Handbook on Complexity and Public Policy
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Handbook on Complexity and Public Policy

Edited by Robert Geyer and Paul Cairney

Though its roots in the natural sciences go back to the early 20th century, complexity theory as a scientific framework has developed most rapidly since the 1970s. Increasingly, complexity theory has been integrated into the social sciences, and this groundbreaking Handbook on Complexity and Public Policy has brought together top thinkers in complexity and policy from around the world. With contributions from Europe, North America, Brazil and China this comprehensive Handbook splits the topic into three cohesive parts: Theory and Tools, Methods and Modeling, and Application.
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Chapter 22: Complexity and health policy

Tim Tenbensel


A much-cited article published in the British Medical Journal in 2001 by Paul Plsek and Trisha Greenhalgh has provided a powerful impetus for the application of complexity theory to the domain of health. This introductory article concluded with the following clarion call for complexity thinking: This introductory article has acknowledged the complex nature of health care in the 21st century, and emphasised the limitations of reductionist thinking and the ‘clockwork universe’ metaphor for solving clinical and organisational problems. To cope with escalating complexity in health care we must abandon linear models, accept unpredictability, respect (and utilise) autonomy and creativity, and respond flexibly to emerging patterns and opportunities. (Plsek and Greenhalgh, 2001: 628) Since the early 2000s, health policy has provided a fertile source of inspiration for those adopting a complexity perspective (Kernick, 2004; Haynes, 2008; Geyer, 2013; Marchal et al., 2013). In this chapter, I begin by addressing a number of questions that are central to this collection. The first question addressed is whether complexity theory is a coherent theoretical framework or a stock of useful concepts. I then briefly explore whether complexity theory has generated methodological and theoretical advances, and address the question of the nature of advice provided to those involved in policy processes using a complexity perspective.

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