I have seen the NHS from the waiting room and ward as a NHS graduate management trainee and clinical services manager, and the boardroom as a non-executive director.
I have worked in the Midlands (Birmingham, Solihull and Coventry), and Middle-Earth (Wellington, New Zealand). I have looked at the NHS from the inside as a manager, and from the outside as a researcher and policy analyst.
It is this connection - between research and practice, between theorists and managers - which has particularly fascinated me. How do these communities interact, if at all? What could be done to enable more fruitful connections?
The most important issue in health is, of course, to recognise that there is no most important issue in health. How could one possibly choose between the evisceration of the NHS, the abandonment of social care, grotesquely widening health inequalities, the looming nightmare of antimicrobial resistance, or the incipient planetary catastrophe of climate change?
So I’m not going to try and define any single, most important problem, because that’s a mug's game. What I would like to do instead is explore why it is that we are so often drawn back to trying to rank issues by importance, and why we find the complexity of these problems so challenging. What I’d like to propose is a set of approaches that can be used to conceptualise them in ways that may help us to achieve better outcomes.