Healthcare is often referred to as a complex environment and managing in this environment does not have direct parallels in any other industry or sector. The complexity of health systems arises not because of the structure of healthcare, but because of the myriad of complex relationships between the various stakeholders in health. The successful healthcare policy maker, manager or clinical professional must be able to navigate through this maze, strategizing, negotiating, persuading, motivating, empowering, and making some tough decisions along the way. The recognition that academic models need to be complemented by context-specific pragmatic approaches (some of which can only emerge from experience) is a prime motivation for this book. The contributors are highly regarded individuals with considerable experience of bringing about change in the health sector. Previous works in the area have done a good job of laying out some of the key problems of Irish healthcare but are less inclined to consider how these problems might be overcome. Theory-led accounts of how to change things for the better can fall on barren soil when the reader finds that they are based on an idealised world that bears little resemblance to what they see piled up in their in-tray. This book distils some of the collective experience that exists within and around the Irish healthcare system on how to push for change and how to deal with some of the obstacles one inevitably meets.