Despite clinical advances over the last fifty years, there remain six major problems that affect health systems worldwide;

Unwarranted variation
Patient harm
Inequity
Waste
Failure to prevent the preventable
Rising need and demand

These problems will not be solved by;

  • Injecting more money into healthcare: healthcare budgets are shrinking.

  • More medical technology: some new technologies will mitigate the problems, others will aggravate them.

  • Structural reorganisation within existing frameworks: the existing healthcare bureaucracies are necessary but not sufficient.