Health care systems across the world are in a state of permanent revolution as they struggle to cope with multiple pressures arising from changing demography, new technologies, and limited resources. Focusing on the British NHS, this book offers a fresh look at how it has coped with such pressures over its 60 year history and considers what the future holds. The book explores the complexity of health policy and health services, offering a critical perspective on their development. A number of tensions are evident in contemporary health policy and the book is organised around a selection of these, including: the funding of health systems and the changing mix of public and private arrangements; the capture of medicine by management; the imbalance between health and health care; and the growing emphasis on markets and competition in health care systems.The health debate offers a lively and accessible reassessment of successive reforms of the NHS and their cyclical nature. A unique feature of the book is its breadth and assembly in one place of a range of interrelated, and largely unresolved, policy puzzles. The book will appeal to all students of health care and health policy, and to policy-makers and health care professionals. "Policy and Politics in the Twenty-First Century" - This exciting series offers a guide through some of today's most hotly contested policy issues by distinguished leaders in the field. Each book untangles current policy debates, looking behind the rhetoric and spin to discover what is at the core of contemporary political agendas. Authors present their own perspectives and make recommendations for what could - or should - be our priorities for future policy reform.