The aim of this paper is to explore how complexity insights can be used to facilitate resource decision making in public systems. The focus is on health care and in particular the UK National Health System. Attempts at rational resource decision making in public systems have identified that there are no explicit frameworks that are acceptable both publicly and politically and that rational decision frameworks are invariably unworkable. This paper explores insights from the UK National Health Service and suggests how complexity insights might be developed to facilitate resource decision making, particularly at grass roots level. The focus moves from the current development of an increasingly methodological competence to creating the conditions for a conversational competence amongst decision makers from which solutions will emerge that may not be optimal but which will satisfy the constraints placed on the system.