We’ve mentioned Mark Gamsu before. He writes a wide-ranging blog on all things related to local democracy and health. His latest post raises some critical issues…
“So, system level organisations and agencies need to consider what they can be doing to strengthen citizen voice. This is where it gets really hard. A lot of the structures that operate at a system level are dominated (with the exception of local councillors) by professionals who speak on behalf of local citizens. By professionals I mean primarily managers from public sector bodies (mainly the NHS and Local Government) and the Voluntary and Community Sector. Of course they are well intentioned people – but they are constrained by their own organisation and services (they don’t usually have whole system view) and by their responsibilities for meeting their targets and contracts. This too often leads to relationships that operate within a paradigm that ignores conflicts brought on by competition and mistakes activity for systemic action.
Again, in Sheffield the Sheffield First Partnership has been trying to get to grips with this. They set up what was in effect a select committee process to seek to understand what good might look like with regard to community cohesion and voice; taking evidence from a range of witnesses – including voluntary sector organisations, the police, fire service and private sector. The outcome of this investigation is a “Fuzzy Framework” that seeks to provide a platform for a more self aware collaboration on this agenda across the city. It is very much a work in progress – but is a positive attempt to try to be more self conscious about this issue.”
systems thinking
Atul Gawande’s 2014 Reith Lectures on The Future of Medicine
Gawande is a writer, practicing surgeon and Professor at both the Harvard School of Public Health and Harvard Medical School. All the lectures are pretty thought-provoking but the fourth – ‘The Idea of Wellbeing’ is of particular interest from a co-production point of view. Gawande argues for a far more holistic vision for medicine that puts people’s agency, their desires, their interests and their need for connection and purpose at the heart of their care, including and especially when frail or at the end of life. He argues for a medical model that looks at human systems rather than merely symptoms and that puts wellbeing, and the sense of individual purpose that enhances it, at its heart:“Everywhere I see the mistake of ignoring that people have priorities in their lives besides merely surviving another day. Even in severe illness or frailty people desire connections to others and to purposes of their own choosing. I think we’ve been wrong… I think we’ve been rather limited about what we think our job is in building systems of care for human existence. We think our job is to ensure health and survival but really it is larger than that: it is to enable wellbeing, and fundamentally wellbeing is about sustaining the reasons one wishes to be alive.” Well worth a download or listen: http://www.bbc.co.uk/podcasts/series/reith
Systems and common sense
By Geoff Mulgan, Nesta
“I’m convinced that the ability to think and act systemically is the greatest intellectual and practical challenge of this century.”
“In a world of interdependence, it’s important to learn how to expand the boundaries of management in order to see the larger systems.”
“In a world of interdependence, it’s important to learn how to expand the boundaries of management in order to see the larger systems.” ~ Society for Organizational Learning
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