Throughout the 1980s, the National Health Service has been the subject of almost continuous re-organization and constant political debate. Its sheer size and complexity, however, baffled most attempts at systematic description and analysis. This is a guide to the way the NHS works. Based on anthropological research behind the scenes in seven district health authorities, it features first-hand accounts of the age old methods of administration and the new attempts at business-style management. It will be of interest not only to health service professionals and academics in social policy, public administration and health studies, but also to anyone interested in our changing national health service.