School of Economics from 1950 until his death in 1973, and one of the architects
of the intellectual framework underpinning the British welfare state. He was an 
influential adviser to the Labour Party and to governments around the world, and
played a central role in establishing social policy as an academic discipline. _The
Gift Relationship_ was his final book.

## **Reviews**

> “A first-class study — moving from the relationship between blood donor and blood
> recipient to that between patient and physician, and thence to the very foundation
> of human societies.”
> _**Washington Post**_

> “Richard M. Titmuss’s _The Gift Relationship_ has long been acknowledged as one
> of the classic texts on social policy.”
> _**New York Times**_

> “Titmuss’s argument about how altruism binds societies together has proved a powerful
> tool in the analysis of welfare provision. His analysis is even more topical now
> in an age of ever-changing health care policy.”
> **Policy Press**

 * **[Richard Titmuss and social policy at LSE](https://blogs.lse.ac.uk/lsehistory/2017/09/26/richard-titmuss-and-social-policy-at-lse/)(
   26 September 2017)**