Universal, comprehensive health care, equally available to all and disconnected from income and the ability to pay, was the goal of the founders of the National Health Service. This book, by one of the NHS’s most eloquent and passionate defenders, tells the story of how that ideal has been progressively eroded, and how the clock is being turned back to pre-NHS days, when health care was a commodity, fully available only to those with money.

How this has come about—to the point where even the shrinking core of free NHS hospital services is being handed over to private providers at the taxpayers’ expense—is still not widely understood, hidden behind slogans like “care in the community,” “diversity” and “local ownership.” Allyson Pollock demystifies these terms, and in doing so presents a clear and powerful analysis of the transition from a comprehensive and universal service to New Labour’s “mixed economy of health care,” in which hospitals with foundation status, loosely supervised by an independent regulator, will be run on largely market principles.

The NHS remains popular, Pollock argues, precisely because it created the “freedom from fear” that its founders promised, and because its integrated, non-commercial character meant low costs and good medical practice. Restoring these values in today’s health service has become an urgent necessity, and this book will be a key resource for everyone wishing to to bring this about.