From pandemics to climate change, the complexities of our world demand a new breed of leader – one who thrives in the face of uncertainty and orchestrates collective action amidst chaos. Let’s explore what this might mean for those of us in public health.
As I travel around the country meeting fellow public health colleagues, I am consistently struck by one consistent message: We are indeed living in interesting and complex times. Whether working within the context of rising pressures on health services, rising tides of infectious and chronic diseases, widening health inequalities, growing poverty, shrinking budgets accelerated by the cost of living crisis, public health is becoming more challenging and the communities we serve are in greater need.
The truth is that we are standing at a pivotal juncture. Our interconnected systems, once seemingly predictable, now are defined by complexity. Pandemics, the cost-of-living crisis, climate change, and rising inequalities are intersecting to create overlapping and unanticipated challenges. Yet, amidst this uncertainty, a critical opportunity emerges: to forge a new paradigm for public health leadership in complex times, one that transcends traditional models and embraces the intricate realities of our time.
This new leadership paradigm demands a multifaceted lens. It requires us to abandon simplistic narratives and embrace the inherent complexity of our systems. As we learned in the acute phase of the COVID-19 response, linear, top-down and heroic models of leadership were unable to effectively respond to the complexities of a rapidly emerging, unknown disease affecting every part of our globally connected society. More recently, the growing realities of child poverty, worklessness due to poor health, and declining economic productivity require different approaches to tackling them. Critical thinking, a systems-level perspective, and a thirst for diverse perspectives become our guiding lights. By understanding the interconnected web of factors shaping our challenges, we can move beyond symptom-based solutions and craft interventions that address the root causes.
Within this increasingly complex environment, equity must be our compass, not a distant aspiration. We cannot afford to be bystanders in the face of health inequalities that scar communities and end lives prematurely. We must champion equity as a core value, dismantling the social, economic, and structural barriers that perpetuate these injustices. I am encouraged by the leadership that public health teams are providing on issues including poverty, homelessness, structural racism, inclusion health among other areas. We bring our commitment to evidence-based action, collaboration, systems leadership, strategy formulation with a resolute focus on delivery. Prioritising resources and interventions for the most vulnerable is not simply a policy choice; it is a moral imperative that demands unwavering commitment.
Collaboration, not isolation, is the key to unlocking transformative solutions. We must foster trust and forge partnerships across sectors and communities. Integrated Care Systems in England, promoting stronger working in place between health and local government, combined with a strong visibility and input of public health experts provide new opportunities for collaboration to improve population health. Public health colleagues are building coalitions for action locally, regionally and nationally recognising that practitioners, clinicians, researchers, community leaders, and importantly, the people we serve, each hold fragments of the solution. By listening with open hearts and minds, we can harness the collective wisdom of this diverse mosaic and co-create interventions that are both effective and sustainable. This was a recurrent lesson in our COVID-19 pandemic response and must now be an enduring legacy.
Agility and adaptability – both professional and organisational – in this ever-changing landscape is essential. We must be nimble, pivoting in response to emerging challenges and opportunities, and be prepared to take full advantage as opportunities arise. Recent opportunities for action on expansion of opt-out HIV testing in emergency departments, tackling youth vaping and progressing smokefree generation legislation in England all highlight the importance of this preparation with agility. Embracing experimentation, learning from failures, and fostering a culture of innovation within our organisations are essential steps. By staying responsive and open-minded, we can ensure our systems remain relevant and effective in the face of constant flux.
Finally, we must lead with both courage and compassion. We need the courage to challenge the status quo, speak truth to power, and make difficult decisions, even when they are unpopular. Public health teams across the country are leading the difficult necessary conversations on tackling air pollution, climate crisis, structural racism, asylum and migrant health and many other areas deemed politically challenging or difficult given the current funding constraints. Yet, amidst the complexities, we must never lose sight of the human cost of our choices. Leading with empathy, recognising the anxieties and vulnerabilities of those we serve, and demonstrating unwavering commitment to their well-being is the bedrock of effective public health leadership. Ensuring that current and future generations of public health experts have the training, tools and capacity to lead in these new ways will remain a priority for the Faculty of Public Health.
In closing, the paradigm of public health leadership in complexity is not a distant dream. It is the practical toolkit we need to navigate the labyrinth of our present reality. By embracing these principles, we can help to build more resilient health systems, advance health equity, and ultimately, create a world where everyone has the opportunity to thrive. We are not alone in this journey, so let us step forward together, with courage and compassion, to chart a brighter future for public health and the communities we serve.
Professor Kevin Fenton CBE FFPH
FPH President
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