The NHS - A Picture Of Health

The National Health Service is one of Britain’s most remarkable institutions, an organisation founded upon the extraordinary principle that being ill should not automatically lead to bankruptcy. Naturally, having established this admirable arrangement, the country has spent much of the subsequent decades arguing about how to pay for it, who should run it, whether it is working properly and why obtaining an appointment occasionally requires the strategic planning skills of a military commander.

The NHS: A Picture of Health (1983), by Steve Iliffe and published by Lawrence and Wishart, examines Britain’s great experiment in publicly funded healthcare at a particularly turbulent moment in its history. The NHS was approaching its thirty-fifth anniversary, Margaret Thatcher was firmly established in Downing Street, and arguments about public expenditure, political priorities and the future of the welfare state were becoming increasingly heated.

Iliffe, a doctor and writer with a strong interest in the social and political dimensions of healthcare, approaches the subject with an awareness that medicine does not exist in some conveniently isolated world of white coats, reassuring smiles and expensive equipment. It is also inseparable from politics, economics, social inequality and the rather inconvenient fact that the people requiring treatment are not always those with the greatest financial resources.

The book considers the achievements, difficulties and contradictions of a health service that transformed British society after its establishment in 1948. For millions of people, access to medical treatment without direct charges at the point of use represented an extraordinary improvement over earlier arrangements, when the ability to afford a doctor could be almost as important as the nature of the illness.

Yet establishing a national health service did not miraculously abolish disease, eliminate bureaucracy or persuade governments to agree upon its funding. Hospitals still required staff, equipment and buildings, medical priorities competed for resources, and politicians continued discovering that promising improvements was considerably easier than delivering them.

Writing in the early 1980s, Iliffe examines a system facing financial pressures and competing visions of how healthcare should be organised. His perspective makes the book particularly interesting as a historical document, capturing debates that now seem astonishingly familiar despite the passage of more than four decades.

There is something almost reassuring about discovering that arguments over waiting lists, management, efficiency and the appropriate role of government were flourishing long before electronic records, online appointment systems and the modern enthusiasm for reorganising everything every few years.

Published by Lawrence and Wishart in 1983, this volume offers an absorbing perspective on the NHS during a period of significant political and economic change. It will appeal to readers interested in medical history, British politics, public services and the curious national habit of simultaneously celebrating an institution and complaining about it.

Condition: Good. This 1983 edition is a previously owned copy showing ordinary signs of age, reading and handling, but remains a worthwhile addition to any collection concerned with the history of British healthcare.

Offered by Crappy Old Books, where we support the preservation of important historical documents and are delighted to report that purchasing this particular volume does not require a referral from your GP.

A thought-provoking reminder that the NHS has been the subject of passionate argument for generations, and that the search for a perfectly healthy health service may prove to be one of Britain’s longest-running national occupations.

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