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Grant, S. (1990). Politics and Planning in the National Health Service By Neil Small Milton Keynes: Open University Press £10.95.. Psychoanal. Psychother., 5(1):92-92.

(1990). Psychoanalytic Psychotherapy, 5(1):92-92

Politics and Planning in the National Health Service By Neil Small Milton Keynes: Open University Press £10.95.

Review by:
Sandra Grant

Neil Small guides the reader through the labyrinthian complexities of the structure and management of the National Health Service and the powerful political influences that determine it. He covers the major changes over the years between 1983 and 1989, from the intervention of Griffiths to the radical reforms in the White Paper, Working for Patients. The somewhat daunting account of a succession of reports, reviews and Health Service circulars is lightened by the inclusion of contemporary media reports recording personal views of the main protagonists. Small is particularly astute about the endless conflicting and contradictory analysis over numbers. It becomes pine-chillingly clear how the way figures are presented can change a cut in resources into an alleged growth. This is a well-researched book that remains remarkably readable despite the depth of information. The only area somewhat difficult to digest for the reader who comes from a clinical background is Small's rather terse descriptions of the work of theorists in management and sociology. I strongly recommend this book for anyone seriously concerned about the current crisis in the National Health Service.

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