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Sustainability
The first Earth Summit (UN Conference on Environment and Development) was held in Rio in 1983. 20 years later this was reprised as the first UN Conference on Sustainable Development and it proposed 17 sustainable development goals and associated targets (the SDGs). Learn more from this dedicated website
Sustainable Development Goals
Goal 3 is ‘Good health and Well-being’ and has nine main indices for progress.
EHFF believes that important associated goals are:
For a while the SDGs were treated as ‘motherhood and apple-pie’ aspirations, but there are increasing signs in Europe that Governments are attempting to address at least some of the SDGs in their latest policy development plans. Inevitably concerns about climate change have had a role as catalyst to this.
What troubles us is that individual Goals such as Health are being approached as if they were in silos, rather than recognising important overlaps and interactions with other Goals (i.e. a holistic view: the relevant ones as we see it are listed above).
A World in Harmony
Sustainability refers generally to the capacity for the biosphere and human civilization to coexist. A more complex definition illustrates our interest in the inter-connection between different aspects of society, namely ‘the process of people maintaining change in a balanced environment, in which the exploitation of resources, the direction of investments, the orientation of technological development and institutional change are all in harmony and enhance both current and future potential to meet human needs and aspirations.’ Such a view provides for example a context for the relevance of Corporate Social Responsibility

ADAPTABILITY?
There is a more mundane facet of sustainability, namely whether the design and functioning of a system allows it to survive and adapt to major change. This is the other area of sustainability especially relevant to healthcare systems in Europe as many (including EHFF) believe that the present systems are based on antiquated models, much developed and, on the surface technically sophisticated, but actually no longer fit for purpose. While desperately in need of major innovation, the form of these systems tends to actually inhibit the implementation of genuine innovation.
A holistic approach to health in society
More than ten years ago, the germ of an idea that eventually became EHFF was that transformation of health systems could not be achieved from within health and healthcare itself but needed a working together of societal systems, especially health, education and industry. This is not just about avoiding silo-thinking but recognising that in order for society to work more effectively, there is a need to somehow reconcile the different prevailing cultures of the three major components.
Strategic Planning
With a holistic approach as a guiding principle, our view of how change might be influenced is based on a model derived from the Shell Scenario planning approach (e.g. Kees Van der Heijden: scenarios, the art of strategic conversation). Conventionally organisations do their strategic planning based on distinguishing the transactional space (the actors that the organisation interacts with) and the contextual space (aspects of the wider environment that must be adapted to, but which can’t be directly influenced). We argue that for a holistic approach to be effective, we have to turn the model on its head, what we call ‘dancing with dinosaurs’. Difficult as it may be to implement, we see influencing the players in the contextual environment as a crucial part of a holistic approach to health and healthcare in society.
