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A new mantra in the health service is the rehearsal of all its problems; the dominance of the health professionals (mainly doctors) and thus the dominance of the medical model of ill health; the subordination of management to the profession; the lack of citizen/user input; the lack of clear financial and clinical information; and the fudging of the rationing issue. Adding to these structural problems are the pressures of demography, technological innovation, and consumer choice.
Oliver Morgan’s book is a worthy but not exciting attempt to clarify the elements of each of these problems. The answers, threaded through the text with a slightly irritating presumption of radicalism, are accountability, transparency, and high quality information for all.
All this is to be achieved by creating an informed and participatory citizenry through the imaginative use of information technology, coupled with diffusion through society of the many exciting new ways of engaging the public.
The book does, therefore, offer useful thoughts on the depressingly familiar question of what we should do to rescue our health system. But its style, half way between a scholarly review and a call to arms, makes for dreary reading. I wish it were more feisty. As it happens I agree with Morgan’s central thesis, that public engagement contributing to all aspects of health care has the best chance of provoking sensible reform. If only the text had done more to persuade me that this radical option was not only right, but also worth striving for, I would have fewer reservations about the book and be clearer about who should read it.
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