Scenarios for health planning and management: the Dutch experience

The processes of health planning and management require a clear insight into: future developments in society at large; the magnitude of disease categories (mortality and morbidity patterns); the rapid developments in medical technology; and, changing concepts of "good" health care delivery systems. In 1983, the Dutch Secretary of Welfare, Health and Cultural Affairs decided to establish a Steering Committee for Future Health Scenarios (STG). The chief task of this Committee is to create alternative pictures of possible futures in the field of public health and health care. These health scenarios are used to increase the anticipatory capability of policymakers and health managers. This paper evaluates the Dutch experience with scenario- projects on "health and ageing", "cardiovascular diseases", and "cancer". After a short introduction on the structure of the STG, and the concept of scenarios, the scenario-projects are described and analysed. The conclusions to date of the projects are mentioned briefly. This article ends with some recommendations, with respect to the methodology of scenarios in the field of health, the structural prerequisites for successful projects, and the communication aspects of these types of studies.