Role of politics in understanding complex, messy health systems

Rather than exclude politics from health, Fuse Deputy Director David Hunter argues that we must embrace it if we are to improve our complex health systems.

In an essay in the Analysis section of the BMJ David (pictured), Professor of Health Policy and Management at Durham University, writes:

"Health systems have always been complex, messy, hard to comprehend and even harder to change. Meeting these challenges has not been helped by the endless meddling in health systems by politicians. In this endeavour they have been assisted by numerous snake oil merchants peddling the latest fads and fashions. These are invariably derived from the ideologies of those funding numerous think tanks, and lobbyists engaged in what has been termed institutional corruption - a case of faith based policies triumphing over evidence.

"The political nature of the policy process is therefore central to any understanding of a complex system. It is also why political science is uniquely well placed to explore its inner workings. Largely ignored and unappreciated, the discipline has much to offer those seeking a deeper understanding of current health systems, how they operate, and what needs to occur if they are to undergo effective and sustainable change."

 Key messages from the essay:

  • Randomised controlled trials and quasi experimental research designs have limited value in understanding and changing complex systems
  • Political science has much to offer in understanding complex systems and yet remains undervalued
  • Insights from political science research can help identify the enablers and barriers to change in health systems.

To read the full article please visit the BMJ website or download the PDF version here: bmj.hunter_politics.full.

Last modified: Mon, 16 Mar 2015 12:10:09 GMT