Health policy in Britain

Fourth edition By Christopher Ham Macmillan 240 pages£45 hardback£14.99 paperback

Among health policy analysts, Chris Ham is unrivalled in his ability to distil and synthesise complex policy developments and present them in a clear and digestible manner for non-specialists. The fourth edition of Health Policy in Britain has all these familiar hallmarks.

It is aimed primarily at undergraduate social policy and administration students but, as with earlier editions, it will almost certainly acquire a far wider readership. Indeed anyone seeking a general review of current developments in UK health policy will be hard pressed to find a better text.

The book falls into two main sections. The first part provides a narrative account of the development of health policy from the 19th century to the present day.

The chapter on New Labour and the NHS is impressively up-to-date. It must be the first general textbook to discuss primary care groups, new approaches to clinical governance, the comprehensive spending review and even the 'third way'.

The second part focuses on the policy process, with chapters on making and changing, implementing, monitoring and evaluating policy. The last chapter brings together diverse material from the audit explosion to health improvement programmes.

Reflecting Ham's political science background, the final chapter is on power in health services.

Ham has 20 years' experience of straddling the academic, policymaking and practitioner worlds and draws on this to present an extremely comprehensive account of the policy process.

But the book does have its limitations. Parts are showing their age. Much of the policy process discussion draws on literature published 20 years ago or more, with extensive references to the diaries of Castle, Crossman and Wilson. Discussions of corporatism and Marxist approaches to power have a rather 1970s ring.

Readers looking for insights into the very different policy world of the 1990s may be rather disappointed.

Ham's declared intention of discussing policy in a dispassionate manner, while admirable in a textbook, does lead to a certain blandness and sometimes Panglossian view of the evolution of policy.

But, overall, these deficiencies are more than counterbalanced by the breadth of material in the book, the way it has been woven together and the clarity of its presentation.

Everyone with an interest in health policy should possess a copy of this book.

Professor Ray Robinson London School of Economics