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Desert Island Texts

When I started thinking about what books I would like to have with me on a desert island the three that have most influenced me came to mind. The common denominator amongst them is that they are about how social systems work. All of them are from outside the health sector, but that is all to the good. We need to understand that behaviours in health care are not unlike those in other sectors and equally we need to understand the wider environment in which we work.

"Diffusions of Innovations"

E M Rogers wrote the book with this title. It sounds a bit dry but in part it offers enormous insight into the way change takes place in any social system: the path that is followed, the types of change which will be easy to make and those which will be difficult. It makes so clear that the health system is no different from others. However, it is an academic work summarising 7,400 individual studies and in my lonely existence on a desert island I felt it wasn't quite warm enough to be the one book I was left with.

"Essence of Decisions"

This book by Graham Allison is about the Cuban Missile Crisis and the game of chess which was being played between the USA and USSR at the time. It looks at the events from three alternate decision making paradigms. It made me realise that how we operate will depend so much on our own preferred mode, for example how much is it about logic or alternatively how much we intuitively think through how someone else will react, but also how we are influenced by the way a particular organisation does things.

"Age of Unreason"

The book I finally decided I would want with me is Charles Handy's "The Age of Unreason". If you are at all interested in what is happening in organisations and in the wider economic environment in the 1990's, this is an essential read.

Charles Handy doesn't necessarily explain why things are happening as they are, but he certainly puts our world in a wider context. It often seems ridiculous to me that those in the NHS are working so hard with such long hours when there are so many people unemployed. Handy shows that this phenomenon applies in organisations across all the developed world. If we are going to make society in the next century at all comfortable to live in we need to understand what is happening and take steps to change our societal approach.

That would give me plenty to think about on my desert island and perhaps result in some new thinking I could bring back into the real world - following my rescue!

Barbara Stocking
Anglia & Oxford Regional Health Authority

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