Trust me (I'm a doctor)

By Phil Hammond and Michael Mosley Metro Books London 215 pages£9.99

Or should it be: 'Trust me - I'm a comedian' or, perhaps, 'Trust me - I'm a medical journalist'? The response may be the same in either case: 'Why?' The problem is that the purpose of this book is confused. If, as the blurb has it, it is to help patients to judge 'not just whether a treatment will work, but whether it will be right for you' then is it really a good idea to devote half the book to the inadequacies of doctors and the system, particularly when the authors later say: 'Faith and suggestion have always been at the heart of medicine'?

They claim that patients need to understand the culture surrounding medicine, 'to give you an insider's guide to the practice'. To help us (sic) we then hear of the appalling practice and behaviour of some doctors.

Maybe it is true that black humour, to which many doctors are addicted, stopped Phil Hammond from, as he puts it, 'going under' but didn't stop him from caring for his patients. He believes so, but then he and his media mates have made quite a living from telling tales that turn your stomach. Worried lest I should appear defensive (Phil Hammond worked in Bath when I was in managerial charge) and conscious that I have often been guilty of black humour among colleagues, I cannot quite decide whether the rationale for the first half of the book is justified.

There is plenty of up-to-date stuff on the Bristol case and Rodney Ledward, the disgraced gynaecologist, but perhaps a little too much reiterates what we already know. It is not enough at this stage to point out that Private Eye was first with the story of the Bristol fiasco; indeed, that magazine's somewhat crude - and anonymous - brand of satire may have made it inevitable that what it said was not taken that seriously. What the parents and patients want to understand is why the system doesn't pick up on clinical malpractice sooner. The authors' discussion is hamstrung by their approach.

They tell jokes and want to be taken very seriously at the same time - a difficult trick to pull off in cold print.

If readers are still hanging in there, the second half does not suffer from the same problems and is an estimable attempt to educate the lay person in some of the more common ailments they may face and to explore some of the difficulties that face the NHS.

For example, patients are given questions to ask their doctor. There is a mature discussion on cervical screening, welcome at a time when it is definitely not politically correct to query its efficacy, its cost and the fact that it causes considerable anxiety. And people will be reassured if they haven't already heard the good news that alcohol in moderation and sex, ditto, are likely to lengthen life.

A chapter on common ailments tells us: 'Gill has back pain...' and we are taken through her tribulations. Colds, obesity and depression are all given a going-over and it is difficult to quibble with the down-to-earth sense of what is said.

All told, though, the shocking bits of this book are so much opportunism while the useful bits already exist in countless other publications on the shelves of GP surgeries and health food shops.

Andrew Wall

Visiting senior fellow, health services management centre, Birmingham University