Avoiding complexity

01 October 2014
Volume 30 · Issue 10

Roger Matthews looks at the benefits offered by keeping things simple.

Catching a Frisbee is a serious matter. Why else would the Deputy Governor of the Bank of England have chosen it as the title of a speech to US bankers?
I’m equally serious here: what Andrew Haldane took as his theme was this. If you asked a physicist to write down an equation for how to catch a Frisbee (aeronautics, meteorology, Newton’s laws of motion and gravity and so on) they would conclude it was a next-to-impossible feat. But humans do it all the time, in fact most dogs can do it – better than humans.
So what’s the secret? The answer is not to over-complicate things, but to come up with the simplest approach that solves the problem. Haldane goes on to point out that in the wake of the global financial crisis, governments’ response has been to create ever more complex and intricate regulation. In his view, this is a self-defeating strategy.
Not only do we have infinitely more data to collect, but we need vast new tiers of regulators, inspectors, trainers and staff dedicated to nothing more productive than trying to fathom out and comply with all the regulations.
Is this beginning to sound familiar? Try again. For ‘global financial crisis’ substitute ‘Shipman’ or ‘Mid- Staffs enquiry’ and the result is the same. As Haldane points out, it’s all ultimately futile. He says: “Collecting and processing the data necessary to model complex decision–making is costly – perhaps punitively so. And fully defining future states is beyond anyone’s cognitive ability.”
What’s more, complex rules lead to defensive behaviours. For example creating rules which say doctors should refer more people to hospital, leads to the situation where more patients are then subject to secondary infections. I’d add that creating rules which require dentists to refer patients via complex administrative pathways, adds to delays, potentially worsens symptoms, and results in even more destructive therapies.
Whether you’ve read Malcolm Gladwell’s Blink, or Jeffrey Kluger’s Simplexity, you’ll realise that Andrew Haldane’s thinking is not unique or screwball. To use another metaphor, the signal is simply getting drowned out by the noise.
There are lessons here across most disciplines. If, for instance (and I’m not suggesting anyone would want to try it) you created a complex software system that input huge amounts of patient data and provided it to, say a couple of hundred independent dentist operators, and kept changing it from time to time as bugs became apparent, you might find that analysing the outcome data became so incredibly complex that you needed lots of people just to make sense of it.
It would take longer and longer to find out exactly what was, and what wasn’t important or relevant, and in the meantime everyone would get so frustrated with whatever previous complex system was in place that they would never trust whatever the new system looked like. Just speculating....
That wouldn’t just happen in dentistry, as Gladwell noted when he quoted research on the diagnosis of myocardial infarct in A&E units. What was found what that just a few indicators gave clearer, quicker and more accurate treatment pathways.
Sadly the current trend is evident across society as a whole, and politics has a seminal role to play. Richard Heaton, parliamentary counsel and permanent secretary to the cabinet office, notes that new legislation creates up to 30,000 ‘secondary effects’ (requiring amendment of previous legislation) each year and that even the civil service is unable to stay up to date with these. He laments that: “there is no compelling incentive to create simplicity”.
Perhaps we should consider voting for whomever promises to bring in the fewest reforms in their manifesto, and who also agreed (if they dared) to set up a small group in every department tasked (and suitably incentivised) to simplify the ever-growing web of complexity. Ah, dream on!