Thursday, July 18, 2013

Avoiding systemic failure in health systems?

Will the litany of systemic failures in the English NHS give pause to those responsible for public sector governance to rethink what it is that they and others do?  The quality of the parliamentary debate suggests little hope for optimism. But there are other approaches.

Some health policy practitioners advocate a turn to systems thinking. The video below was "produced by the Alliance for Health Policy and Systems Research and was filmed during the launch of the Alliance's 2009 Flagship Report: Systems Thinking for Health Systems Strengthening, at the Global Forum for Health Research in Cuba in November 2009. It features experts and policy-makers from LMIC's providing their views on Systems thinking and its potential contribution to health systems strengthening in developing countries."  

There are no reasons the arguments mounted by this group should not be appplied to the UK NHS.  It is also clear that parties of all political persuasions have consistently failed because of the thinking that informs governance and managment.  Simon Caulkin, former management editor of The Observer, has been consistent in his reporting of the failures in understanding on which public sector management (or mis-managment) has been built...and continues to be built.  An excellent article, "'Kittens are evil': heresies in public policy" summarises many of the key points and offers alternatives that need to be considered with some urgency.  It is to be hoped that in the wake of the Keogh Report there will be more investment in the approaches outlined in the Caulkin article. And in greater capacity building in systems thinking in practice more generallly.

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