Broken promises and/or techno dreams? The future of health and social services in Europe

Emerald - 2004
OzcanSaritas1, MichaelKeenan2
1Research Associate at PREST, University of Manchester, Manchester, UK (E‐mail: [email protected])
2Research Fellow, at PREST, University of Manchester, Manchester, UK (E‐mail: [email protected])

Tóm tắt

Despite differences in political approaches and institutional frameworks, health and social services in all European Union (EU) Member States face similar challenges, notably the need to adjust to demographic ageing and to changing employment and family patterns. This article takes a closer look at some of those issues (drivers) that are likely to have significant implications for the future of the sector. On this basis, three diverging “integrated visions” for health and social services are presented. The first vision is a “best guesstimate” and assumes that current developmental targets, for example, on reducing cardiovascular disease, are generally met. The second vision is a “problem‐plagued” view of health and social services, where targets are missed and the current level of service generally stays the same or deteriorates. Finally, the third vision presents a more “visionary” picture of health and social services where services are largely transformed from what is known today. All “integrated visions” have been constructed from existing health‐care scenarios as well as the drivers identified earlier. The paper is rounded off with an account of some of the policy measures being implemented by the European Commission and Member States in addressing several of the areas highlighted as important for the future of the sector.

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Tài liệu tham khảo

Amara, R., Bodenhorn, K., Cain, M., Carlson, R., Chambers, J., Cypress, D., Dempsey, H., Falcon, R., Garces, R., Garrett, J., Gasper, D., Sanstad, K.H., Holt, M., Kirsch, S., Kuehn, N., Kuiper, H., Kyrouz, E., Mittman, R., Morrison, E., Morrison, I., Nilsen, G., Pascali, M., Robertson, A., Runde, D., Sarasohn‐Kahn, J., Schmid, G., Wilson, C. and Yu, K. (2003), Health and Health Care: The Forecast, The Challenge, 2nd ed., Institute for the Future, Jossey‐Bass, San Francisco, CA, available at: www.iftf.org/docs/SR‐794_Health_&_Health_Care_2010.pdf.

Bundesministerium für Bildung und Forschung (BMBF) (2002), Future Lead Vision: “Healthy and vital throughout Life by prevention”, Futur, Berlin, available at: www.futur.de/en/dateien/Lead_Vision_Healthy_by_Prevention.pdf.

Comas‐Herrera, A. and Wittenberg, R. et al. (2003), European Study of Long‐Term Care Expenditure: Investigating the Sensitivity of Projections of Future Long‐term Care Expenditure in Germany, Spain, Italy and the United Kingdom to Changes in Assumptions about Demography, Dependency, Informal Care, Formal Care and Unit Costs, Report to the European Commission, Directorate‐General for Employment and Social Affairs, available at: www.pssru.ac.uk/pdf/B14/B14Comas‐Herrera1.pdf.

Commission of the European Communities (CEC) (2000), Social Policy Agenda, COM (2000) 379 Final, Brussels, available at: www.europa.eu.int/comm/employment_social/social_policy_agenda/com379_en.pdf.

Commission of the European Communities (CEC) (2002), Social Protection in Europe 2001, Directorate‐General for Employment and Social Affairs, Office for Official Publications of the European Communities, Luxembourg, available at: http://europa.eu.int/comm/ employment_social/news/2002/nov/soc_prot_rep_en.pdf; www.europa.eu.int/comm/ employment_social/social_policy_agenda/com379_en.pdf.

Coomans, G. (1999), Europe's Changing Demography: Constraints and Bottlenecks, Demographic and Social Trends Issue Paper, No. 8, Seville, Joint Research Centre (JRC) and the Institute for Prospective Technological Studies (IPTS), available at: www.jrc.es/home/publications/publication.cfm?pub=4.

European Commission (1999), “A concerted strategy for modernizing social protection”, Communication, COM(1999) 347, 14 July.

Judge Institute of Management (2002), “Hopes and fears for the future of health: scenario for health and care in 2022”, (WHO scenario), University of Cambridge, available at: www.jims.cam.ac.uk/research/health/polfutures/pdf/hopes.pdf.

Ling, T. (1998), The Madingley Scenarios, NHS Confederation, London.

Mossialos, E., Dixon, A., Figueras, J. and Kutzin, J. (Eds) (2002), Funding Healthcare: Option for Europe, Open University Press, Buckingham.

Office of Science and Technology (OST) (2001), Healthcare 2020, Report of the Foresight Healthcare Panel, Department of Trade and Industry, London, available at: www.foresight.gov.uk/.

Organisation for Economic Co‐operation and Development (OECD) (2003), Health Data, Paris, available at: www.oecd.org/document/16/0,2340,en_2649_34631_2085200_1_1_1_1,00.html.

PricewaterhouseCoopers (1999), HealthCast 2010: Smaller World, Bigger Expectations, available at: http://healthcare.pwc.com/cgi‐local/hcregister.cgi?link=pdf/hc2010.pdf.

Rotmans, J., van Asselt, M.B.A. and van Notten, P. (2002), “VISIONS scenarios on the future of Europe”, in Ringland, G. (Ed.), Scenarios in Public Policy, Wiley & Sons, Chichester.

Swedish Technology Foresight (Teknisk Framsyn) (2000), Health Medicine and Care Panel Report, available at: www.tekniskframsyn.nu/old/rap_oh_dok/ pdf_ppt/slutrapport_panel1.pdf.

Wanless, D. (2002), Securing Our Future Health: Taking a Long‐term View, HM Treasury, available at: www.hm‐treasury.gov.uk/Consultations_and_Legislation/wanless/consult_wanless_final.cfm.

Commission of the European Communities (CEC) (2000), The Future Evolution of Social Protection from a Long‐Term Point of View: Safe and Sustainable Pensions, COM(2000) 622 Final, Brussels, available at: http://europa.eu.int/comm/employment_social/soc‐prot/schemes/news/pension_en.pdf.

Commission of the European Communities (CEC) (2001), The Future of Healthcare and Care for the Elderly: Guaranteeing Accessibility, Quality, and Financial Viability, COM(2001) 723 Final, Brussels, available at: http://europa.eu.int/comm/economy_finance/epc/documents/epcspchealth_en.pdf.

Ling, T. (1999), “Which way to a healthy future?”, foresight, Vol. 1 No. 1, pp. 17‐34.

Ringland, G. (2002), Scenarios in Public Policy, John Wiley & Sons, Chichester.