Systems governance: towards effective partnership working

Stewart, M.: 2002

Tackling health inequalities poses many of the same challenges that confront all those policies and practices which address the cross-cutting social problems. These challenges include conflicting understandings of cause and effect, multiple organisational engagement, failure to mobilise and integrate programmes, and imperfect communication between policy and action. They reflect the ‘wicked issues’ (Rittel and Webber 1953) which have confounded all the efforts of fragmented government to address the most intractable social issues. At the heart of this intractability lies the recognition that most organisations work to their own agendas, make the best use of their own resources and perform to standards and targets which inhibit joint working.