I strongly recommend this passionate and important book to anyone who cares about the state of the NHS. Dr Rachel Clarke was a key player in the junior doctors' strike in 2016, and she paints a grim picture of the impact of government cuts on the front line of the service. Health Secretary Jeremy Hunt does not come out of the book with a great deal of credit, and the circumstances around the strike itself and the battles with Hunt are told in some detail; junior docs were misrepresented by their own union almost as badly as by the government and the media, which I not been aware of.

I recently read the fantastic Do No Harm by neurosurgeon Henry Marsh (he reviewed Clarke's book in The Times) and it was interesting to consider the comparisons between the two accounts. Marsh, the better writer of the two, is nearing retirement, and reflects philosophically on mortality, altruism, the doctor's role and so forth. While Marsh's book is profoundly moving at times and he does bemoan many developments in the NHS, it's with a certain dispassionate distance. Clarke on the other hand is telling a story right from the front line, and her descriptions of the impact of inadequate funding, government spin and the effects on patients are filled with passion and fury.

In many of the chapters she uses a device whereby she tells a personal anecdote, perhaps about a patient with a certain type of physical ailment, and then uses this as a platform to highlight an analogous systemic problem in the health service as a whole. This generally works well but is a bit clunky at times. For example, after telling a thrilling tale of a man haemorrhaging blood, the next paragraph starts 'The haemorrhaging of staff from the NHS threatens its survival just as surely as unstaunched blood around a human heart.' Clarke is sincere and makes very powerful arguments, and her previous role as a journalist adds credibility to her take on the state of the NHS. However, she acknowledges that 'it's not just about money' and that the NHS could be more efficient - it would have been nice to hear some the ways this could be achieved.



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3.75 / 5

While this is a good book to read to see the behind the scenes of a hospital and a doctor. There were many times in the book where it switched from one event, to another. When it happened it required me a few seconds to remember what happened before.

The end of the book is a nice ending. ( )

This was both interesting and depressing. I work in the NHS and I know how bad things are getting but I am in an office role so am protected from the full war of patient care. Although Dr Clarke tries to put a positive spin on this story of junior doctors taking on the Tory government, the truth is they lost - the contract was imposed in England. Only the statisticians can tell us if the loss of junior doctors has increased even more since then. I know many went to Wales and Scotland who have so far kept the old contract. The Tories want to destroy the NHS and if you doubt that, then read this book. They have already indicated a plan to renegotiate the main pay scale that non-doctors are on, so the rest of us are next. Yet somehow they keep getting voted in..... ( )