Professor David Hughes
Professor in Health Policy
Public Health, Policy and Social Sciences
Telephone: (01792) 602114

Professor David Hughes has worked in health policy, medical sociology and socio-legal studies. He is based in the Department of Public Health & Policy Studies at Swansea, and previously held appointments at the Universities of Dundee, Oxford and Nottingham. After a career which has focused mainly on studies in the British NHS, Hughes has developed an interest in international comparative research. He has published on the universal coverage health care reforms of Thailand and Turkey, and was a member of the team that recently undertook the 10 year assessment of the Thai universal coverage scheme.

David is currently one of the editors of the Wiley journal Sociology of Health & Illness
http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1467-9566

Areas of Expertise

  • health policy
  • purchaser/provider reforms
  • NHS contracts
  • universal coverage healthcare
  • medical sociology
  • PPI. engagement

Publications

  1. (in press). Informed consent, judicial review and the uncertainties of ethnographic research in sensitive NHS settings. (SAGE Research Methods Cases (Online Collection)).
  2. & Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand. PLOS ONE 12(3), e0174055
  3. UK-wide health policy under the Coalition. In Exworthy, M. Mannion, R. and Powell, M., (Ed.), Dismantling the NHS? Evaluating the impact of health reforms. Bristol: Policy Press.
  4. Cultural influences on medical knowledge. In Schramme, T and Edwards, S. (Ed.), Handbook of the Philosophy of Medicine. Springer.
  5. (2016). Migrants’ right to healthcare: accepting limits on what European healthcare systems can provide (letters). (British Medical Journal No. 353).

See more...

Teaching

  • ASP214 Health Policy 1

    This module addresses developments in the organisation of the health services across the UK, setting this within wider relevant historical, political and social contexts. It examines the concepts of `health¿ and `illness¿, the formulation and evaluation of health care policy and its economic dimensions, as well as analysis of inequalities in health, comparative health systems, professionalisation and accountability.

  • ASP314 Health Policy

    This module introduces students to developments in the organisation of the health services across the UK, setting it within the historical, political and social contexts of society. It examines the concepts of `health¿ and `illness¿, the formulation and evaluation of health care policy and its economic dimensions, as well as analysis of inequalities in health, comparative health systems, professionalisation and accountability.

  • SHBM00 Social, Cultural and Economic Context of Health

    In this module students will develop a critical understanding and appreciation of the wider context of health care management. The social, cultural and economic context within which health and illness are defined and experienced and how these impact and influence the organisation and financing of health care and health systems will be critically explored.

  • SHHM14 Introduction to Research and Study Skills

    This module aims to provide students with the necessary generic skills to undertake research successfully, including organisation and time management skills, handling relationships with supervisors and research personnel (informants, gatekeepers etc), use of bibliographic sources, conduct of literature searches, use of internet, communicating research results, making oral presentations and writing for different audiences and purposes.

  • SHHM16 Ethics and Philosophy of Social Research

    This module will address the ethics of conducting social research. The discussion of research ethics will include, but not be limited to, informed consent and how to protect the anonymity of research participants. Discussions will also address the limits of researchers' obligations to protect anonymity and confidentiality, along with taking a more detailed look at the process of applying for university research ethics approval. Philosophical problems associated with conducting social research will be explored - asking questions such as 'How is our understanding of others limited? ''Are my research findings objective?¿.

  • SHHM34 Case Studies in Applied Social Research: Social Work

    The module examines key issues in research on social work and social care by presenting a series of case studies illustrating various research methods applied in these areas.

  • SHQM27 Politics and Policies

    This module is a compulsory module in the MSc Health Care Management programme. It will analyse the forces and processes that shape modern health care policies, discussing the phases of policy formation, implementation and evaluation. Theories and models of the policy making process will be examined as they relate to actual practice and the potential obstacles to `perfect implementation¿ will be studied. A series of contemporary issues such as rationing, patient and public involvement, and policy divergence after devolution will be discussed.

  • SHQM31 Comparing Health Care Systems

    The module will provide an opportunity to examine different health care systems and analyse different financing mechanisms, coverage policies and attention to equity within different political and socio-cultural contexts. Health care systems will be examined in terms of the balance and relationship between the public and private sectors. The involvement of global and international organisations will also be considered. Students will have opportunities to describe and discuss health care systems from around the world.

  • SHQM37 Organising Health Care

    The aim of the module is to provide a comprehensive understanding of the factors influencing strategic and operational planning in health and social care. The module is concerned with the theory of strategic planning and the concepts that underpin resource allocation in health and social care. It is increasingly difficult to claim that strategic planning is a distinctively different process in the public sector compared with the private sector, and any differences in philosophy and process will be explored and examined. The module will emphasise how ideology, politics, value systems and resource constraints pose particularly challenging issues in the development, formation and implementation of strategic plans in health care. The module will also deal with resource allocation mechanisms in the public sector, in particular the relationship between allocation of resources to that of meeting objectives related to addressing inequalities in health status and service provision.

  • SHQM40 Social, Cultural and Economic Context of Health

    In this compulsory module students will develop a critical understanding and appreciation of the wider context of health care management. The social, cultural and economic context within which health and illness are defined and experienced and how these impact and influence the organisation and financing of health care and health systems will be critically explored.

Supervision

  • Dual practice of medical professionals in public hospitals in south-east Nigeria: An economic and policy analysis (current)

    Student name:
    PhD
    Other supervisor: Prof Ceri Phillips
  • Obstacles and challenges affecting the move towards universal healthcare coverage in Nigeria (current)

    Student name:
    PhD
    Other supervisor: Dr Eryl Maunder
  • Performance improvement and innovation in Saudi Arabian health care: barriers and opportunities (current)

    Student name:
    PhD
    Other supervisor: Dr David Rea
  • Public participation and good governance in Thailand's public sector organisations. (current)

    Student name:
    PhD
    Other supervisor: Dr Gillian Spedding
  • Challenges in consolidating and protecting universal health care coverage in Malaysia. (current)

    Student name:
    PhD
    Other supervisor: Dr Gillian Spedding
    Other supervisor: Dr Alison Hann
  • Comparative Study of the implementation of Regional Health Plans in Oman (current)

    Student name:
    PhD
    Other supervisor: Dr David Rea
  • Untitled (current)

    Student name:
    PhD
    Other supervisor: Prof Sue Jordan
  • An ethnographic study of emotion work in emergency pre-hospital care (current)

    Student name:
    PhD
    Other supervisor: Dr Michael Coffey

External Responsibilities

  • Editor, Wiley journal Sociology of Health and Illness

    2013 - Present

Impact

It is my research on Thailand’s universal healthcare coverage reforms, rather than my UK studies, which has had the most impact in recent years.  The Thai universal coverage scheme (UCS) brought low-cost healthcare to 47 million Thai people.  My fieldwork-based study of the implementation of the reforms in the relatively-poor north-eastern region was one of the few empirical studies in English-language journals, and helped demonstrate the feasibility of UHC reforms in a lower-middle income country to an international readership.  My work was cited in the WHO World Health Report 2008, Global Healthwatch 3 (Alternative World Health Report) 2011, the India Health Report 2010, and featured as one of two case studies in the launch document for Bill and Belinda Gates’ Ministerial Leadership Initiative for Global Health Reform.  It is available on the Joint Learning Network’s ‘resources’ webpages, and has been used for UHC workshops in India.   The research had highlighted a problem of ‘equity of distribution in local healthcare systems whereby money intended for prevention and promotion work was being diverted to curative hospital projects.  This finding led the Health Insurance System Research Office (HISRO) to commission further research on the issue and to a policy of ring-fenced budgets for primary care units. Subsequently I was asked to assist in background research for the implementation strand of the Thai government's 10 year assessment of the UCS scheme.  I co-authored the implementation (TOR 3) report and helped in the preparation for the overall 10 year assessment report, which later fed into the 2013-15 Health Sector Plan.  The 10-year assessment report attracted considerable international  interest, and led WHO and Rockefeller Foundation to commend the Thai UCS reforms as a model that should be considered by other Asian nations.