Radcliffe Publishing now has an increasing range of books for health policy writers and practitioners including the latest edition of Rudolf Klein's excellent ‘New Politics of the NHS’ (2006) [ref required. The book being reviewed here presents work organised by the Judge Institute in Cambridge, based around the examination of policy futures for UK health (Dargie et al., Reference Dargie, Dawson and Garside2000; Dawson and Saussman, Reference Dawson and Saussman2005). The book is marketed as helping ‘policy makers and stakeholders plan the future of healthcare in the United Kingdom by summarising the context within which health policy is developed, identifying the key current issues and pointing out the various factors that feed into decision making’ (back cover).

The book begins with an ‘environmental scan’ that attempts to condense the wide-ranging changes taking place not only within the NHS, but in the world healthcare environment under the headings of ‘disease, society, environment, governance, economics and industry’ (p.3) which update similar sections from the Policy Futures report of 2000 (Dargie et al., Reference Dargie, Dawson and Garside2000). This introduction is primarily descriptive, and is a useful source for those wishing to find further sources in each of the topic areas, but necessarily contains so much information that it leaves the reader slightly dazed. After the environmental scan, two substantially overlapping chapters appear that explore the legal and ethical context of healthcare, and which provide especially valuable information on trends around litigation and euthanasia that are both informative and interesting.

The book then moves on to a series of chapters exploring questions based around key policy issues for the future. Each of these chapters ends with specific policy recommendations. The first of these chapters, ‘Who's going to govern?’, covers an admirable range of topics and manages to be informative as well as giving the reader plenty of sources of further reading. The next chapter ‘Who's going to care?’ has less material to cover, but manages to present clearly and concisely the general themes I would expect, moving from the boundaries between unpaid and paid care to issues around nursing training and recruitment, to medical training, and to shifting professional boundaries, in a thoughtful way.

The chapter on ‘What will be the burden of health?’ provides a useful survey of trends in morbidity change that will be of interest to those looking to find sources on how illness patterns are changing, and how policymakers have responded. ‘Where will technology take us?’ is as good, exploring changes in both therapy and drug innovation as well as the use of ICT (please sgive in full) by patients and telemedicine, although I was surprised to see that work from the informatics group at York was excluded from this section (Burrows and Nettleton, Reference Burrows, Nettleton, Burrows and Pleace2000; Burrows et al., Reference Burrows, Nettleton, Pleace, Loader and Muncer2000; Nettleton and Burrows, Reference Nettleton and Burrows2003).

Perhaps the biggest topic of all is left till last. ‘What will health cost?’ gives its authors an extremely difficult topic which they manage admirably, and which in many respects helps bring together many of the other topics in the book. The chapter covers health trends and their implications as well as governmental responses through Wanless and beyond, and then moves on to explore in more detail trends in financing health systems. The authors cover the (in the UK) difficult subject of private payment and insurance, but I would have liked to see more mention of the private finance initiative as the authors seem a little quick to accept, following Maynard, that the source of investment in future healthcare is less important than the direction of medicine and medical effort, when it remains a hugely contentious area.

Finally, the book moves on to its concluding section which presents a discussion around the question ‘What are the linkages for joined up policy?’ which attempts to find intersections between the other chapters, and which effectively acts as a further summary of the book's contents. Finally there is a single page which highlights future policy challenges including the need to articulate a strategy for health as an individual good, the need to locate health policy in a global context, the need for the increasingly fragmented NHS to review accountability more explicitly, the need for greater strategic leadership in healthcare, and concerns about dealing with what the authors call the ‘crisis of care’.

In all, this book can perhaps be best regarded as a useful summary of existing trends in health policy which point the way towards lots of further sources to back up the authors’ review and summary. The recommendations it offers at the end of the chapter, however, can feel a little over simplified, appearing in bullet point form where perhaps it might have been better to present a little more discussion. Equally, I am not entirely clear that the authors point the way to policy in the future as they aim to do, but this is certainly asking a great deal. Equally, the book tends to be a little descriptive in places, and so will not serve an academic audience as well as it might have done had the information been arranged more into analytical themes. However, it is well worth acquiring for its range and its use as a source book to locate further materials. The authors are to be congratulated for the range of subjects contained within the book.