This book provides an original analysis of the trajectory of health policy reform in the United Kingdom from the beginning of the 'Thatcher reforms' in the 1980s right up to the latest changes in England in 2022. Rooted in political science and health policy analysis, it tackles key arguments around the 'new integration' of the NHS since 2015, what the new and emerging NHS structure represents, the UK's poor response to the Covid-19 crisis, and the future threat to a comprehensive public NHS. It includes significant new material on what has happened since 2015, such as the politics of the Covid-19 pandemic, the effects of Brexit, and the conundrum of 'social care'. The book is a scholarly and polemical analysis from an expert who has studied the politics of health services for more than forty years. It will be a key resource for students, academics and policy makers.