As the chairman of the BMA (1990-3) during the implementation phase of many of Margaret Thatcher's NHS reforms, Jeremy Lee-Potter is well qualified to chronicle the planned reforms and the political forces that in many cases steam rollered them through. Ostracised by the more left wing of the BMA members as a closet Tory, Lee-Potter has been criticised for using this book to attempt to excuse his unconfrontational stance against the politicians. This book is, however, an entirely readable and relatively unbiased account. On only one occasion does the author portray himself as a martyr to the cause, and that surely should be his right both as author and as deposed chairman.

The book opens with an introduction to the proposed reforms in the white paper Working For Patients. The author goes right back to the origins of health care in Britain, discussing the Poor Law and the establishment of a national health service at the end of the second world war. He also discusses the various government reports commissioned in the years preceding the reforms, and explains why a review was needed.

He follows this with a comprehensive account of how the reforms were introduced and the discussions between BMA officials and politicians. Specifically he considers the problems encountered in trying to implement the changes, discussing the terrifying results of the largely ignored Rubber Windmill project, in which a model of the reforms demonstrated that the NHS was destined to collapse because of the failure of the internal market system to succeed for a product as volatile as health care.

Throughout the book an equilibrium is achieved between factual detail and humorous insight into political opponents. On William Waldegrave he writes: "He was reputed to buy his wife Caroline's clothes, but I often thought she might have bought his with advantage. Less curly shirt collars and fewer drab ties, usually at half-mast, might have sharpened up his political image quite a bit. I wondered whether Mrs Thatcher might have had a few words with him on the subject, as she was reputed to have done with Nigel Lawson on his need of a haircut."

Although Lee Potter may not have been the perfect candidate to lead the BMA through the difficult period of opposition to the reforms, he has without doubt shown himself to be an excellent historian, detailing events as they occurred and along the way recounting numerous anecdotes reflecting the mood of the medical profession.

"I tried," he says, "to explain the feelings of the consultants ... confronted with new general managers, who in medical terms were of about senior registrar experience and seniority, who now seemed to have skipped ahead of them in influence and power."

Perhaps the weakest part of the book is its final chapter, in which the author presents an altruistic vision of the NHS, at odds with the tone of the rest of the book. However, as the author eventually resigned from the NHS because of his personal views, perhaps his own biography is a reasonable forum in which to air them.