It seems that every aspect of life as we know it is currently changing.

Of course, rapidly evolving climate change with altered conditions, more-frequent natural disasters, and flow-on economic consequences and climate refugees, will increasingly effect all of our lives.

However, many other elements of our lives and society are also shifting. These include:

• an increasing wealth disparity, lack of fairness, and segmented society
• increased political polarisation – perhaps most-obviously seen in the US with the ‘red/blue’ divide
• Far right extremist political parties, movements, and attitudes in many countries
• Lack of trust in leaders – political and business
• Low birth rates and aging populations in developed countries

Many of these changes seem to have come on quite quickly. But most actually occur slowly, almost invisibly, for some time until they are recognised. Similarly, in many countries of the Western world, systems that have lasted for generations seem to be stretched and failing. This includes Healthcare. Some of the manifestations of our failing health system (due to unrecognised long term change) are the erosion of general practice, unprecedented demand on Emergency Departments, reduced healthcare worker wellbeing and skyrocketing burnout levels.

These indicators of a struggling system have not arisen overnight and are not solely due to the Covid pandemic. Instead, they have come about silently, almost imperceptibly, over many years until they ‘suddenly’ become a pressing issue. Perhaps this is inevitable. All things, including social systems, decay over time – particularly when overlooked, taken for granted, or neglected. And all systems, including the mode of healthcare, eventually become obsolete and are replaced by other systems.

But before one system can be replaced by another stable system there will be a period of turmoil that includes instability and uncertainty. As humans, we dislike feeling unsettled and we resist change. We prefer the familiar than the unknown. Change comes with fear and anxiety. Routine patterns are comfortable and require less cognitive effort.

However, in many systems including healthcare, this period of turmoil can be appreciated rather than resisted. This is the time that delivers potential for needed change, even rebirth, and can be used to great effect. When we accept the inevitable degradation of our systems, and instead recognise the opportunity for improvement, we can let go of fear and resistance to change. Rather than trying to maintain things exactly as they are, we can approach the new dynamic with curiosity and optimism about creating better systems and better ways.

Health organisations, teams, and the overarching bodies that have an ability to guide societal healthcare delivery systems, are all important to this process. All have a role to play. Acknowledging current challenges and deficiencies will be crucial to allow acceptance and recognition of opportunity. Those who can develop hope and enthusiasm about the future will direct change in more positive ways than those who are motivated through fear or an inability to imagine a new paradigm.

Guiding positive change can regenerate healthcare and enable better integration of all facets of our system. Positive change can further create a collaborative environment that optimises desired results while also prioritising communication, inclusion, and facilitation of the wellbeing of staff and workers.

In many ways (and to paraphrase ex-Prime Minister of Australia, Paul Keating), perhaps this is the turmoil that healthcare needed to have.