Review

Minor irritant

The Insider’s Guide to the NHS – how it works and why it sometimes doesn’t
Roy Lilley
Radcliffe Medical Press Ltd, 2003. £17.95

All organisations need a Roy Lilley – a bit of grit in the system whose presence cannot be ignored and which produces the occasional pearl. And given its huge quangocracy of over-compliant chairpersons and board members, the NHS has a particular need for his sort.

This, his latest offering, is not a pearl but has the makings of a seed which could become one.

The NHS has undergone a period of unprecedented change over the past six years with the unfolding of the government’s modernisation agenda. So much so that even old pros like me find it increasingly difficult to keep up. So an easy-to-read ‘rough guide’ to assist in this process is welcome, especially when written in Roy’s trenchant style: ‘This inspection malarkey is such a big job. I have visions of half the NHS closing down, while it goes off to inspect the other half!’

The problem, however, is that the book’s span is nowhere near wide enough. It feels like a taster for a much larger future work, which would have to be regularly updated. I doubt that Roy would be interested in such a commission and to institutionalise his idea would be to risk losing much of its freshness and punch.

So better perhaps to see this as a diverting and undoubtedly informative one-off rather than the start of a much-needed NHS encyclopaedist movement.