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Greg Fell OBE shared Adam Briggs’ new paper on public health systems leadership (links below). It’s an extremely good description of what senior leaders are trying to do, what helps them, and what gets in their way. My difficulty is turning that into something that helps systems change; I’m less convinced by the move from description to a prescription.
Take ‘systems’ out of the framework and it still reads well: humility, authenticity, trust, shared vision, adaptability. Desirable qualities and practices. The paper also addresses organisations, power, resources, and governance. Yet ‘the system’ appears mainly as the difficult arean in which the leadership team must perform.
In #systemsleadership and #systemschange, I distinguish better leadership of existing arrangements from improving how they function, questioning their legitimacy, and helping people reshape them. These activities overlap, but/and developing the leader doesn’t tell us how to do the rest, or settle who gets to decide what ‘better’ means.
Suppose government responds to rising hospital demand by protecting treatment budgets while squeezing prevention, housing support, early-years. Those cuts lead to more hospital demand, strengthening the pressure to prioritise treatment. The saving appears in one budget; costs emerge years later in others. Caring, competent leaders can all favour prevention while funding rules, performance targets, and political time horizons keep reproducing its neglect.
‘Build trust’ might help people work on that pattern. It doesn’t explain what sustains it or how to change it. Equally, judging ‘participation’ to be ethically desirable doesn’t establish how a particular form of participation will affect an outcome.
A systems contribution would help us investigate those relationships, including how our own decisions reproduce them. It would make the purpose and boundaries of ‘the system’ open to question, with people whose experience may contradict the leadership team’s account.
This is my concern about ‘leaderism’: problems in how we organise public services can become demands for more capable, adaptable people. A personal development response can leave the arrangements producing those demands substantially intact.
Briggs explicitly acknowledges that the framework hasn’t been evaluated. I’d take the next stage of work into real, particular situations, with leaders and the people affected: investigate a recurring pattern, test changes to what sustains it, and use the results to question our original understanding of the problem. That may also change who needs to lead, and what leadership is for.
Have you seen ‘systems leadership’ devolve to ‘leadership development of people at the top of a set of institutions’ and then turn into personal development?
Where have you seen ‘systems leadership’ change the conditions that kept a problem recurring – and what did people actually do?
