Due to a passing in the family a few years ago and my subsequent health issues stemming from that, I was unable to download this book in time to review it before it was archived as I did not visit this site for years after the bereavement. Thank you for the opportunity.

I wanted to like this book, I really did. The subject is a matter of great importance to all of us and the need for reform of the healthcare system is urgent. I agree completely with the author that our current system is actually broken and unsustainable and I find myself in agreement with several of his diagnoses as to why that is the case.

But not all of them and there are many others that are not really examined here. This is a curious book, written with an upcoming event in mind (since passed) and it seems to fall between several different categories: part book, part academic paper and part flyer for an event that has passed by the time anyone in the wider public is likely to read it. It could do with some judicial editing, I believe, and the topic is important enough and there are so few titles that do address these issues that this should be undertaken. In particular there is a randomness and lack of flow that needs to be addressed for this to reach a wider audience.

The author approaches the problem from a particular viewpoint, that of the process engineer or supply chain expert, and this is an interesting viewpoint for me as it is one where I have little experience. For that reason this is welcomed and adds to my knowledgebase. But it is a biased viewpoint and not, in my view, the most important one by any stretch of the imagination. Although patients are (as is the fashion these days) held to be at the centre of things they are actually mostly absent in this book, save for a few patient testimonials near the end.

The few brief references to the regulatory role in medicines development demonstrate a lack of understanding and awareness of this important aspect of the business and the total lack of discussion on the much more thorny issue of HTA (Health Technology Assessment, or evaluation of effectiveness) is virtually ignored, save for a few random comments on the sky-high cost of new age genetic treatments.

I am afraid that the author lost me completely with his rugby comparisons and I think this is something that has such limited appeal it could usefully be dropped in any future revisions. And I hope there are revisions, because this is so important and there are some gems hidden in here for those with the determination to find them.

Wonderful and factual!
Thank you Netgalley and the publisher for a copy of this book in exchange for an honest opinion.