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The Leveson Centre for the study of Ageing, Spirituality and Social Policy
 
Betraying The NHS, Health Abandoned

Betraying The NHS, Health Abandoned

Michael Mandelstam, October 2006,
Jessica Kingsley Publishers, 320 pages, ISBN 1 84310 482 2 £14.99

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Review by James Woodward (Director, the Leveson Centre)

As a former employee of the NHS in the 1990’s (a period of immense change, initiated by the Conservative Government), a former non-executive Director of a Primary Care Trust during a period of enormous change by a Labour Government, I read this book with some care and interest.  It is an impressively written, biased and carefully argued thesis, which attempts to demonstrate that recent changes have inflicted untold damage on the people of Suffolk, especially the elderly and other vulnerable people. 

There is a robustness and groundedness about the arguments, though the author might have been more critically self reflective about his own prejudices and presuppositions.  There might also have been some further space given to the question of how far it is possible to meet such diverse and wide-ranging expectations of a service which is comprehensive and national.  I’m not convinced that there has been a wide spread collapse of public trust in the NHS and how far it is possible for the NHS, as a bureaucracy, to engage in detail with the range and diversity of local reality.  However, his experience of the effects of changes on older people clearly present a case of how humane care can be compromised by the determination of management to increase patient throughput and hit Government set targets.

Mandelstam is strong on analysis and skilled in asking the right range of questions.  The book might have been a stronger one if he had taken his analysis and experience and offered some solutions in the light of perceptions of mis-management in his geographical area.

It’s a spirited, engaging and intelligent book and deserves wider publicity and readership.  Any manager initiating and delivering a changed agenda should read this book with care.

James Woodward (Director, the Leveson Centre)

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