Review

Too businesslike by half

The NHS: Myth, Monster or Service? Action Learning in Hospital
Nelson Coghill and James Stewart
The Revans Press, Salford, 1998

This extremely useful study of the NHS is a must-read for any serious student of the health service and the options open to it in the immediate future.

The authors place both cherished public beliefs about the NHS alongside genuine critical appraisal of recent events that have led us to where we are now. The result is that they comprehensively set about debunking many of the attitudes to management and human resource provision that we have acquired within the service over the last few years.

It is refreshing to find writers who are not afraid to question the status quo of resource management, as it has been presented to us by non-nursing professionals. Coghill and Stewart do not hesitate to confront us with uncomfortable truths about the scenarios that we have been offered in recent years about ‘best management’ of the NHS and which, by default, we have colluded in and supported.

Can the health service be a ‘business’ and run as such? We have been told that it is, and that it should be. We have bought into that basic statement and the NHS, and the nursing profession in particular are now in crisis as a direct result of where that thinking has led us.

The authors tackle this assumption (‘that makes patients and children into commodities; we are not’) head on, and challenge it, fully supported by references from successful business gurus such as Tom Peters. They offer hope of returning to the caring profession for which we thought we were training – if we retake the initiative. Please read this book.