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The global Covid-19 pandemic is posing considerable challenges for governments throughout the world and has and will have a significant influence on the shape of peoples social and economic life and wellbeing in the short and longer term. This opinion paper discusses the current health policy response adopted in England to control or manage the epidemic and identifies the key sociological and political influences which have shaped these policies. Drawing on the theoretical approach set out in his recent book, which emphasises the interplay of powerful structural and economic interest groups, the author will consider the influence of the key players. Government policy has tied itself to scientific and medical evidence and protecting the NHS so the key roles of the medical profession, public health scientific community and NHS management and their respective and relative powerful influences will be discussed. The government needs the support of the public if their policies are to be successful, so how have the government addressed maintaining public trust in this “crisis” and how much trust do the public have in the government and what has influenced it? The strong emphasis on social distancing and social isolation in the national government policy response to Covid-19 has placed an increasing public reliance on the traditional and social media for sources of information so how the media has framed the policy will be considered. One policy aim is for an effective vaccine and the influence of the drug industry in its development is discussed. Finally, the role of the state will be discussed and what has shaped its social and economic policies.

The purpose of this paper is to compare the perspectives of actors who contribute to trust in the food system in four high income countries which have diverse food incident histories: Australia, New Zealand (NZ), the United Kingdom (UK) and the Island of Ireland (IOI), focussing on their communication with the public, and their approach to food system interrelationships.

Data were collected in two separate studies: the first in Australia, NZ and the UK (Study 1); and the second on the IOI (Study 2). In-depth interviews were conducted with media, food industry and food regulatory actors across the four regions (n=105, Study 1; n=50, Study 2). Analysis focussed on identifying similarities and differences in the perspectives of actors from the four regions regarding the key themes of communication with the public, and relationships between media, industry and regulators.

While there were many similarities in the way food system actors from the four regions discussed (re)building trust in the context of a food incident, their perceptions differed in a number of critical ways regarding food system actor use of social media, and the attitudes and approaches towards relationships between food system actors.

This paper outlines opportunities for the regions studied to learn from each other when looking for practical strategies to maximise consumer trust in the food system, particularly relating to the use of social media and attitudes towards role definition in industry–regulator relationships.

The aim of this paper is to draw together suggestions for future research from the papers and from the discussion that took place at the workshop.

The suggestions are summarised under four broad themes.

At an international workshop on trust organised by the UK MRC Health Services Research Collaboration there was broad agreement that trust was still a salient issue in diverse health care contexts. The workshop proceedings identified a number of important questions for empirical research and several key conceptual, theoretical and methodological questions relating to trust that need to be addressed in support of or alongside this. The collection of papers in this volume starts to address some of these questions.

Considers trust relations in health care from patient, clinical, organisational and policy perspectives.

The aim of this paper is to provide a rationale for examining trust in health care.

Conducts a review of the literature of trust relations in health care that highlighted that most empirical research has addressed threats to patient‐provider relationships and trust in health care systems from the patient's perspective, but studies in the organisational literature suggests that trust relations in the workforce, between providers and between providers and managers, may also influence patient‐provider relationships and levels of trust.

Suggests that trust is not primarily dispositional or an individual attribute or psychological state, but is constructed from a set of inter‐personal behaviors or from a shared identity. These behaviors are underpinned by sets of institutional rules, laws and customs.

This introductory paper has presented some evidence from an international, comparative study but there is the need for further, more detailed investigation into why trust relations may vary in different health care systems.

This introductory paper provides a rationale for examining trust in health care and a context for the different elements of trust.

This paper seeks to address how and why trust relations in the NHS may be changing and presents a theoretical framework for exploring them in future empirical research.

This paper provides a conceptual analysis. It proposes that public and patient trust in health care in the UK appears to be shaped by a variety of factors. From a macro perspective, any changes in levels of public trust in health care institutions appear to derive partly from top‐down policy initiatives that have altered the way in which health services are organised and partly from broader social and cultural processes. A variety of policy initiatives, including the introduction of clinical governance and the resulting use of performance management to scrutinise and change clinical activity, increasing patient choice and involvement in decision‐making regarding their care, are examined for how they have changed the context for trust relations within the NHS.

It is argued that these policy initiatives have produced a new context for trust relations within the NHS, shifting the inter‐dependence and distribution of power between patients, clinicians, and mangers and changing their vulnerability to each other and to health care institutions. The paper presents a theoretical framework based on current policy discourses which illustrates how new forms of trust relations may be emerging in this new context of health care delivery, reflecting a change in motivations for trust from affect based to cognition based trust as patients, clinicians and managers become more active partners in trust relations. The framework suggests that trust relations in all three types of relationship in the “new” modernised NHS might, in general, be particularly characterised by an emphasis on communication, providing information and the use of “evidence” to support decisions in a reciprocal, negotiated alliance.

The paper examines the drivers for change in trust in health care relations in the UK and develops a theoretical framework for the emergence of new trust relations that can be subsequently explored through empirical research.

This paper describes the methods used within the Dignity and Older Europeans (DOE) Project and in particular the approach involved in developing the bibliographical database, the philosophical methods used in creating the theoretical model of dignity, together with the empirical methods involved in data collection with older people, health and social care practitioners and the younger and middle‐aged adults, will be described.The paper will attempt to provide the reasoning for the chosen methods and highlight some of the difficulties involved in carrying out comparative cross‐cultural research.

This paper considers some implications of recent developments relating to patient safety for understandings of trust in health care contexts.

Conceptual analysis focusing on patients' trust in health care providers and health care providers' trust in patients.

Growing awareness of the scale of the problem of iatrogenic harm has prompted concerns that patients' trust in health care providers may be threatened and/or become inappropriate or dysfunctional. In principle, however, patients' trust may be both well placed and compatible with current understandings of safety problems and efforts to address these. Contemporary understandings of patient safety suggest that, to be deemed trustworthy, health care providers should make vigorous efforts to improve patient safety, be honest about safety issues, enable patients to contribute effectively to their own safety, and provide appropriate care and support after safety incidents. Patients who trust health care providers need not be ignorant of patient safety problems and may be vigilant in the course of their care. Iatrogenic harms do not necessarily reflect breeches of trust (not all such harms are yet preventable), and patients who are harmed might in some circumstances appropriately forgive and resume trusting. Health care providers may feel vulnerable to patients in several respects. From their perspective, trustworthy patients will act competently to optimise the outcomes of their health care efforts and to preserve health care providers' good reputations where those are justified. Providers' trust in patients may strengthen patients' trust in them and facilitate safety improvement work.

Shows how, in principle, trust can be compatible with current understandings of patient safety issues and may enhance efforts to improve patient safety.

Evidence from epidemiological studies (Doll and Peto, 1981 European Atherosclerosis Society, 1987) has clearly pointed to a strong association between food consumption and disease. This association has been used to account at least in part for the relationship between social class and a range of diseases (Townsend, Davidson and Whitehead, 1988), as evidence from survey research (MAFF, 1987) suggests that patterns of food consumption and dietary intake vary markedly between social classes and income groups. The aim of this article, drawing on data derived from an exploratory, qualitative investigation of patterns of food consumption in middle class and working class households, attempts to throw some light on the relationship between social class and food consumption.

Considers the importance and relevance of taking into account the views of the public in the provision of health care. Identifies the salient questions and explores some of the broader issues. Aims to describe how far countries have been concerned to take into account citizens′ views, the mechanisms and channels through which these views are represented and their effectiveness for influencing decision making.

If public trust in health care is to be used as a performance indicator for health care systems, its measurement has to be sensitive to changes in the health care system. For this purpose, this study has monitored public trust in health care in The Netherlands over an eight‐year period, from 1997 to 2004. The study expected to find a decrease in public trust, with a low point in 2002.

Since 1997, public trust in health care was measured through postal questionnaires to the “health care consumer panel”. This panel consists of approximately 1,500 households and forms a representative sample of the Dutch population.

Trust in health care and trust in hospitals did not show any significant trend. Trust in medical specialists displayed an upward trend. Trust in future health care, trust in five out of six dimensions of health care and trust in general practitioners actually did show a decrease. However, only for trust in macro level policies and trust in professional expertise this trend continued. For the remaining trust objects, after 1999 or 2000, an upward trend set in.

No support was found for our overall assumption. Explanations for the fact that trust did increase after 1999 or 2000 are difficult to find. On the basis of these findings the study questions whether the measure of public trust is sensitive enough to provide information on the performance of the health care system.

The aim of this research is to study public trust in health care on its abilities to be used as a performance indicator for health care systems.