If integration is to improve the performance of a system it is necessary to attend more to the interactions than to the elements. Good health professionals do not make a good health system. Good professionals interacting well with other elements of the health system make good health care. If integration is to achieve its aim of socially responsive improvements in technical care, services, outcomes and costs, there is no choice but to invest in improving the interdependency among individuals, professionals and organisations. In this context, the following principles are suggested as a guide to integration and system improvement.
Improvement requires clear aims for improvement.
Complex systems do not improve without a clear agenda for change. Improving a system requires system leadership. If the health professions are to provide this leadership they must redefine, renegotiate and renew their mandate from the public. Health professionals must embrace openness and the measurement of performance as a step towards their own and organisational learning. Measurement is not a threat, it is an opportunity to learn.