Health blog

The talk of the palace – Rich Taunt

Gather 60 people together from around the world. Put them in a magical palace. Give them an unsolvable problem to debate, and five days to do it.

The method behind Salzburg Global Seminar isn’t exactly conventional, nor easy to replicate, but it is rather wonderful. But given such a hospitable environment, there’s always a risk that disagreements go unexposed. That everyone’s happiness to be in a place where the hills are alive masks unresolved tensions.

It’s a pleasure and privilege to be in Salzburg currently, discussing childhood obesity and complexity. Led by the Robert Woods Johnson Foundation, debate ranges from food to families, power to politics, and well beyond. Everyone sort of agrees. Perhaps. Yet with a number of tensions bubbling through from our early sessions. Here’s three:

1: How we talk

How you frame what the exact nature of the childhood obesity problem is hard. How you then talk about it with the public is harder still. Making it harder still is industry competition wishing to disagree. It’s easy to think that the food industry always has a narrative which is really disciplined with public messaging full of joy (ooh, chocolate), while public agencies can only talk in academic terms and give the public messages of gloom (just stop it alright).

Ok, it’s not a level playing field. Show we a public health communications team with the same resources as their industrial counterparts and I’ll eat my civil service issued hat. Yet the implication for those working to reduce childhood obesity is to up our game. First by joining forces across organisations to make the most of limited resource, such as the Australian Obesity Policy Coalition. Second to be more creative in our public messaging, such as the graphic novel approach in South Africa. Third is to reframe, such as talking about health not weight, and to talk about the joy of eating, not just its risks.

2: What we talk about

This is a conference with ‘complex systems’ in the title. It’s very starting point is to work with a level of abstraction which isn’t just about individual organisations or people.

But then how does this tally with constant talk about the need for a person first approach, and the importance of understanding stories? The event so far has involved deeply personal testimony about individuals own lived experience with relation to obesity. So are we thinking systems, or people?

The glib answer is to say ‘both’. Which of course is true. We have to start with understanding how people live their lives. Making wrong assumptions is what got us into the cul-de-sac of thinking obesity is all about people’s own self-discipline in the first place. Yet we also have to think about the systems in which people operate in. Let’s not get confused between our internal plans and our public messaging. The plans have to be complex in order to deal with the complex system. The messages have to be simple in order to be understandable. It’s an approach championed by the public health professor Harry Rutter (and shamelessly stolen by me in a recent piece on policymaking).

3: The breadth of our approach

So we’re doing systems thinking. However, as our participant acutely put, we can do the thinking, it’s putting into practical change we struggle with. Quite. Everywhere you look there’s a way to expand the size of the system we need to think about. Obesity isn’t just about food, it’s about soil — so is it about climate change too? It’s not just about what food we buy, it’s about poverty — so is it about jobs and welfare as well?

The countervailing view is that we have to get stuff done. We don’t have the time or resource to solve everything, so let’s just pick a bit and get on with it.

Once more, we’re dealing with a false choice. Complex systems leadership requires a completely different skill-set to managing change in linear environments. It’s too easy to think about ‘driving’ change in complex systems. It’s not possible, better to think of ‘herding’ change, bringing lots of different pieces together and getting them all pointing in the same direction. The hard practical graft of the skills and resources to do this work may be less intellectually stimulating than debating specific individual interventions, but without it, we’re sunk.

At the organisation I’m part of, Kaleidoscope, we run Holacracy, a management system which thrives off the raising of tensions by anyone who feels one. It works because it stops issues being glossed over, or left to rankle, but instead be dealt with. Palace tensions are welcome. Now the only issue is to act on them.

Rich Taunt is part of Kaleidoscope Health and Care. You can follow the Salzburg seminar Halting the Childhood Obesity Epidemic: Identifying Decisive Interventions in Complex Systems on Twitter.




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