In the late seventeenth century, London’s coffee houses drew in thinkers and launched marine insurance, the Stock Exchange and auction houses. Meanwhile, physicians consulted, wits and writers debated, and there was thinking space for scientists.
I was reminded of that scene when I was a guest at Café Blac in Glenferrie Road, Melbourne, where 30 people paid money for an afternoon on healthcare. The room was lined with wavy rows of books – hardbacks, paperbacks, old and new – some hanging open from the rafters, creating fabulous acoustics. The front tabletop lay entirely on books, while the walls were punctuated by small shelves piled with books, creating a jarring juxtapose in their randomness: Terry Pratchet’s A Hatful of Sky sitting atop Tom Monahan’s The Do-It-Yourself Lobotomy.
When I looked them up I found them a fitting, if accidental, complement to creativity. Those around the table were hardly less varied in their drive and interests: GPs, nurses, OTs, doctors, social scientists, physiotherapists, business consultants, managers and academics. This was a community that fuelled its discussion by reading beyond its background. Inspiring, but why did it matter?
Nobody there had a significant budget or formal role in making big decisions, but coffee houses are not about decisions, they are about conversation and ideas. The old London scene connected communal thinking to those who could do something in trading, publishing, or drama.
As for this network, I am sure someone there will find the funds to realise their collective vision of a health system of their dreams in South Australia and Victoria.
But what of the thinking itself? A speaker that day, Harold Nelson, had worked with the team for some time, focusing on design for health. I kept wondering why everyone was so taken with the idea of design. It’s not that I’m against design, quite the reverse, but knowing that design matters is like knowing that the earth is an oblate spheroid: I take it for granted except when I travel halfway round the globe and sense its impact on my sleep.
And halfway around the globe, I realised that design – designing services – is still a new idea for health. Up to now, services happen and we try to improve them and then they happen differently. But human agency can determine our requirements. It can drive a complex mix of arrangements and resources to create a service that does what we want, when we want, for what we want to pay. Healthcare does not have to take as long as it takes, or cost what it will cost; we can crack the problem, perhaps the mould, to get a designed service. And that is still
a novel idea.
Which is why coffee shops matter.
Professor Terry Young
Reference:  Accessed Dec 2 2016