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Review
"At a time when current policy seems bereft of original ideas and sustainability, Hunter has produced an insightful and coherent analysis, which underscores a strong argument for a different approach." --Neil Goodwin, Visiting Professor of Leadership Studies, Universities of Durham and Manchester and a former CEO in the NHS
Product Description
Health care systems across the world are in a state of permanent revolution as they struggle to cope with multiple pressures arising from changing demography, new technologies, and limited resources. Focusing on the British NHS, this book offers a fresh look at how it has coped with such pressures over its 60 year history and considers what the future holds. The book explores the complexity of health policy and health services, offering a critical perspective on their development. A number of tensions are evident in contemporary health policy and the book is organised around a selection of these, including: the funding of health systems and the changing mix of public and private arrangements; the capture of medicine by management; the imbalance between health and health care; and the growing emphasis on markets and competition in health care systems.The health debate offers a lively and accessible reassessment of successive reforms of the NHS and their cyclical nature. A unique feature of the book is its breadth and assembly in one place of a range of interrelated, and largely unresolved, policy puzzles. The book will appeal to all students of health care and health policy, and to policy-makers and health care professionals.
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Most Helpful Customer Reviews
7 of 8 people found the following review helpful
The Explanation of why the last 20 years of NHS reforms have cost so much and delivered so little
4 Oct 2008
Format:Paperback
This is an important analysis of the mismanagement of the NHS in the last twenty years. The UK NHS is both a good example and a dire warning to the rest of the world. It's a good example in that we achieve population coverage to some level. The dire warning bit is that the standards (of access, and outcomes achieved) are not as high as we like to think, or as good as in comparable European countries.
Imagine a car company that did not like its engineers. That's about the relationship between NHS management and the doctors and nurses who deliver the care to patients. Hunter clearly shows the problems that such an attitude causes and reminds us, ""As any change management text will state, the chances of ensuring that successful implementation occurs are seriously impaired if those working on the front line are not signed up to the changes and seek to contest, or undermine them.....A key feature of the most recent changes in the NHS in England is that the key professions have been disengaged from the reform process"
The UK NHS is a dire warning to others. It has consumed vast amounts of policy ideas and money, and delivered little in return for all the investment spent on it. The processes of change have been disruptive, faddy, and not sustained rather than constructive with long term outcomes in mind. Hunter describes the policies and their botched implementation carefully, and is clear about the consequences. The book is clearly written and well referenced, and so makes a strong case for its conclusions.
The tragedy is that all of us are suffering from this- doctors, patients, managers, voters, taxpayers, politicians.
Read this excellent book to find out where things have gone wrong in the NHS and why. And then make a note that centralized top down schemes which do not engage the workers will never succeed. No matter how much you paid the management consultants and special advisers to write them.
Imagine a car company that did not like its engineers. That's about the relationship between NHS management and the doctors and nurses who deliver the care to patients. Hunter clearly shows the problems that such an attitude causes and reminds us, ""As any change management text will state, the chances of ensuring that successful implementation occurs are seriously impaired if those working on the front line are not signed up to the changes and seek to contest, or undermine them.....A key feature of the most recent changes in the NHS in England is that the key professions have been disengaged from the reform process"
The UK NHS is a dire warning to others. It has consumed vast amounts of policy ideas and money, and delivered little in return for all the investment spent on it. The processes of change have been disruptive, faddy, and not sustained rather than constructive with long term outcomes in mind. Hunter describes the policies and their botched implementation carefully, and is clear about the consequences. The book is clearly written and well referenced, and so makes a strong case for its conclusions.
The tragedy is that all of us are suffering from this- doctors, patients, managers, voters, taxpayers, politicians.
Read this excellent book to find out where things have gone wrong in the NHS and why. And then make a note that centralized top down schemes which do not engage the workers will never succeed. No matter how much you paid the management consultants and special advisers to write them.
Most Helpful Customer Reviews on Amazon.com (beta)
Amazon.com:
1 review
The Failings of the UK NHS laid bare
2 Feb 2009
Format:Paperback
This is an important analysis of the mismanagement of the UK NHS in the last twenty years. The UK NHS is both a good example and a dire warning to the rest of the world. It's a good example in that we achieve population coverage to some level. The dire warning bit is that the standards (of access, and outcomes achieved) are not as high as we like to think, or as good as in comparable European countries.
Imagine a car company that did not like its engineers. That's about the relationship between NHS management and the doctors and nurses who deliver the care to patients. Hunter clearly shows the problems that such an attitude causes and reminds us, ""As any change management text will state, the chances of ensuring that successful implementation occurs are seriously impaired if those working on the front line are not signed up to the changes and seek to contest, or undermine them.....A key feature of the most recent changes in the NHS in England is that the key professions have been disengaged from the reform process"
The UK NHS is a dire warning to others. It has consumed vast amounts of policy ideas and money, and delivered little in return for all the investment spent on it. The processes of change have been disruptive, faddy, and not sustained rather than constructive with long term outcomes in mind. Hunter describes the policies and their botched implementation carefully, and is clear about the consequences. The book is clearly written and well referenced, and so makes a strong case for its conclusions.
The tragedy is that all of us are suffering from this- doctors, patients, managers, voters, taxpayers, politicians.
Read this excellent book to find out where things have gone wrong in the NHS and why. And then make a note that centralized top down schemes which do not engage the workers will never succeed. No matter how much you paid the management consultants and special advisers to write them.
And if Americans are looking for a scheme to emulate then the UK NHS probably is not it.
Imagine a car company that did not like its engineers. That's about the relationship between NHS management and the doctors and nurses who deliver the care to patients. Hunter clearly shows the problems that such an attitude causes and reminds us, ""As any change management text will state, the chances of ensuring that successful implementation occurs are seriously impaired if those working on the front line are not signed up to the changes and seek to contest, or undermine them.....A key feature of the most recent changes in the NHS in England is that the key professions have been disengaged from the reform process"
The UK NHS is a dire warning to others. It has consumed vast amounts of policy ideas and money, and delivered little in return for all the investment spent on it. The processes of change have been disruptive, faddy, and not sustained rather than constructive with long term outcomes in mind. Hunter describes the policies and their botched implementation carefully, and is clear about the consequences. The book is clearly written and well referenced, and so makes a strong case for its conclusions.
The tragedy is that all of us are suffering from this- doctors, patients, managers, voters, taxpayers, politicians.
Read this excellent book to find out where things have gone wrong in the NHS and why. And then make a note that centralized top down schemes which do not engage the workers will never succeed. No matter how much you paid the management consultants and special advisers to write them.
And if Americans are looking for a scheme to emulate then the UK NHS probably is not it.
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