books

With political attention being focused on rural services and the provision of healthcare, the addition of this little textbook to the excellent Radcliffe Medical Press stable is both welcome and timely.

Overall, the editors have achieved what they set out to do in amalgamating the diverse subjects into a readable and practical book packed with information, resulting in a unique manual on rural medicine.

Michael Cox's witty line-drawing cartoons are interspersed between the text and offer a lighter look at the issues. Primary care group chief executives and primary care team managers with rural practices in their areas will find this book invaluable in understanding the problems of equitable resourcing of services.

They are not alone - rural nursing teams, GPs and GP registrars will also want to add this to their libraries.

It lists a number of useful organisations, but the provision of addresses, telephone numbers and electronic addresses could be more comprehensive.

There is a strong section on medical emergencies associated with the agricultural community, and excellent advice to doctors on medical equipment needed to cope with emergencies in isolated areas where ambulance response times are longer.

There is also an explanation of how dispensing practices operate - although since the book was written the cost-rent scheme has been improved to allow floor-space flexibility when designing a dispensary. It is important to note that the practice nurse will only be able to prescribe under the new nurse prescribing scheme if they have a district nursing or health visitor qualification.

Communications in rural practice are vital, and the writer describes the latest reliable technology available in rural and isolated areas. Teamwork and flexible schemes are encouraged to use each person's skills as they work further away from the nearest hospital, as well as reducing the risk of professional isolation.

Patient access to care and the problems associated with distance are discussed, along with ways of addressing them, but the writer has no answer to the funding issue.

No easy remedies are offered for dealing with the effects of rural poverty and deprivation.

The chapters on continuing professional development and rural research give ideas for keeping the rural practitioner bright and in touch with colleagues in rural areas. The final chapters pick up the loose ends with descriptions of the use of community hospitals, branch surgeries and the schemes available to isolated practitioners to provide services to patients.

The first textbook about rural medicine in the UK, Rural Healthcare is easy to read, comprehensive and authoritative.

It would seem to be invaluable for intending and established rural primary healthcare workers, including GPs, nurses, managers and administrators, and also represents good value for money.

Dr Russell Walshaw Chair, rural practice sub-committee of general practitioners committee, British Medical Association