Customer Reviews:
 I've become a grumpy old man September 23, 2008
0 out of 1 found this review helpful
I am a recently retired General Practitioner (April '08 aged 58). I retired early from the NHS because I was disillusioned and demotivated by the 'Stasi' administrators (we have them in General Practice). Now,in retirement, I have been ranting and raving about what is written in 'The Hospital Revolution', excellent commentary on the state of the NHS - I am glad I am out of it. Good read for the layman.
Bravo! July 16, 2008
3 out of 4 found this review helpful
As a fellow NHS employee I welcome this excellent analysis of the problems facing our once envied health service.To criticise the style and wordplay of the authors is to miss the point-they are doctors not journalists.They have courageously risked their personal and professional reputation to highlight what they see as the basic problem with NHS-the people who control the NHS are not concerned with the well being of the nation but with petty punishments and ineffective cost cutting exercises designed to self promote their own careers.Some may see fit to critisice the use of the word "Stasi"-the fact that one of the authors prefers to remain anonymous suggests that paranoia is the one thng alive and well in our NHS.How many other critiques of government policy not only highlight the problem-the management-and come up with a solution that does not entail extra spending?Get rid of the incombent management and replace it with experienced medically knowledgeable personnel who are not motivated by future career prospects-perhaps another solution exists but I would be surprised if it would result in a reduction of NHS expenditure.A problem exists-here is a solution;I suggest we try it rather than nitpick on the motivations and backgrounds on the authors who are risking their professional careers because of their longstanding commitment to their patients.
A refreshing, raucous & rivetting expose of the NHS July 9, 2008
5 out of 7 found this review helpful
Excellent! This book is just what the doctor ordered - an expose to let the general public know what sort of idiots are ruining our once wonderful National Health Service. Some of the true anecdotes about the incompetence of NHS administrators (humorously referred to as the "Stasi" throughout the book) are actually frightening. JRY and his two pals have hit the nail on the head: the people who actually work in the NHS don't work for their employers (the Stasi) - they work for their patients!
It is however hilarious in parts and when you are not crying, you will be laughing.
This book is not meant for other doctors (who nonetheless would find it a "tonic" after all the criticisms and no praise): it is aimed at the man in the street, who will find it not only surprising but alarming.
A big thank you to the authors who offer an alternative view on the NHS as it turns 60.
Excellent June 23, 2008
6 out of 7 found this review helpful
I think the above reviewer has somewhat missed the point; the book does not pretend to be a "deep and comprehensive critique", Its a book aimed at the lay person which is intended to both educate and entertain. But having read Mr Riddington Youngs excellent "Offbeat Otolaryngology", I was perhaps more aware of what to expect. Suffice to say I was not dissapointed!
To my mind the book is a joy to behold, I found myself repeatedly laughing out loud at the manner in which the authors outwit the petty minded, mean spirited and downright vindictive drones, whom despite having no level of education or training seem to have taken to calling themselves 'managers'.
Yet despite this clear lack of either medical or even administerial capability, these 'managers' believe that they are deserving of the same status of highly trained medical pratictioners! Whats more they now have a level of authority over these doctors that seems to be absolute, ignoring the employers own contract, basic statutory employment law and even the European Court of Human Rights!
The authors wishes ultimately seem to be reasonable, a return to self governance and fairness and this book had me convinced.
 A limited viewpoint June 22, 2008
3 out of 11 found this review helpful
I saw this book by chance and bought it anticipating a revelatory read that would be persuasive, moving, frightening, and valuable.
No such luck. This is a very narrowly focused volume, and its parochial view might make things worse, though I can see how the authors might think it was setting the record straight. However, it is difficult to believe that this extended and breathless rant was written by senior doctors, and published in 2008. Actually, there is very little in it about up-to-date NHS history, that is from 1997 onwards, when things truly started going down the tubes under the managerialist obsession of New Labour. I wonder how old the manuscript is (there are two references to a conference dated, very precisely, 8 July 1998, that make me suspicious - together with lots of detailed references to events from the mid-to-late1990s). It certainly has a very dated feel - in more than one sense.
The central theme is their big-time grievance against managers (or administrators, or, as they persistently and rather nastily refer to them, "Stasi"). The back blurb even talks about cancers requiring excision; this is pretty unpleasant, combative and offensive stuff, presumably intentional. It doesn't seem to strike the authors as ironic that they spend many pages obliviously complaining about these self-same traits in managers. But they have missed the real point: the problem is not hospital management; it's the political system and Department of Health that has transformed managers from, in many instances, reasonable and well-meaning people, to automatons whose sole purpose is to be the effectors of malignant deliverology and targetry. Many are fully aware of this perversion of their ethos. The authors date the rot from the early 80s with the Thatcher-inspired Griffiths reforms setting up professional management in the NHS, but the aggressive management style that gets up their noses is pure New Labour.
I hadn't read a doleful reminiscence in many a year about the good old days of matrons, lady Almoners and Hospital Superintendents, Doctors' Dining Rooms, Consultants' Car Parks, and free bacon butties at midnight: they're history, doomed, won't return, and it's futile trying to turn those particular clocks back. The authors constantly - correctly - put patients at the centre of their practice, as good doctors have always done - yet they seem to write mostly about erosions of their own status. The one chapter that contains some genuine reflection, and some up-to-date stuff, is the one relating to suspensions of doctors, and the proposed reduction in burden of proof in GMC hearings, among other important matters, though it still contains Stasi references which diminish its impact, and detract from the bigger problem - the huge cultural change in the way the government sees the profession. This demands that we argue with great clarity not against the hospital management system, which is just a symptom, albeit an annoying one, but on a wider platform that includes the reduction of junior doctors to form-fillers and minimally competent practitioners, the target culture that makes everything look great on paper but can still deliver pretty awful service for the patient, and the fundamental inability of the Health Service to look at what's really important - the service we deliver, rather than the demented targetry that employs thousands of people to do futile things and further thousands to obsessively measure them. These are barely touched on, yet are much more important than details of petty squabbles between the authors and their hospital administration, of which there is evidently a long history. The nearest I've seen to an intellectually sound demolition job is John Seddon's brilliant book "Systems Thinking in the Public Sector", and his arguments and wonderful examples could be transferred wholesale to the Health Service (demonstrating nicely that the paranoia on show in almost every page of this book is not warranted - doctors are just the latest victims of a generalised process). The use of the word "regime" in his book is wholly appropriate and justifiable, in contrast to the nasty words used here. Or try Allyson Pollock's "NHS plc". Both have the right balance of polemic, politics and facts.
This book, whose original title, according to pictures on various websites, including Amazon, was presumably intended to be "Meltdown" (I assume someone - possibly "NHS Identity" (not kidding) - discovered their illicit use of the NHS corporate logo, together with the clearly misleading original title) is largely an unedifying assemblage of anecdotes, nit-picking stuff on minor infringements of word usage, historical factoids, and accounts of supercilious memos and letters to managers (the authors don't seem to have entered the email age - another hint of its provenance). The dozens of footnotes mostly irritate and rarely illuminate, there's lots of amusing literature quotes whose point mostly escaped me, except to inform us, like we didn't know, that the authors are jolly well educated - and moreover did Latin at school - and the unstoppable torrent of exclamation marks adds to the annoying, heavily ironic, slightly sneery, mock-academic tone. They haven't done themselves and the profession the service they hoped. It misses by a very long way the deep and comprehensive critique that's so badly needed.
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