This book is not what it may seem at first glance. Although seven of its 12 chapters trace the NHS’s development from Bevan to Hewitt, it is not primarily a history of the service. And although its author teaches health policy at Coventry University, it is not really an academic work.

For John Lister has been the eyes, ears—and mouth—of the campaigning organisation London Health Emergency for the past 24 years; and it is from his “distinctive point of view” as a campaigner and trade union activist that he has written a book concerned more with the NHS’s present and future than its past. He admits that it is not an “impartial study” but a “campaigner’s book.” He is frank that it may contain “weaknesses” and “inadequate knowledge,” but his aim is to examine how policies have worked in practice at a local level.

The current crop of policymakers and their advisers will deplore his analysis and conclusions—at any self congratulatory 60th anniversary celebration Lister …