11 January 2011

The Impacts of Health System Reforms: The triumph of hope over experience?

Many health systems around the western world are being restructured, with major implications for preventive health agendas. This also means big changes to the contexts in which health impact assessments are undertaken and supported (or not).

The NHS Confederation in the UK has produced a fascinating report that looks at the available evidence about health system reorganisations and their impacts:
Although there is widespread acknowledgement of the problems of frequent reorganisation, there is still a tendency for it to be enthusiastically advocated as a solution - often with little reference to the problem it is trying to solve...

Even if there had been a more systematic evaluation, the number of changes in the last two decades means that many structures have had little time to settle down and produce results before being reorganised...

Poorly designed organisations and hasty change are likely to result in further restructuring.

Source: Edward N. (2011) The Triumph of Hope Over Experience, NHS Confederation: London.
In Australia, 1 January 2011 heralded the next round in the seemingly endless series of reforms and restructures. There's a lot we can learn from the report.