Operational research in health services planning

A survey of OR investigations (both tactical and strategic) in the area of health services planning supports the case that the mainstream OR contribution does violence to the nature of the system under study.

Abstract

Some of the characteristics which distinguish social planning from planning in the private sector, or in publicly owned industry, are identified. A survey of OR investigations (both tactical and strategic) in the area of health services planning supports the case that the mainstream OR contribution does violence to the nature of the system under study. In particular, problems are formulated in terms of (or transformed into) single objectives, to be optimized; aspects of the social world are subject to wholesale quantification, with resulting distortion; models make implausible data demands; project definition and execution reinforce the 'scientisation' of political debate; problems are formulated on the assumption of a single hierarchically powerful decision-maker; and problems are formulated as if they must be solved in toto at one point in time. It is suggested that we should look to the converse of these qualities for new directions in the application of operational research in social planning. Some examples are given of techniques and approaches, drawn both from within health services planning and from other areas, which exhibit these alternative characteristics.