Ideas, evidence and questions
Exploring how population need becomes care, work and workforce — and the architecture that shapes what happens along the way.
I write about the parts of health systems that are easiest to miss: where need becomes demand, where work crosses professional and organisational boundaries, and where funding, regulation and data shape what care can actually happen.
Six ways into the thinking
Begin with the work
Population need, social determinants, unmet need, demand and where system failure becomes visible.
Constitute capability
How care is actually delivered across services, settings, professions and support roles.
Make the workforce visible
Capability, roles, careers, scope and how expertise is organised around the work.
Assure safe practice
Funding, regulation, classification, data, governance and professional boundarie
Mobilise and fund the workforce
What health systems measure, what they miss, and how data shape what becomes visible, funded and planned.
Govern the whole
Earlier studies, current research, datasets, methods and retrospective re-analysis.
Latest thinking
We Moved Care Out of Hospital but Still Plan Around the Hospital Bed
Care has moved beyond hospitals, but workforce governance has not followed. The workers who prevent deterioration, support people at home and enable safe discharge are often those government can see, count and organise least effectively.
When a smelter goes idle
Governments spend billions preserving industrial capacity when smelters become unviable. But when government redesigns the NDIS market it created, thousands of small, feminised allied health businesses are expected to absorb the transition alone.
PEASI: A Problem-First Method for Designing Change
PEASI is a practical, problem-first methodology drawing on program logic and Theory of Change to diagnose complex problems, design credible interventions and create measurable change.
Solving Complex Problems? Stop Starting With the Solution
Why do organisations keep investing in plausible solutions that fail to resolve the underlying problem? The answer often lies in the planning process itself.
Program Logic vs Theory of Change vs Realist Evaluation — Where PEASI Fits
There’s a good reason complex problems have generated decades of serious methodology — and a good reason almost none of it made it into general use. Here’s the lineage PEASI actually comes from.
The Hospital Is Where the Failure Shows Up
We keep treating downstream demand as a hospital problem — when much of it begins somewhere else entirely.
From the archive
I’ve been writing about health workforce, professions, service design and reform for a long time. Some of the language has changed; many of the underlying problems haven’t.
