The author's declared objective is to suggest that health services exist 'in place of fear', in Aneurin Bevan's phrase, and that they should be judged according to that criterion, rather than by their limited success in reducing deaths and disability.
He seeks to prove this contention, using the NHS as an example.
Arguably, the NHS is unique among major healthcare systems in seeking to realise Bevan's vision because, as the author implies, people's fear is not so much about the disease itself as about the ability to obtain competent care when they need it.
This slim volume is a heroic attempt to highlight in chronological order the major landmarks in the philosophy, history and functions of the NHS.
The method is to pose 101 selective questions and to offer refreshingly idiosyncratic answers.
In general, the longer answers are the most satisfying, notably in relation to the future for primary care and the box about increased interest in clinical effectiveness.
Brevity leads to some regrettable over-simplification and sweeping assertions, which could mislead a reader using the text as an introduction to the NHS. Examples are the contention that the relationship between health professionals and patients is 'a con'; that health visitors' work 'was confined to helping mothers to look after their babies after the midwife had completed her tasks' when, in reality, much of their best specialised work has always been done with elderly and mentally ill people; the impression that organised health education and health promotion was discovered only in the 1970s; and the repeated assertion that the reorganisation in 1974 brought all doctors and nurses in the NHS 'under one authority'.
The text is interspersed with clear illustrations, some of which are commendably original. But I was bemused by the graph showing a positive relationship between the proportion of Labour councillors and home helps in a Welsh county, which might surely be explained by higher relative need in poorer areas.
Dr Vetter's educated cynicism - a feature that he shares with eminent colleagues in South Wales such as Cochrane and Tudor Hart - leads him to do less than just ice to h is medical colleagues, particularly to the pioneering zeal of many medical officers of health, whom some of us still recall with admiration. It is carrying self deprecation rather far to criticise public health physicians for failing to give people information to make sense of health issues when they have demonstrably not been free to do so.
The references are an excellent guide to further reading, and the index is admirable.
I would commend this work to the knowledgeable reader as a source of stimulating illustrations and material for debate.
Sir Alexander Macara Former chair of council of the British Medical Association.