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Ed Peter K Leaver, London: Royal Society of Medicine Press Ltd, 2004, pp 360; £30. ISBN 1-85315-580-2.
Like John Mortimer’s book of a similar title this third volume of the history of Moorfields Eye Hospital is an affectionate but critical look back at the hospital that has been a major influence in many ophthalmologists’ training and subsequent practice. The volume is written in a positive upbeat style but also describes some of the faults and difficulties that have beset it in the past four decades. In a complex organisation such as a hospital there are inevitable inefficiencies and problems with personalities but the author has wisely stuck to the facts and has plotted the course of the management of the hospital in a very readable way; he has sensibly avoided petty confrontations and offers a lucid outline of the course of Britain’s flagship ophthalmic hospital.
The two previous histories of Moorfields described times past when ophthalmic practice changed only gradually and political upheaval was minor. The current author has been in the unique position of being involved with Moorfields throughout the 40 years he describes. Given the turmoil, both professional and managerial, that has engulfed the delivery of health care during this period he was fortunate that many of the individuals involved with the hospital were available for interview, thus providing first hand accounts of the good and bad times that affected the hospital. The various chapters outline lucidly the clinical and political changes of the time; Moorfields represents in microcosm all the influences to which NHS consultants of all disciplines have been subjected. One special feature of the period described is that it also covers the first 40 years following the foundation of the Institute of Ophthalmology and the not always easy relationship between the hospital and the institute is recorded both openly and tactfully.
The book comprises a number of chapters outlining the various aspects of the hospital development—for example, clinical, managerial, financial, etc. The first chapter is an overview involving all aspects of the hospital during the 40 years from 1963 to 2003. It provides a concise synopsis of all the forces bearing on the hospital; not only clinical but also in terms of research, teaching, and political upheaval. Indeed, for those younger ophthalmologists entering the profession at the present time this chapter gives a concise overview of those political influences that have shaped the lives of the NHS and its staff during recent decades.
As the author points out in his preface the subsequent chapters take up the issues raised in the first chapter and analyse them in more detail. If one, therefore, picks up the book and reads it cover to cover there is a strong repetitive element but it was not really the author’s intention that the book should be necessarily read in this way. Each of the later chapters is written in a stand alone fashion dealing with clinical progress, academic development, research, management, and finance so that some repetition is inevitable. The major characters in the story of Moorfields development are given due weight; particularly Professor Barrie Jones, under whose influence Moorfields progressed from a rather slow moving organisation to the establishment of all the subspecialist services we know today.
Apart from rather a large number of nautical metaphors such as “calm waters,” “stormy seas,” and a few petty errors of detail, such as dates, this volume is a good read, particularly if approached as the author intended. He himself has made major contributions to the standing of Moorfields Eye Hospital and the book is written in the typically clear and polished style, reminiscent of his own scientific contributions.