Abstract

Sooner or later, we will all need care – whether for ourselves or for our loved ones. The viability of the healthcare system in the Netherlands is increasingly threatened by societal developments, such as a shortage of healthcare staff and informal carers. In this Dutch Public Health Foresight exploration (PHF), we explore how broad societal developments (together) impact future care demand.

Our ageing society will result in increasing numbers of people suffering from multiple conditions. This will in turn lead to higher, and also more complex, care demand. Care demand will become more complex because of combinations of conditions often requiring different kinds of care. Part of such care also relates to tackling causes in the social domain, such as a lack of socio-economic security.

Because of staff shortage, the care sector can only meet part of the increasing demand for care. Care demand from the informal network will grow, with many people currently already providing informal care. Looking forward to 2050, the number of people needed will far exceed the people able to provide care. If growing demand for both formal and informal care cannot be met, there is no guarantee that care in the future will be as accessible as it is now. Because of staff shortages, the care sector will only be able to meet some of the increased demand itself. Many people are already providing informal care, and towards 2050 many more informal caregivers will be needed. With an aging population, they are proportionally less available. But if the growing demand for both formal and informal care cannot be met, there is no guarantee that care will remain as accessible in the future as it is today.

More and more people are self-reliant into old age. They live independently at home and can manage the care they need well. They also have a network that supports them with informal care. In the future, more and more people will need to care for their loved ones into old age. This care can quickly fall away when these informal caregivers need care themselves. When people cannot get enough informal care, the demand for formal care may increase. This can widen the gap in health and quality of life between self-reliant and non-self-reliant people.

Future care will increasingly be given in digital form, for example through e-consults and smart sensors. These digital applications mean that remote care will become standard in most cases. A positive effect is that this will allow healthcare workers to remain in contact with people who continue to live in their own homes independently well into old age. A negative effect is that there is less room for personal contact between the care provider and the user. There will be more focus on bare data, such as examination results. Whether more digitisation can ease the pressure on care is uncertain; human intervention will always be needed.