Throughout this book there has been a sense of old and new, of traditional ways of doing things that are in transition but have not yet been fully replaced with new ways of thinking and acting in leading change. We work in organisations that rely on routine and regulatory processes to deliver complex services. We usually acknowledge that the contribution of people who staff these services, whether the organisations are public, private or voluntary, creates the quality of these services. We talk about valuing staff and respecting differences, but we so often fail to demonstrate this. As leaders in our organisations, we have the opportunity to shape transformation. This may only be possible when the conditions are right. One of the greatest difficulties to overcome is complacency because people have to want change before they will contribute to creating a new future. I wonder how bad things have to get before we face up to the need for transformational change?