A good piece, but I wouldn't start with 'change'. To do so suggests that 'change' is what leaders are there for. I don't agree. Not everything has to change, and perhaps the most important change is quite minor, though difficult. I would start with developing a coherent picture of what the organisation is for, and moving from that to ask what stands on the way and what can be done about it. The answers have to come from the bottom, I agree, but the leader is the one who can give people the courage to say what they would like to say, and in doing so, give them the self-confidence to act in new ways.

I don't think that Steven Leeder would disagree. It's just that the essay put 'change' up a bit too early for me.

Health services will not change until we change the definition of health service from bureaucratic career to health service.
The medical people do a great job it's their bureaucrat hangers-on who let the country down. Same goes for the rest of the public service.