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Members of the inaugural meeting of the Sciana network have spent days contemplating the challenges facing the health and health care systems of today, and of the future. But when theorising solutions to  these challenges, Sir Harry Burns, professor of global public health at the University of Strathclyde,  Scotland, stresses the importance of not falling victim to the belief that one grand scheme is the solution.“The way in which to change a  complex system isn’t through a  grand plan – it’s through people  examining problems, coming up with  solutions, testing those solutions, and spreading learning,” Burns says.Burns’ focus is on how societies can create overall “wellness” for  its citizens, where health is a state of physical, mental and social wellbeing, not just the absence of illness. But this approach, he explains, is one based on a series of  complex systems coming together. “It would be a mistake to think that  the health care system on its own can tackle the determinants of  health,” he says. “First of all, the  health care system tends to focus on illness, whereas wellness goes  hand-in-hand with treating illness in terms of creating a society where wellbeing is the aim.” He continues: “A society with lots of wellbeing isn’t just a society where  health is good, it’s a society where  education attainment is good, where people are engaged, where there  is a high level of social cohesion,” noting there is scientific evidence indicating this process begins with children and young people. “Children who experience difficult in  early life through parental absence,  through mental illness of parents, through poverty, will often find it  harder to learn, to behave correctly  in stressful situations,” he says. “As a result they’re more likely to  fail. So giving support to families who find themselves in difficult  circumstances is the basis of a  wellbeing society. But it doesn’t stop, it continues through life.”After spending just three days with members of Sciana, the health leaders network, Burns, whose  involvement will continue with the  network in the coming months as a senior ambassador, says he has  gained a greater insight into the way  different health care systems are financed, and how that financing  determines their functionality and  ability to change. “What I’ve heard in some systems  is finance doesn’t seem to be a  huge problem, therefore what’s the  incentive for change? Whereas in  the UK system our government has decided there is a limited amount of  money for health care, [so] we are  forced to discover new, more efficient  ways of delivering care, which is why  we focus on wellbeing as a way of  reducing the need for care.”