Based on his experiences of helping to fight cuts and closures in Suffolk, Michael Mandelstam delivers a damning verdict on the mismanagement of the NHS at national, regional and local level. He charts the widespread cutbacks and closures, both rural and urban, to clinics, A&E services, beds, wards and scores of community hospitals. He outlines how humane care, particularly for older people, is compromised by the ruthless determination of NHS management to increase patient throughput and hit government-set targets.

The author highlights how the chaotic change to the NHS is being driven by concealed agendas - including privatisation of the NHS, obsessive interference from central government as well as selective use, if not abandonment, of evidence-based practice. Seriously flawed and damaging decisions are the result, affecting the population at large as well as those most vulnerable - older people with chronic and complex needs, people with physical or learning disabilities and people with mental health problems.

Above all, he exposes the scandalous lack of transparency and accountability behind changes that threaten to destroy the NHS.