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Future challenges to the provision of health care in the 21st century

This presentation will attempt to outline the future broader and far reaching trends and challenges that face the provision of European health care in the 21^stcenturys.

Reference will be made to contemporary debates in the political science, economics and public policy literature. The paper will therefore attempt provide a birds-eye view of the political, social, scientific and ethical factors need to be taken into consideration if the infrastructure of health care provision is going to be "fit for purpose" in the next 20 to 50 years. It will analyse the future demographic trends in relation to health care, both in terms of the portfolio of skills and human resources required by the medical and paramedical professions, as well as the ramifications of an ageing population.

The presentation will also assess the implications of the reconfiguration of the health sector throughout Europe, particularly in relation to the retrenchment of public sector provision, and the growth of a multiplicity of health care providers, including those from the voluntary and private sectors. A further important issue that warrants consideration is the widely expectations of the recipients of health care, who are increasingly being seen as "consumers", who are endowed with the inherent rights to make informed choices regarding the treatment they receive, and by whom. This is exasperated by the exponential advancement in medical science, and what is scientifically and humanly possible to achieve. In addition, it will be important to recognise the growing disparities and inequalities in accessing health care by different groups within societies, disaggregated by socio-economic status, geographical location, age and disability. This latter point will draw heavily on the Social Determinants of Health literature.