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Book Review - Politicians' impact on the NHS

The latest edition of this guide suggests few political leaders will have a long-term effect on the NHS.

Any book with such a dry title as The New Politics of the NHS that reaches a sixth edition must be pretty good.

Written by Rudolf Klein, a senior fellow of the British Academy and emeritus professor of social policy at Bath University, this is a pre-White Paper update on the development of the NHS.

There is little doubt that health services are influenced by politics. The relative lack of controversy regarding the NHS in the recent general election was in reality due to politicians trying to steer away from healthcare issues. However, the huge difficulty for President Obama and his health bill in the US demonstrates how political healthcare is.

History of the NHS
The first seven chapters and most of the eighth remain the same as the previous edition. The author admits he deals mainly with the English NHS, not feeling able to tackle the health areas that have passed to devolved governments.

The book takes the reader through the history of the NHS, from its astounding inception in the middle of a war for the nation's survival, to the present and into a vision of the future.

Great knowledge
Professor Klein's great knowledge of the events that have formulated the NHS over the past few decades gives good insight into the roles politicians have played. But it becomes clear he believes only a few of those he has come into contact with will leave a permanent mark.

As with many NHS guides, the emphasis is on secondary over primary care, and the 2004 GMS contract is dealt with in little more than one paragraph.

And, it is surprising that he does not mention the chaos that affected many doctors following the disastrous introduction in 2007 of the Medical Training Application Service.

The final chapter discusses the future, comparing today's consumer-driven health service with how the NHS was initially envisaged. His analogy of its founding to starting a benevolent church is apt given the Labour party's historical connection with Methodism.

Given the book's wealth of detail, it would not be amiss for all GP registrars to read it if they are to understand how the NHS has developed.

Discount offer
Readers can buy this book for £23.79 plus p&p (usual price £27.99 plus p&p). Order through www.radcliffepublishing.com and enter discount code DX50 at the checkout, or call 01235 528820 and quote the code. Offer ends 15 November 2010. Also available at www.healthcarerepublic.com/bookstore

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