Here's a talk I gave last night to the Graduate Entry Medical School, in their seminar series. The slides for the talk are here. My main point is that the health care system is a complex adaptive system, and that talks of reform that don't accept this as a fact are doomed to fail. The health system is not a huge ship, to be turned slowly. It is a vast web, whose connections are broken when change is attempted at the wrong levels. To get real change, we need to ditch the drive for efficiency, focus on estimating unit costs (this requires unique patient identifiers and world class health informatics) and move toward a 2-stage model of intensive and extensive health care delivery. This is the first time I've written these thoughts down, so I'm grateful to Profs. Clodagh O'Gorman and Colum Dunne for the invitation to speak.
Critical Reflections on the Organisation of Healthcare in Ireland from Stephen Kinsella on Vimeo.