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Dr Sally Ruane

Job: Reader in Social Policy – Director of Health Policy Research Unit

Faculty: Health and Life Sciences

School/department: School of Applied Social Sciences

Address: De Montfort University, The Gateway, Leicester, LE1 9BH.

T: +44 (0) 116 207 8732

E: sruane@dmu.ac.uk

W: https://www.dmu.ac.uk/hpru

 

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Personal profile

Dr Sally Ruane has worked at De Montfort University since 1992, contributing to a number of postgraduate and undergraduate courses. She is currently Director of the Health Policy Research Unit, Doctoral Training Programme Lead in Applied Social Sciences and programme leader for the Masters in Research.

Dr Ruane's research activity in recent years has included health service reconfiguration, the private finance initiative, political opposition to privatisation in health care and taxation. She has strong links with colleagues in Spain and has given lectures and presentations at Spanish universities, conferences and workshops.

Dr Ruane has a keen interest in the future of the health service, including political aspects of health service reform, and she is happy to speak at public meetings and to groups of non-specialists who would like to know more about changes in the health service.

Research group affiliations

  • Health Policy Research Unit
  • Centre for Reproduction Research

Publications and outputs

  • Servicios de salud del Reino Unido en el periodo de pandemia y pospandemia
    dc.title: Servicios de salud del Reino Unido en el periodo de pandemia y pospandemia dc.contributor.author: Ruane, Sally dc.description.abstract: This book chapter examines the difficulties faced by the health services in Britain during the Covid-19 pandemic following a decade of severe funding contstraints in capital investment, public health and health services themselves. it considers outstanding challenges as the NHS operates in an environment shaped increasingly by a combination of problems including economic instability, funding restrictions at a time of high levels of patient need resulting in a weakening of public confidence in the service, and the global climate emergency.
  • Taxation, Health and Social Care
    dc.title: Taxation, Health and Social Care dc.contributor.author: Ruane, Sally dc.description.abstract: This chapter examines aspects of the role of taxation in health and social care in the UK. It examines the taxation basis for the funding of the NHS and its durability over time and juxtaposes this with the persistent calls for change in the way social care - only partially funded through taxation - is financed. The chapter explores public support for raising taxes to increase funding for the NHS, the increased use of taxation to fund private health care providers and attempts by both private providers and NHS Trusts to reduce tax liabilities through appeals to ‘charitable’ status. It considers two key ways in which taxation is implicated in the need to reduce socio-economic inequalities in order to reduce health inequalities. The first concerns the role of taxation in achieving a redistribution of resources and the second the levying of taxes on health-harming behaviours at both industry and individual levels.
  • Global Pandemics, Conflict and Networks – the dynamics of international instability, infodemics and healthcare in the 21st Century: Commentary
    dc.title: Global Pandemics, Conflict and Networks – the dynamics of international instability, infodemics and healthcare in the 21st Century: Commentary dc.contributor.author: Ruane, Sally dc.description.abstract: The article provides a commentary on Global pandemics, conflict and networks – the dynamics of international instability, infodemics and healthcare in the 21st Century dc.description: The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
  • Can the government’s new Integrated Care Systems deliver for children in England?
    dc.title: Can the government’s new Integrated Care Systems deliver for children in England? dc.contributor.author: Ruane, Sally dc.description.abstract: The creation of Integrated Care Systems in England is proving challenging as local ICS leads attempt to create structures which enable NHS and Local Authority services to work in a more joined-up way. Concerns around the complexity of the new ICSs have increased following the publication of a second White Paper on integration while the legislation associated with the previous White Paper on integration has yet to complete its passage through Parliament. The second White Paper adds further complexity, and potentially contradictions, particularly in relation to accountability structures in the new ICSs. Paediatricians may question whether the energies going into ICSs will serve to support child health care or impede it. dc.description: The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
  • Taxation and Social Policy
    dc.title: Taxation and Social Policy dc.contributor.author: Collins, Michael L.; Ruane, Sally; Sinfield, Adrian dc.description.abstract: This social policy textbook chapter examines the role of taxation in social policy. Specifically it asserts that: the tax system contributes to the distribution of resources but is often overlooked in social policy debates; different kinds of taxes differ in the way they affect inequality; tax expenditures, such as tax reliefs and allowances, often give more to the better off but lack scrutiny in public policy; policy makers believe that taxation affects the behaviour of individuals, households and firms; and there are increasing concerns about the activities of wealthy individuals and firms seeking to reduce their tax liabilities.
  • Written Evidence To The Health And Social Care Committee’s Inquiry Into the Department’s White Paper On Health And Social Care
    dc.title: Written Evidence To The Health And Social Care Committee’s Inquiry Into the Department’s White Paper On Health And Social Care dc.contributor.author: Ruane, Sally dc.description.abstract: This written evidence submitted to the House of Commons Health and Social Care Committee's Inquiry into the White Paper "Integration and Innovation: working together to improve health and social care for all" discusses concerns relating to: the lack of clarity surrounding the membership and functions of the two ICS Bodies; the reduction in local accountability; and the Increasing role of the private sector.
  • What can statistics tell us about the state of the NHS upon the outbreak of the SARS-CoV-2 pandemic?
    dc.title: What can statistics tell us about the state of the NHS upon the outbreak of the SARS-CoV-2 pandemic? dc.contributor.author: Ruane, Sally dc.description.abstract: This paper draws upon selected statistics to paint a picture of a National Health Service which was not only ill-prepared for the pandemic, but the resilience of which had been undermined by policy, especially during the decade leading up to the pandemic. The paper argues that financial constraints, failure to care adequately for the workforce and the ongoing closures of hospital beds in a context of rising pressures had resulted in the health service having insufficient capacity to meet health needs even prior to the pandemic. The policy priority of restructuring health services and the shrinking of the NHS estate, reflecting in part inadequate capital investment, distracted attention from pandemic preparedness and reduced the room for flexibility available to NHS managers when large numbers of infectious patients began to be admitted to hospital. Public health had been significantly damaged by reductions in its budget and by its three-way partition in the 2012 Health and Social Care Act, reducing its ability to mount an effective and coherent response to the pandemic crisis. The capacity of primary care and NHS 111 were insufficient to meet need even before the impact of the pandemic was felt and social care, upon which the NHS depends for the effective use of its own resources, had been debilitated by chronic underfunding and the application over many years of competitive market forces in a context of severe financial constraint. dc.description: The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the URI link.
  • La Pandemia en el Reino Unido
    dc.title: La Pandemia en el Reino Unido dc.contributor.author: Ruane, Sally dc.description.abstract: Like many other countries, the UK was not prepared for the coronavirus pandemic in early 2020. The early policy response was flawed and the seriousness of the threat appears not at first to have been appreciated. The NHS and care system were unprepared and hospital capacity was quickly stretched to the limit with most non Covid-19 patients needing elective care being required to wait longer for their care. Early mistakes were made around the discharge of patients into residential homes and the danger of Covid-19 to residents of care homes was not at first understood. The public health system was fragmented following legislation in 2012 which split it into three parts and this undermined the coherence and effectiveness of the public health response. The test and trace capacity available at the start of the pandemic was inadequate and the new test and trace system created in late Spring/Summer, on a national and largely privatised basis, failed to interact adequately with local public health departments and supply the necessary data in a timely way. The pandemic has exacerbated and made more visible socio-economic inequalities and the death rate has been severe, including among residents of care homes. High levels of public compliance with restrictions in the early stage of the pandemic gave way to lower levels of compliance in later months. The pandemic experience points to the importance of a coherent and well resourced public health system in pandemic preparedness and the need for new initiatives to be properly integrated into existing structures, dc.description: open access journal
  • Report on the Proposals for Maternity Services in the Building Better Hospitals For the Future Public Consultation
    dc.title: Report on the Proposals for Maternity Services in the Building Better Hospitals For the Future Public Consultation dc.contributor.author: Ruane, Sally; Reynolds, Kathy dc.description.abstract: The report sets out the proposals for maternity services, and the key stated drivers, contained in the Building Better Hospitals For the Future Consultation in Leicester, Leicestershire and Rutland. The report provides an assessment of the proposals drawing on relevant evidence, particularly in relation to the possible loss of free-standing midwife led birth unit, one of the four options which should be offered to low risk mothers according to the NICE quality statement. The report finds strong evidence for good quality outcomes in free-standing midwife led units and recommends the retention of a free-standing midwife led unit for expectant women in Leicester, Leicestershire and Rutland.
  • Proposals for Maternity Services in the Building Better Hospitals for the Future Public Consultation: Briefing Paper
    dc.title: Proposals for Maternity Services in the Building Better Hospitals for the Future Public Consultation: Briefing Paper dc.contributor.author: Ruane, Sally; Reynolds, Kathy dc.description.abstract: The briefing paper summaries a longer report setting out an analysis of the proposals made for reorganising inpatient maternity services in the 2020 Building Better Hospitals For the Future public consultation in Leicester, Leicestershire and Rutland. It draws attention to the reduction in choice for expectant mothers and the potential loss of a free-standing midwife-led birth centre as an available option for women at low risk of suffering complications in childbirth. It draws attention to the greater travel distances likely to arise for expectant mothers in the eastern side of the geographical area served by the Hospital Trust.

Click here for a full listing of Sally Ruane's publications and outputs.

Research interests/expertise

  • Health service reform
  • Health service reconfiguration
  • Taxation 
  • Political aspects of, and alternative approaches to, health service reform
  • Public private partnerships 
  • Private Finance Initiative

  • Faculty Research and Innovation Committee member
  • School of Applied Social Sciences Research Committee member
  • University Research Training Committee, deputy delegate
  • REF coordinator Unit of Assessment 20
  • Applied Social Sciences Doctoral Training Programme Lead

Areas of teaching

  • Health Policy
  • Globalisation and health
  • Postgraduate dissertation supervision
  • PhD supervision

Qualifications

  • BA (Hons) Sociology and Social Policy (Dunelm) 1981
  • MA Latin American Studies (Liverpool) 1984
  • PhD Sociology and Social Policy – Adoption talk and the social construction of motherhood (Dunelm) 1991

Courses taught

  • Applied Social Sciences Doctoral Training Programme
  • MA Applied Health Studies
  • Masters in Research
  • BA (Hons) Health Studies

Membership of external committees

Conference attendance

(2017) The welfare state and the Christian response to reform. Nottingham RC Diocesan Justice and Peace Annual Assembly. Derby, November.

(2017) Taxation and the Middle Class - evidence from UK households and the political implications of taxation for welfare, ESPAnet annual conference, Lisbon. September. With D Byrne.

(2017) How ‘public’ authorities keep the public at bay: public engagement with NHS ‘reform’, Dilemmas in Human Services annual conference, LSHTM, London. September

(2016) Privatización en el Sistema Nacional de Salud Británico, XXXIV Congreso de la FADSP -III Jornades de Salut d' ACDESA-PV, Castellón, Spain. November.

(2016) El impacto de la Iniciativa Privada de Financiación en el sector sanitario en el Reino Unido, European Conference in Defence of Public Health, Vigo, Spain. October.

(2016) ‘Public views of fairness and the UK tax system’. Annual conference of the Social Policy Association, Belfast 2016.

(2016) Logros y fracasos de las campanas contra la privatización del Sistema Nacional de Salud en Inglaterra. Keynote Speaker, Annual Conference of FADSP, Santander. February.

(2016) Cuts and closures in the NHS, Health Campaigners Together Conference, London. January.

(2015) Large scale reconfiguration in the NHS: challenging the evidence base, NHS in Crisis conference, London. December.

(2014) The distribution of the UK tax burden 1977-2011/12, Annual Conference of the Social Policy Association, Sheffield. July.

(2013) The political economy of taxation in the 21st century UK. With David Byrne. Annual Conference of the Social Policy Association, Sheffield University. July.

(2013) Exclusion and inequality in the new English health system, Key speaker at a health conference in the national Congress of Deputies, Madrid, at the invitation of Gaspar Llamazares MP. February.

(2013) Costs, cuts and inflexibility in the UK Private Finance Initiative, Key speaker at a conference on health in the Regional Parliamentary, Madrid, at the invitation of the Gaspar Llamazares MP. February.

(2013) The 2012 Health and Social Care Act: the end of the NHS as we know it?, lecture to the Leicester Secular Society. January.

(2012) Key proposals and implications of the 2012 Health and Social Care Act, fringe meeting, UCU national Congress, Manchester, June.

(2011) The NHS: Evolution and current prospects. Workshop series on international health systems for health professionals from Spain and Latin America. Bilbao, Spain.

(2011) Key political institutions in the saga of the NHS reforms Annual Regional conference of Medical Sociology. De Montfort University. June.

(2010) Overview of NHS reforms and impact of devolving commissioning responsibilities: some implications for professionals. Health Educators Summit, hosted by UCU. London. November

(2010) The principles of a progressive health policy in a time of change. Invited lecture (funded by European Citizens Foundation). Madrid Complutense University. July.

(2010) Costs in services, finances and inflexibility: The Private Finance Initiative in the UK.  Guest lecture (invited and funded) by Ernesto Lluch Foundation. Valencia University, Spain. June.

(2010) Invited participant at roundtable discussion on alternative approaches to health service reform; chaired by Nick Timmins at BMA House, Tavistock Square

(2010) PFI in the UK.  Guest speaker - International Chamber, Congress of Deputies, Madrid, at the invitation of the President of the Parliamentary Committee on Health, Social Policy and Consumer Affairs. Funded by European Citizens Foundation.

(2009) Reform and Recommodification: The Modernisation of the National Health Service in England, paper presented at the annual conference of Historical Materialism, School of Oriental and African Studies, London. November. Funded by Historical Materialism.

(2009) Developing an alternative vision of the NHS, presentation at a public meeting of the Northampton Trades Union Council. Northampton. November. Funded by NTUC; attended by trade unionists.

(2009) What can the public sphere offer us?, paper presented at a conference of the Bretton Woods Project: Recovery towards what? Finance, justice, sustainability G20 Finance Ministers’ Alternative Conference. Congress Centre, London. November. Funded by Bretton Woods Project. Attended by international audience of academic teachers and students; development agency personnel.

(2009) Experiencias de las Reformas de los Sistemas Sanitarios en Europa: el Caso de Inglaterra, Invited by conference organisers at a conference of the International Association of Health Policy: Health and the Global Crisis. Ministry of Health, Madrid, September. Funded by conference organisers.

(2009) Save Our Hospital campaigns in England: Why do some hospital campaigns succeed?, paper presented at a conference of the International Association of Health Policy in Europe, Coventry. June. Self-funded and DMU funded.

(2009) Health Service Reform in the UK: Developing an Alternative Approach, invited presentation  at the House of Commons, London. June. (Funded by Keep Our NHS Public)

(2009) Health Service Reform in England: Consequences and Concerns, presentation to a meeting of the Secular Society, Leicester. April.

(2008) Private Finance Initiative and the hospital sector in the UK. Presentation to trade union conference, Madrid, Spain. November.

(2008) ‘The relevance of Marxism to health policy’, paper presented to the annual conference of the Social Policy Association, Edinburgh. July.

(2008) ‘La Iniciativa de Financiacion Privada (PFI) en el Reino Unido: El impacto sobre los trabajadores sanitarios y la comunidad sanitaria en general’ conference of the Federacion de Asociaciones de la Defensa de La Sanidad Publica, Santiago de Compostela, Spain. March

(2008) ‘Health briefing’, East Midlands National Pensioners Convenstion Regional Parliament, Leicester

Current research students

PhD students:

  • The impact of public and patient involvement on the outcomes of cancer research
  • Record keeping among pharmacists
  • The lived experiences of childbearing among obese women
  • Men's views of timings and circumstances of parenthood
  • The experiences of migrant surrogate mothers in Russia
  • The experiences of mothers who have been imprisoned
  • School Refusal: Investigating an International Model of Interventions to Support Children and Families

Externally funded research grants information

  • Social Policy Association Opportunity Grants Scheme, 2017
  • ACCEPT mental health charity – advisor for service evaluation research, 2009-10
  • Leicestershire County Council – training and report on service reconfiguration, 2008
  • Rochdale Metropolitan Borough Council – report on service reconfiguration for the Independent Reconfiguration Panel, 2007