BAMM Conference: The road to nowhere?

The full title of Denis Smith’s presentation was The road to nowhere? Pillars and other metaphors for changes in healthcare, but as usual his metaphors were exceedingly obscure. Denis’s BAMM presentations have become legendary for their side-splitting humour, often funny to the point of obscuring his underlying message. This time, though still very funny in places, he had a more approachable message— namely that (if I may paraphrase) every system has embedded within it the seeds of its own failure, and that in trying to compensate for this we simply add to the complexity and, ultimately, to the certainty that at some point failure will occur. When it does, unravelling the ‘root cause’ can be a nightmare. Systems work because of the people in the system, but failure often reflects system complexity rather than human error.

[This theme will be familiar to computer programmers, and is well illustrated by the repeated security failures in Microsoft’s Windows operating system. CAR (Tony) Hoare wrote about the phenomenon over 20 years ago in his Turing Award lecture The Emperor’s old clothes. The parable that ends his lecture is well worth reading, as is the full text]

Denis is a natural, gifted and entertaining presenter. His visuals are the complete antithesis of the powerpoint misery which was the butt of yesterday’s rant (probably in part because Denis uses Keynote rather than powerpoint).