The Dutch National Institute for Public Health and the Environment (RIVM) has explored the developments likely to have the greatest impact on palliative care in 2050. These include an ageing population, increasing staff shortages, digitalisation and other technological innovations in care, and growing societal diversity. Based on these developments, RIVM has set out three possible scenarios focusing on the community, the individual or the professional.
This foresight study was commissioned by the Dutch Ministry of Health, Welfare and Sport. RIVM conducted it together with scientific experts and care professionals. The Dutch Ministry of Health, Welfare and Sport is working with stakeholders to develop a vision for the future of palliative care in the Netherlands. Palliative care encompasses all care and support for people with incurable diseases and their loved ones. The aim is to ensure the best possible quality of life for these individuals.
Focus on the community
The scenarios are based on different perspectives. In the ‘Focus on the community’ scenario, the emphasis in 2050 will be on taking care of each other. As an example, this could take the form of local care communities, in which everyone takes care of each other based on their ability to do so. In this scenario, technology will be used to provide better care for people, for instance through accessible home monitoring. The central government will ensure an equal distribution of funds and other resources. Private parties, such as local entrepreneurs and small-scale care facilities, will be able to make meaningful contributions as well. Adding social value outweighs the profit motive in this scenario.
Focus on the individual
If the focus is on the individual, people will make their own choices in 2050 when it comes to deciding what is best for them in terms of things like treatment plans, wishes to end their own life or what quality of life means to them. They will also take relevant initiatives themselves. New technologies, digitalisation, monitoring and self-monitoring will be embraced. The central government will limit itself to facilitating theses choices, trusting in individuals’ self-reliance. Private parties will be offered considerable scope as well.
Focus on the professional
The third and final scenario focuses on the quality of care. The investment in prevention and care (in terms of time and effort) will be such that the Netherlands has never been healthier. This will also enable people to continue working for longer. People suffering from incurable diseases will receive the most suitable palliative care. In this scenario, the central government will take charge of organising care, with quality being considered paramount. The knowledge and expertise of professionals will be crucial for this.
Making choices for the future
These scenarios highlight that the fact that there are multiple perspectives on the future of palliative care. However, not all solutions are possible. Choices will need to be made. The scenarios provide guidance for holding a discussion on the future of palliative care in the Netherlands.