Existing health policy literature has tended to neglect the political process of health reform, the context in which it occurs, the actors involved in it and the distribution of power between them (Walt, Reference Walt1994; Figueras et al., Reference Figueras, Saltman and Mossialos1997). Instead, it has tended to produce an ideal image of health systems advocating ‘modern’, ‘rational’ and ‘efficient’ health policies. For example, although Abel-Smith's classic textbook is intended to be ‘about how to improve health in a cost-effective and politically acceptable way’ (Abel-Smith, Reference Abel-Smith1994: vii), it does not address the political process of health reform. The situation is no different in practitioners’ literature either. The 2000 World Health Report ignores conflicts of interest between health policy actors, and the World Health Organisation makes recommendations ‘as if health sector reform occurs in a political vacuum’ (Hsiao et al., Reference Hsiao, Roberts, Bergman and Reich2001: 70). Laudably, the aim of Crinson's book is ‘to contextualise the essentially political process of formulating and implementing health policy by locating specific developments within a broader set of social and institutional processes’ (p. 13). In doing so, Crinson integrates various conceptual themes drawn from sociology and political science into a critical assessment of health policy developments in the UK and Europe.

The book consists of 11 chapters grouped in four sections. The first section lays the theoretical foundations for health policy studies. Chapter 1 scopes the field of health policy and introduces ‘power’ as a key concept for critical health policy analysis. Chapter 2 discusses the role of the state and democratic politics in modern societies, including pluralist, elitist, Marxist, neo-liberal and new institutionalist approaches, and then goes on to examine various welfare state ideologies. Chapter 3 analyses the policy process of health policy by juxtaposing Weber's classic model of ‘ideal-type’ rational bureaucracy with Lindblom's ‘muddling through’ and other post-Weberian approaches. The major strength of this section is in the comprehensive coverage and critical assessment of competing theories and concepts. Yet, there is a bias towards macro-level sociological analysis and much less attention is given to meso-level concepts and processes, which would be useful for applied health policy research.

The second section focuses on the UK's healthcare system in the European context. Chapter 4 treats the organisation of the NHS in a historical perspective, highlighting differences between the UK's countries. Chapter 5 describes the system of healthcare funding in Britain, including the purchaser–provider split and the role of private finance in the NHS. Chapter 6 affords a comparative study of the British and European healthcare systems. Some readers may find the material covered here too descriptively factual, but for a novice health policy student the section will be helpful as it would be virtually impossible to synthesise this material via the Internet, or by other means. However, it is a pity that this section does not address the issues of governance and accountability of NHS trusts, e.g. the accelerated conversion of NHS trusts into foundation trusts accountable to local communities, the role of the independent regulator Monitor and the introduction of US-style service-line management. Also, it would be an added advantage if the comparative chapter included the US – a crucial case demonstrating the importance of critical health policy analysis and allowing the English-speaking reader to sustain their interest in the politics of health policy by following US health policy debate in the media.

The third and fourth sections are devoted to specific issues in contemporary healthcare policy. Chapter 7 investigates the role of the medical profession in the structuring of the NHS. Chapter 8 looks at the management and performance of the NHS, focusing on the new regulatory frameworks and agencies, organisational culture and the challenges of decentralisation. Chapter 9 discusses a set of concepts related to the patient-led NHS agenda, including the supplier market, patient choice and equity. Chapter 10 explains the growing demand for long-term care in the community and the logic that shapes new eligibility criteria for care. The final Chapter 11 concentrates on the major health challenges associated with dangerous lifestyles and widening social inequalities. The chapter and book conclude by outlining global health risks and pondering whether governments around the world would be able to forgo their policy-making sovereignty to develop global health policies. Unquestionably, the author is well acquainted with contemporary health policy, and so these chapters are arranged in a way that is illustrative of the contemporary issues in health policy and of critical policy analysis, without compromising the concision of the book.

This well-ordered, relatively concise and timely textbook will find a home on the shelves of healthcare and social science students taking modules in health policy, their teachers, as well as the general reader seeking both theoretical and practical insights into contemporary health policy. The merit of this book is not that it has proposed a definitive framework for health policy analysis, or that it has covered all the current health policy issues, but that it has related key sociological and political science concepts and theories to health policy analysis, which the reader may put together as they like to develop their own lines of inquiry. Moreover, vignettes with key concepts and suggested activities that appear throughout the text will help the reader further develop their critical thinking and understanding of the issues discussed in the text.