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Global Policy Institute

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Publication details

Hunter, D.J. (2015). Role of politics in understanding complex, messy health systems: an essay by David J Hunter. BMJ 350: h1214.

Author(s) from Durham


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.1 These are invariably derived from the ideologies of those funding numerous think tanks, and lobbyists engaged in what has been termed institutional corruption2—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.