BOOKS

Laing's Healthcare Market Review 2001-2002 Publisher: Laing & Buisson. ISBN: 1 85440 077 0. 460 pages.£185. Orders: 020-7833 9123. www. laingbuisson. co. uk

It may sound like an unlikely recommendation, but this is my new favourite volume.

OK, it is built like the back of a phone book and character development is poor, but everyone who cares passionately about the NHS should read it. Though, at£185 a throw, that doesn't seem likely. One for the pooled budget, perhaps.

There is a mine of fascinating information here about trends in the private healthcare industry - taken sector by sector - its prospects and its take on government health policy. And there is plenty of insight for commissioners:

read this to see what the private hospital is doing about your waiting-list overflow, or what the care-home owner aims to get out of the deal.

But even more can be gleaned by reading between the lines.

For there is something of an NHS-shaped hole in the text.

The health service is described only as it impinges on the industry. There is no underlying assumption that the NHS should be there at all.

At the back is a charming directory of private providers, complete with blurb: 'Set in landscaped parkland'; 'rooms all equipped with nurse call, en suite facilities and colour TV and video'.Your local NHS hospital probably has rooms equipped with a colour TV. . .

and 11 other patients. It is enough to make an NHS manager weep.

But the meat of the book is the market review itself. The NHS has had a complex relationship with the private sector ever since Nye Bevan stuffed the consultants'mouths with gold. There is both interpenetration and conflict.

This book, therefore, contains a discussion of the impact of consultants'NHS commitments on their private sector work that acute trust managers should find illuminating. There is similar analysis of every point on the ragged line between the NHS and the private sector.

Laing & Buisson are leading industry analysts; they do more than count the beans.

This market review is a model of calm, sober analysis. It is stripped of the rhetoric of ministers urging the NHS into partnership with the private healthcare industry as if it is there mainly to offer up its spare capacity.

It is also shorn of the gungho, 'we'll-do-a-millionops-a-year' attitude of the cheerleaders at the Independent Healthcare Association.

It is a presentation of how the other half thinks. For example, there is 'the possibility that a modernised NHS may fundamentally undermine the demand for privately funded healthcare by delivering a more accessible, timely and efficient elective surgery service which is free at the point of use'.

Sounds good? Not at all: here, it is 'a threat' - to the independent sector.

There is some relief, however, from the harsh Labour warnings that the NHS is in last-chance saloon, with the advocates of personal medical insurance - aka the Tories - waiting eagerly in the wings.

In fact, the equation is more complex.

It is 'too early' to say whether public perceptions of the NHS will change and lead to a fall in demand for private insurance, these more cautious analysts write. And factors outside NHS managers' control, such as economic recession, affect private healthcare demand too.

This is a looking-glass guide to recent government health and social care policy. It is not patient-centred, nor does it pretend to be. It is there for private sector managers to plan their business development more profitably.

Read this - and read between the lines - and the absence of underpinning social values may give you a sharp reminder of why you care about public service. A rather different ideology governing the private sector is starkly revealed here.

Is that the sound of barriers going up? Careful, now.