This is a punchy, succinct examination of contemporary issues facing UK healthcare.
David Haslam is a former president of the BMA and, amongst other qualification, is well situated to be writing this type of book. He also has a qualified position from which to argue from. The main argument is that the issues facing modern British healthcare are not going to be solved simply by providing more funding. He makes this argument carefully and is well aware it is against popular thinking. Across the three opening chapters, Haslam details what has caused the increase in healthcare costs on a macro level since 1948, why they are a problem for us today and how healthcare practitioners have tried to address them.
It is a neat structure, and helped a great deal by Haslam's plain spoken language. The middle chapters take narrower arguments into account, looking at ageing, mental health, pain management and medicalisation in every day life. There is far less of a political edge to Haslam's writing than one might expect from a book about this topic. At no point does he attempt to win the reader's favour by taking cheap shots, or slip into a critical evaluation of various political policies. Most of Haslam's focus is on the provision of care by the NHS and the ways in which it has spiralled out of control financially.
Unfortunately, this does make the book very boring. Haslam's writing is purposefully plain, and his arguments are without force or vigour. It has urgency, but without any of the ideological direction such arguments require in order to win reader's hearts. For some reader's, this will be ideal. On the whole, it feels like a very dry think tank paper. In the final chapter Haslam attempts to centre the argument onto solutions but they all come across as well worn, and without novelty. Greater patient engagement, decentering care from hospitals towards communities, and reducing waste, are all commonly argued solutions not unique to this book. This is disappointing, and makes the ending feel a little damp.
What is novel is the arguments and how Haslam makes them. There are some exceptionally good ideas here, well worth checking out for people with a passion for healthcare policy. As such, people who want to read this book, will read it without needing to check the review.