This is an important and thought provoking book which should be read widely not only within the medical profession but also by interested parties such as health economists and government officials whose responsibility it is to set budgets for healthcare programmes. I think it will also be of great interest to the lay public. The practice of medicine is as susceptible to the whims of fashion and pervasive ideology as any other human activity. It is therefore interesting to investigate how these fashions are set. James Le Fanu has a background in medical and scientific journalism, having spent time on the staff of the Daily Telegraph, one of the UK's broadsheet newspapers. His thesis is that despite the significant advances in combatting disease which reached their peak in the post-war years, the promise of modern medicine as we are at the end of the century has failed to materialise. In …