I recently attended a one-day conference organised by health service leaders in an industrial town in the Northwest of England. The town was once a thriving centre of manufacturing industry, but now faces social and economic decline. In line with the thinking of the authors of this book, the health service leaders had set out to tackle the problems they faced by ‘getting the whole system in the room’. As a result, those attending were not only from all parts of the NHS, but also from local authorities, businesses, community groups and churches. Everyone present understood that improving the health of local people would be a long and arduous process. There would be no easy quick fixes, and many difficulties and challenges lay ahead. What is more, they recognised that hitting government targets and improving their town’s position in the relevant league tables, was actually about improving the sense of wellbeing and quality of life of everyone who lived there.

All too often this isn’t the face of public sector change that grabs the headlines. Instead the ‘mad management virus’ described by the authors of this book is perceived to be the predominant model for getting change to happen in the public sector. The myth is one of inflexible top-down targets being ruthlessly administered by faceless bureaucrats. The reality is increasingly one of public servants working creatively to develop new and effective means ofimplementation.

For far too long public service delivery in the UK has been characterised by policy thinking that has been unambitious and often poorly implemented. Just as risky are bold and radical ideas that are unsupported by effective implementation. This is frustrating for everyone: for politicians, who do not see the pace of progress that they would wish; for citizens who do not see services improve; and for those working in the public services who are trying their absolute hardest and yet feel criticised for not implementing ideas that they see as unrealistic and unworkable. What is needed is a new approach to the effective implementation of change in the public sector that can match the bold radicalism of new policy thinking. It is unquestionably the role of politicians and policy makers to develop effective policies that will meet the changing demands of the 21st century. Such visions need to be painted in bold colours to capture the imagination.