Book review: New Life For Health: The Comissino on the NHS

Will Hutton
Random House, 2000; £4.99
ISBN 0 099 28575 4
Rating: 2/4

Political and journalistic debate about the NHS is widespread at the moment. Waiting lists, "accountability," and the role of the GMC spring to mind as having been thoroughly (although not always accurately) reported recently. One of the problems with subjects that become "issues of the moment" is that several words and phrases tend to become overused, and perhaps lose their meaning. "Accountability" and "public interest" become ends in themselves, rather than simple descriptions of part of a wider process. Do patients really go home from hospital saying, "Well, I'm in a lot of pain, but at least the doctors and nurses were all very accountable"?

The commission's report is full of such jargon. But perhaps this minor fault also makes it worth reading. To read this significant political paper is to acquaint oneself with the important principles sometimes hidden in overused phrases. But beyond that, this is a report by an influential committee, likely to shape future discussion and, possibly, political decisions. It is beneficial for anyone to understand the organisation in which they work, if only better to understand seemingly bizarre administrative decisions (without necessarily agreeing with them).

Broadly, in the early chapters, New Life for Health puts the problems of the NHS into a historical and political context. The rest of the book discusses defects of the service and puts forward the major recommendations of the commission. The level of debate verges on the abstract, and conclusions appear very unscientific. The highly qualified members of the commission speak of making the health service more "inclusive" and accessible to the public-but they do so in a very inaccessible language.

Certainly, this is not a light hearted, easy-to-read book, but perhaps it is worth the effort. We are allowed an insight into a key contemporary political debate and provided with many examples of the problems faced in reforming the NHS. Many points are made, and some are well made. But above all, a serious issue is under discussion. Judge the commission for yourselves, but do not dispute that there is an intricate problem to be solved. Ultimately, the best ideas must be gathered from all sources if health care is to be improved in this country.

Andrew Coulton, third year medical student, Imperial College School of Medicine, London
Email: andrew.coulton@ic.ac.uk


studentBMJ 2000;08:303-346 September ISSN 0966-6494