Understanding the Human Rights Act A tool kit for the health service By Roy Lilley, Paul Lambden and Christopher Newdick Radcliffe Medical Press 165 pages£30

English law is based on case law - the Americans have a constitution and a bill of rights. Not surprisingly the British find the Human Rights Act potentially threatening.

Suddenly to codify and set out a series of rights which we, through our European involvement, have to some degree at least 'signed up to' leaves us trying to understand how this will work out in practice. For those who worry about such things the intervention of Roy Lilley with his co-authors must seem to be a godsend.

But the problem is that the tool kit series has become a kind of hammer - and for Lilley every problem now begins to look like a nail. Is this in fact the most helpful way to look at this complex topic?

Lilley warns us to 'become an expert, but not a barrack-room lawyer. . . remember that this is all so new that not even the lawyers are sure how it will pan out. . .'Nevertheless he believes the act to be so important that we should be circulating copies throughout the NHS. Do we really want so many people struggling to get to grips with such a complex area if we haven't really got the case law to substantiate interpretations?

This is best highlighted by the suggestion that ethics committees should develop a draft policy on patient consent for medical trials and experimental treatments based on the Human Rights Act.

Surely this is an area where being part of a national service has advantages.

My concerns about the book's format are reinforced by its wealth of case law. The authors cover most of the wellknown cases. This book needs at least two indices. An index of all the areas in which there is an impact from the Human Rights Act and an index of all the cases listed. I needed to flip back and see how some of the cases that I know about are now seen in the light of the Human Rights Act, but I am frustrated from doing that.

If the book was more of a general summary of legal issues within the NHS and the potential impact of the Human Rights Act and perhaps designed in - dare I say it - a more traditional way, it would be more useful. The section on public enquiries (when you stumble on it) is very helpful.

But you would have trouble knowing it was there.

Is the format familiar? Lilley does repeat two of his jokes in different places. Great content - shame about the design.