Michael Schluter of the Relationships Foundation writes in the foreword to this book: 'Partnership, collaboration, involvement,' joined-up 'government: the language of relationships pervades current health policy and practice. The complexity and uniqueness of any relationship means that the reality of this rhetoric must involve more than motherhood and apple pie.'

Cynical commentators may feel that the use by political managers of such buzzwords within the British National Health Service is indeed little more than 'motherhood and apple pie', but if any Christian has hitherto wondered whether the concepts espoused by the Relationships Foundation qualify for that description too, this book proves them wrong.

Based on relational research conducted in the new NHS between 1995 -1999, and at a time of an enormous but almost unrecognised shift of power and resources from secondary to primary care, such that the 80%-20% distribution is likely to be reversed, this stimulating book moves lucidly and logically through key concepts. Consecutive chapters cover agenda, policy, resources, strategy, organisation, delivery, development, review, quality, and prospects.

Highlights for me included acknowledgements of 'a widespread disillusionment about the state of relationships in the NHS and their impact on health', that 'relationships are much neglected by the NHS as a resource in both policy and practice' and that 'the new NHS runs the risk of pursuing strategies which outstrip their relationship basis'. In other words, in all the reorganisations and quality initiatives, the NHS is failing to take its million or so staff along with it! The authors also recognise the sense of threat which sadly so often prevails at the moment: 'there are risks to relationships in healthcare arising from the use of quality principles to justify stronger central scrutiny'.

By contrast, at the end of the book there are a couple of paragraphs on 'love' which are explicitly but sensitively Christian. The book is implicitly Christian throughout, but otherwise only explicitly so in that every one of the chapters begins with a quote from Ecclesiastes. The book ends with Ecclesiastes 12:12, 'Of making many books there is no end, and much study wearies the body'. You will be slightly wearied reading this book as it is meaty stuff, but it is study well worthwhile not just for those in British primary care but for Christians and others working anywhere in health services throughout the world.

Reviewed by:
Andrew Fergusson
Head of Policy at the Centre for Bioethics and Public Policy