T. R. Marmor, R. Klein. Yale University Press price £80.00; pp 544 ISBN

9780300110876

What makes a good book? The key themes that come to mind include its importance, accuracy, objectivity, thoroughness and relevance to the potential audience. To this can be added the extent to which any content makes the reader think. Dealing with the first four categories this book, beautifully written by two gifted academics, scores highly.

Ted Marmor based at Yale, and Rudolph Klein from Bath, have been highly influential in health policy for a number of decades. The book is structured around policy themes, and is a collection of their thinking over their careers. Two examples include the relationship between the state and the medical profession and rationing. While the majority of the essays have been published elsewhere, the introduction to each policy issue section provides a basis for the essays inclusion: each section highlighting the relevance of the works to current debate.

Of particular relevance is the section titled New paradigms: health care to population health'. It deals with two of the most influential reports affecting the growing orientation of health services, namely the Lalonde Report, published in Canada in 1974, and the Black Report in Britain in 1980. The authors provide a wonderful exploration of key issues. The subjects of inequalities and of need, both central to the present dental policy agenda, are discussed. Those responsible for debating the issues would be wise to read this section if nothing else.

In the preface the authors lay out their objectives as contributing to: a better understanding of the political dynamics of policy making in healthcare; a more informed discussion of policy options, and (using a beautiful turn of phrase, examples of which litter the book); fewer cycles of naïve enthusiasm leading to disillusion. All are achieved.

It is not in my opinion a book to sit down and read from start to finish in a single sitting. The great strength of the work, the erudite thinking presented, means that the issues raised require time for consideration.

As to who is the intended audience? I would suggest that anyone who wishes to engage from a knowledgeable position in the debate about the future provision of healthcare. While the book is not about dental policy the principles are the same. Indeed, the opening chapters on policy analysis should be on any academic reading list. Dental policy is in a mess. The lucid and engaging manner in which themes are discussed cannot but help. Thoroughly recommended.