Reviewed by A.R. Giles


This volume of 321 tightly written pages is not for the faint-hearted! But its subtitle, ‘voluntary and statutory relationships in Irish healthcare’, indicates that it might be essential reading for the voluntary worker (unpaid) and the manager (paid) in Irish care services.

As activists in ‘the voluntaries’ our morale is lifted on the very first page by Dr Mary Redmond’s foreword, in which she points out that the government Green Paper published in 1997 insisted that society must have ‘an active citizenship’ and an ‘active voluntary and community sector that contributes to a democratic, pluralist, …society’. But, so that we do not get above ourselves, O’Ferrall points out that it has just not been like that! His book offers a contribution to the subsequent White Paper on the relationship between the voluntary sector and the state, so that perhaps those grand words of 1997 might become reality.

O’Ferrall’s book derives from his thesis, submitted for a Master’s Degree at Trinity College Dublin, and this shows in the style. The contents page gives an excellent overview of the practical development of voluntary work since the founding of the state, and policy development at government level since 1986. Later we are led through an overview of the theories of voluntary action in society.

Difficult or not to read, the early section provides for the reader a journey through the history of our state which is not focused, as is usual, on revolution and politics, but on the development of care. Here we have a new history of Ireland highly relevant to ourselves as participants in the politics of care.

Are the flag-sellers standing for hours in the cold wet street thinking of the ‘theory of voluntary action’ which underlies their wait in the rain? O’Ferrall explains that there is such a theory and what it is. He argues the need for an ‘active citizenship’ in our democratic republic, as opposed to the simple enjoyment of our freedoms, in a non-active way. He argues that the path of active citizenship may be via the voluntary organisation, but with a full understanding of the relationships and possible conflict with the state. O’Ferrall takes the reader through the reasons why voluntaries exist in a democratic society, and why they are essential even in a welfare state. A careful reading of this section is rewarding.

Throughout the book the writer seldom strays from his experience with the management of public voluntary hospitals and their ‘politics’, sometimes traumatic within themselves and with the state. The later part of his book is focused on the experiences of acute hospitals and he brings, as a case-study, the experience of the Adelaide and Meath Hospital.

The topic is important, since 11.5% of the non-agriculture Irish workforce is employed in the voluntary sector and they represent 43% of all public-sector employees. The expenditure of the voluntary sector takes up 8% of GDP (Freda Donoghue, quoted in The Irish Times, 12 November 1998), with 3800 organisations registered as charities with CHY numbers.

So should you, unpaid or paid worker in this voluntary sector, spend your £15 and considerable time on this book? That depends. If your involvement is in the area of coffee mornings, flag-selling and fund-raising, maybe. If you want to know what lies behind being a voluntary worker, read it. If you are a manager negotiating with the health boards or government departments, then this book deserves your careful study. Although not specific to the learning-impaired sector, O’Ferrall’s book is a worthy addition to the increasing body of literature on this topic written for the Irish context.

CITIZENSHIP AND PUBLIC SERVICE: Voluntary and statutory relationships in Irish healthcare by Fergus O’Ferrall. The Adelaide Hospital Society and Dundalgan Press, Dundalk (2000) IBSN 0-85221-140-6 £15.00-