This is a well-written and accessible text aimed at the undergraduate reader, including those undertaking nursing and medical degrees. The general analytical approach that is adopted within the book seeks to situate ‘change and continuity’ within the NHS through an examination of what are identified as the three ‘distinct’ organisational features of the NHS. These three features are ‘tripartism’ (the organisational split between hospital-based care, the General Practitioner service, and local authority delivered ‘community care services’), the state-medical profession historical ‘double-bed’ relationship and the funding of the service by means of direct taxation. The emergence and subsequent development of each of these organisational features of the NHS is assessed by means of a historical tracing of ‘key events’ that have occurred over the course of the institution's 60-year history.

Although the bulk of the text is engaged with the historical developments associated with the three ‘distinctive organisational features’, there are additional chapters on the history of the development of the role of nurses within the NHS, and on the role of the public in shaping health policy. While the chapter on the changing fortunes of nursing as a profession within the NHS gives nurses a symbolically high profile in this historical text, the analysis of this role might have been better placed in the section concerned with the evolving state−medical profession relationship given the interconnected nature of the doctor−nurse relationship in the healthcare division of labour. The chapter on the role of the public in the health policy process is well-merited, but to conclude that this role has ‘changed dramatically’ since 1948, and by implication for the better, on the basis that patients are now treated as ‘co-producers of their care’, is a rather overblown conclusion to reach. Given the acknowledgement that treating patient's as ‘consumer’ of healthcare in a tax-funded healthcare system is highly problematic, it is surprising that such a conclusion is reached, and largely on the basis of a reading of formal policy statements rather than empirical work. Nevertheless, I would recommend the book as an undergraduate text on the basis that it more than ably presents a concise account of the historical linkages between the founding principles of 1948 and the contemporary politics of the NHS. The author presents a detailed if occasionally plodding examination (given the structure which sub-divides the analysis by decade 1940s/50s/60s etc) of the key policy developments occurring in relation to each of the three identified organisational features. Here it is also worth noting that for this level of historical overview, students would have previously had to turn to Charles Webster's two-volume Health Services since the War published more than a decade ago.

However, for the post-graduate reader (one of the books identified target audiences) looking for an analytical framework to contextualise the health policy processes that occurred during the period of New Labour ‘modernisation’, the book is perhaps less successful. To expand on this point, the three identified organisational features that form the focus of the text are not as claimed particularly distinctive to the NHS, but can be found in various manifestations within healthcare systems existing elsewhere within the European Union. Here, the inclusion of a brief comparative analysis of EU healthcare systems drawing out their contextual commonalities (as well as their distinctive features), may have avoided some of the parochialism found within the text. The book also lacks an explicit discussion of the implicit theoretical frame (path-dependency) that is deployed in assessing the health policy process. The lack of an explicit frame of analysis is a surprise given Ian Greener's demonstrative commitment in his previous publications to the application of path-dependency theory. In one of his previous thought-provoking case studies deploying the path-dependency model, Greener (Reference Greener2001) examined the continuities between the NHS of the 1950s and 1980s. In this paper, the ‘ideological and fiscal discomfort’ experienced by the newly elected Conservative government's of these two periods are brilliantly described in the face of what are identified as ultimately impenetrable structural barriers to the expansion of a role for the private market in healthcare provision. In the textbook, such an approach is much more implicit, and the analysis suffers as a consequence.

The penultimate chapter is entitled ‘Health policy under Labour’ and aims to ‘bring together the analysis from other chapters of the book to consider health policy since 1997’. While this chapter presents a useful if overly concise account of the key policy developments under New Labour, the attempt at drawing together the previous discussion of the historical lineages of key organisational features rather breaks down following the admission that, ‘the introduction of the market dynamic into the NHS means that the future has become tremendously unpredictable’ (p. 223). This introduction of a market dynamic is a dramatic development in the history of the NHS precisely because it represents the breakdown off the very structural barriers previously identified by Greener himself. However, very little in the preceding chapters has prepared us for the author's acknowledgement that New Labour's new market for care (of a quite different scale and scope than the internal market introduced during the 1990s under the Conservative government) ‘has the potential to be the most radical reform in the NHS's history (p. 223). I feel that such a ‘revelation’ so late on in the book could and should have been avoided by giving a much greater focus within the text to a political economic framing of the historical role of the state in relation to health and welfare.

On a final note, I could find no explicit discussion of the consequences of devolution for the healthcare arrangements within Scotland, which in many important ways diverges from the English NHS, notably in relation to the funding of long-term care. Neither is there a mention of the differences in organisational structure from the English model that pertain in Wales and Northern Ireland, which should also merit inclusion given the books title.