Professor Mackenzie's book is an important contribution to the general debate, for by discussing certain key questions from the political science point of view, he illuminates the mythologies and contradictions of the institution - the NHS - which has a special niche in British social history.
The NHS, about which expectations are perhaps higher than is sensible, seems to be at an important crossroad, which makes it appropriate now for us to examine coolly the assumptions on which it was founded.
The author illustrates the complexity of the apparently simple concept of the NHS and raises questions about the realities of power and accountability which were considered by the 1979 Royal Commission. Indeed, such deliberation is essential, for there are clearly enormous difficulties involved in the relationships and vaguely shared responsibilities between the political, professional, and supportive groupings within the NHS.
These are only some of the issues in the intergration of power and responsibilities which are discussed lucidly by Professor Mackenzie.
Mackenzie WJM (1979) Power and responsibility in healthcare: The National Health Service as a political institution. Nuffield Trust.