The Future of Public Health

How can the public health system best be organised in the future and which factors are the main determinants thereof?
These are key questions in the scenario report The Future of Public Health: a Scenario Study . The report is the result of a study commissioned by the Steering Committee on Future Health Scenarios and carried out by a research team of the TNO Institute of Preventive Health Care and the STG Scenario Committee on the Future of Public Health. The report focuses on activities in collective prevention of diseases, generally known as primary prevention.
The future images developed make use of two examples, the control of infectious diseases and public health for the elderly. In designing those scenarios, two sets of possible trends were combined: centralisation versus decentralisation and nationalisation versus privatisation.
These combinations resulted in three scenarios; a local government scenario, a central government scenario, and a private enterprise scenario. The consequences of these future alternatives were developed in terms of their effect on organisation, policy control, financing, information supply, expertise and effectiveness.
Although the report primarily focuses on the public health system in the Netherlands, the analysis of the processes examined, and the alternative scenarios based on them are also thought-provoking for readers throughout the world.

Zusammenfassung
The report is the result of a study commissioned by the Steering Committee on Future Health Scenarios and carried out by a research team of the TNO Institute of Preventive Health Care and the STG Scenario Committee on the Future of Public Health. a local government scenario, a central government scenario, and a private enterprise scenario.

Inhalt

1: Introduction. 2: Public Health in the Netherlands. 2.1 Health Care Policy in the Netherlands. 2.2 The Concept of Prevention. 2.3 A Definition of Public Health. 2.4 The Institutions Concerned with Public Health in the Netherlands. 2.5 Government Policy and Public Health. 3: The Scenarios. 3.1 The Purpose of the Scenarios. 3.2 The Scenarios in Pure Form. 3.3 The Plausibility of the (Future) Scenarios. 3.3.1 Market versus Government. 3.3.2 Centralisation versus Decentralisation. 3.4 The Final Scenarios. 4: The Scenarios in Practice. 4.1 The Control of Infectious Diseases. 4.1.1 The Surveillance of Infectious Diseases. 4.1.2 The Present Situation in the Netherlands. 4.1.3 Examples from the Scenarios. 4.2 Public Health for the Elderly. 4.2.1 Present Situation. 4.2.2 Examples from the Scenarios. 4.3 The Consequences of the Scenarios. 4.3.1 Policy Control. 4.3.2 Organisation. 4.3.3 Financing. 4.3.4 The Supply of Information. 4.3.5 Expertise. 4.3.6 Effectiveness. 5: The Scenarios and Public Health as a Whole. 5.1 The other Areas of Public Health. 5.2 Final Comments. References.