This article illustrated well the myriad of challenges facing STP's around the country and how and when health and LG partners engage.  This is a good challenge to the fashionable view in management that it's all about people rather than systems and structures.  

It strikes me if you cut to the chase- then we have incompatible financial systems and decision making processes.  People can get on like a house of fire but if the system says no then progress will always  be at the margins.  If people are only interested in protecting their fiefdoms- progress is glacial.  We need a fundamental review of public services in places which are financed and managed in a consistent way.