Hektoen International

A Journal of Medical Humanities

Book review: Understanding the NHS

Arpan K. Banerjee
Solihull, United Kingdom

Book cover of Understanding the NHS by Andy Stein, 2022.

The National Health Service in the United Kingdom was founded in 1948 by Aneurin Bevan, a Welsh Labour Party politician and health minister in Clement Attlee’s post-war Labour government. Bevan was a coal miner before entering Parliament in 1928. He had long campaigned for a free health service for all people.

In 1942, the Beveridge Report suggested that a comprehensive insurance system should exist to provide care “from the cradle to the grave” in which patients would be treated according to their needs and not their ability to pay. This was the beginning of the welfare state in the UK. The Health Service would be free for all, rich or poor. Since its inception, the British National Health Service has been seen with awe and envy by many countries, and criticized by others for deficiencies and inefficiencies in certain aspects of medical care delivery.

In this book the author, a hospital physician with thirty-seven years of experience in the NHS, has set out to explain how the Health Service works, how it is organized, and how it has developed over the years. The book examines the formation of the NHS, how new services and buildings have been funded, how staff are trained, and how specialists and special services are commissioned. Mental health, public health, and general practice (family medicine) are also covered in some depth.

Of late, the Health Service has become digital and this development is explained for the reader. There is a speculative chapter on the future of the NHS and an important glossary of the many acronyms used within this large organization. The book is primarily aimed at those starting work in the British Health Service, but it will also be profitably read by anyone who professes an interest in this organization.

Senior Health Service personnel will be familiar with the many reorganizations that the health service has undergone, as well as with some of the bureaucracy that is described. The statistics provided show that although in certain areas the Health Service has not performed as well as other private systems, it has greatly improved in the past twenty years. It remains one of the most cost-efficient systems of healthcare delivery in the world. Most of the statistics predate the Covid-19 pandemic of 2020, and since then there has been some unfortunate deterioration in the ability of the Health Service to deliver all needed health services for the entire population.

This book is easy to read and provides a useful introduction to this important British institution. It will probably be thumbed not just by those starting their careers in the NHS, but also by those who have spent a lifetime working within this remarkable institution.

Understanding the NHS
Andy Stein
White Owl Imprint of Pen and Sword Books, 2022
ISBN 9781399007962

ARPAN K. BANERJEE qualified in medicine at St Thomas’s Hospital Medical School, London. He was a consultant radiologist in Birmingham 1995–2019. He was President of the radiology section of the RSM 2005–2007 and on the scientific committee of the Royal College of Radiologists 2012–2016. He was Chairman of the British Society for the History of Radiology 2012–2017. He is Chairman of ISHRAD. He is author/co-author of papers on a variety of clinical, radiological, and medical historical topics and seven books, including Classic Papers in Modern Diagnostic Radiology (2005) and The History of Radiology (OUP 2013).

Spring 2022  



Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.