P u b l i s h e d o n b e h a l f o f t h e W H O R e g i o n a l O f f i c e f o r E u r o p e b y T h e N u f f i e l d Tr u s t
THE FUTURE OF HEALTH – HEALTH OF THE FUTURE Fourth European Consultation on Future Trends
THE FUTURE OF HEALTH – HEALTH OF THE FUTURE Fourth European Consultation on Future Trends Keith Barnard (editor) Preface by John Wyn Owen CB
PUBLISHED ON BEHALF OF THE WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR EUROPE BY THE NUFFIELD TRUST
The Fourth European Consultation on Future Trends, held in London on 13 and 14 December 1999 and hosted by the Nuffield Trust and the WHO Regional Office for Europe, considered the prospects for implementing the HEALTH21 policy framework. It explored the future environment of health in Europe and anticipated future problems and opportunities. A point of departure was provided by the results of a study carried out by the University of Cambridge entitled “Policy futures for UK health”. The participants included those involved in the study and other aspects of the Nuffield Trust’s programme, those who had participated in the preparation of HEALTH21, and others with international experience and expertise. The importance of evidence and research and the usefulness of scenarios were reaffirmed. Attention was drawn to the limited “life” of futures studies, based as they are on assumptions that are constantly changing. Experience has proved the usefulness of periodically bringing together people from different sectors and different walks of life to discuss futures. Further periodic consultations would be a valuable tool in the continuing process of monitoring, review and revision to ensure that WHO’s European policy framework remains relevant for the Region as a whole. The Regional Office should continue its policy dialogues with country partners and others, and its collaboration with the Nuffield Trust in the use of futures in the creation and implementation of health policy. This document has been edited by Keith Barnard.
ISBN 1-902089-89-8 © World Health Organization The views expressed in this publication are those of the contributors and do not necessarily represent the decisions or the stated policy of the World Health Organization.
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TABLE OF CONTENTS Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 An explanation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 PART I: THE DIALOGUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-88 Using futures in the policy process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 The work of the Nuffield Trust . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 The British government Foresight programme. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Futures in the Department