BOOK REVIEW: The NHS Things that Need to Be Said by Iain Dale

The author presents the drive time show on LBC Radio, the UK’s only national news talk radio station. This short book is one of a series of polemics being published by LBC on contemporary topics. Sensible debate on the NHS is long overdue and this is a welcome start. The prose flows lightly and well and points are tellingly made. Unsurprisingly the tone is chatty rather than learned, but that does not detract. It is a pleasure to read.

Or rather, it would be a pleasure to read were it not for the underlying tale. How on earth in a time of austerity can the NHS (or any other government department) employ over 7,000 people on salaries of £100,000 per year or more while at the same time performing so badly?

The book starts with the political context, notably the high turnover of Health Secretaries (average tenure of two years). It moves on to the question of private versus public provision, where it uncovers the NHS’s institutional loathing of private sector provision and ask why the NHS doesn’t really function at weekends. Further chapters cover funding issues, demographics and the “post code lottery.” Mr Dale then looks at some looming problems, diabetes (of which he has personal experience) and mental health Examples are provided, most often from callers to his show, but also from research. By the end you will be convinced that there is a case to answer, although to whom the question should be addressed remains a mystery.

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A polemic is only required to make an argument, which this book does engagingly. The author does not go into great detail, but that is not necessary in a polemic. To his credit, the author then goes further and makes some suggestions of how things may be improved. Sadly he is probably correct in thinking that not much will change in the short term due to a lack of political will power.

This book unlikely to be popular with the medical establishment, which the author correctly points out is effectively a trades union protecting doctors and nurses from the customers (taxpayers and paymasters (taxpayers again). I very much doubt that may actual or would be Health Ministers will be accepting invitations onto Mr Dale’s show – more’s the pity.

This is a book that you should read before you vote. So should your friends.

This review originally appeared on ARRSE ( and is reproduced here with their kind permission