Betraying the NHS: Health Abandoned

 Betraying the NHS: Health Abandoned
 Michael Mandelstam
 Jessica Kingsley Publishers
 ISBN 1843104822,


As an example of special pleading, this book can have few equals, writes Mark Ivory. The goodies are the NHS’s clinicians and patients, especially in the author’s home town of Sudbury, Suffolk, and the baddies are government and the faceless bureaucrats who run the health service.

Although the title promises a critique of the way the NHS has been managed in its broadest sense, in fact the focus of this long lament is firmly on community hospitals, particularly Sudbury’s Walnuttree  Hospital, where the author is a member of the action committee.

But Michael Mandelstam does give an impassioned, if repetitious, defence of these hospitals, about 100 of which face closure (like the Walnuttree) or severe cuts. This is contrary to the spirit of last year’s white paper, Our Health, Our Care, Our Say, that stated that they were to be a central plank of health policy. He accuses the  government and health service managers of shrugging off responsibility for patients, pitching them into the “overburdened but increasingly flinty and financially rapacious arms” of local authorities.

The book views direct payments and individual budgets as a Trojan horse by which council social care services may finally be dismantled, whether or not it is in the interests of service users, and he tends to dismiss home care as a cop-out. The result is a well researched but partial account.

Mark Ivory is managing editor of Community Care


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