Review

Labour of love’s lost?

THE PURCHASING OF HEALTH CARE BY PRIMARY CARE ORGANISATIONS: an evaluation and guide to future policy
Nick Mays et al (eds)
Open University Press, 2001, £25.00

Picture the scene: After almost five years of diligent and painstaking effort on one of the largest evaluations of primary care organisations ever commissioned, you are about to type the final sentence. Suddenly, one of the members of your multidisciplinary multiuniversity team enters the room. ‘Have you seen this?’, she asks, waving the details of the new Labour government’s co-operative approach to commissioning. What do you do?

A: Psychologically prepare yourself for life in the ‘Book remainders’ bin?

B: Take the honourable action and impale yourself on your quill? or

C: Perform a seamless attempt at cosmetic surgery and describe a smooth transition from the Conservatives’ total purchasing pilots to Labour’s PCG/T commissioners?

The answer, as any pragmatic researcher will know, is C. Well, almost.

The Total Purchasing National Evaluation Team (‘TP-NET’), under the leadership of Nick Mays, was four months from the end of its evaluation when Labour’s plans for primary care were announced. So this well-edited volume finds itself seeking a double existence as informative retrospect on what it poetically describes as ‘the last gasp of the expiring Conservatives’ ill-fated market experiment’, and as prospective analysis of Labour’s collaborative NHS.

Viewed simply in reductionist terms, the editors have added a one-chapter preface and a one-chapter summary to their work to make it meet both demands. But this would be unfair, as even a cursory check in the index under ‘The New NHS’ reveals that the political change provides a subtext to the whole book.

As a recent addition to the Open University’s well-respected State of Health series, this proves a valuable contribution to our current understanding of primary care. Whether we are doomed to repeat the lessons of the past, without necessarily learning from them, remains to be seen.