OVERLEGEN 3-2014 32 assistance and guidance. However, these investments are currently appearing to be too costly, which has actually resulted in cutbacks where the care of vulnerable people is concerned. The number of elderly people in the Netherlands is also constantly increasing and we are expecting to see a strong increase in this in the years ahead. A quarter of the increase in healthcare costs is related to the ageing population. This healthcare spending has been growing faster than the Dutch economy for many years. This has made it necessary for the government to intervene in order to manage these costs. There is plenty of ongoing discussion in this field. The discussions are mostly about (the advantages and disadvantages of ) possible measures to limit this growth in spending, for example by increasing the citizens’ own contributions, by limiting the provisions included in the basic insurance package or by organising the healthcare differently. This debate certainly isn’t limited to the Netherlands alone, as many European countries are having to face up to similar developments and therefore also similar challenges. We are not just taking a critical look at the affordability of healthcare, but the effectiveness of healthcare is also being scrutinised. How many health benefits are being realised as a result of the spending? Could we have realised the same with less spending? Patients, healthcare providers, the government and health insurers are jointly responsible for top quality, accessible and affordable healthcare, also in the future. This demands flexibility within the healthcare land- scape of all those involved, as well as a finance structure which supports this. Vision of the Dutch healthcare in 2025 Young healthcare professionals are now also involved with the question as to how healthcare can remain affordable, accessible and of high quality in the future, whereby the quality of care for the patients is central. We have looked at this issue from various different disciplines, including medical specialists, GP’s, public health physicians and specialists in the provision of care for the elderly. A number of core concepts are central in the vision which has been developed about the Dutch healthcare in 2025, including: self-reliance, E-health, responsibility, human scale, prevention, cooperation, flexibility, education, data management and self-reflection. Stimulating self-reliance It is expected that medical interventions will be increasingly focussed on quality, health benefits and the improvement of patients’ health in 2025. This is in contrast to the current situation, whereby the focus is on health rather than illnesses and conditions. Plus patients want to manage their own care as much as possible. The introduction of E-health and the provision of reliable patient information means citizens and patients are now in a much better position to achieve this, without the direct physical intervention by expensive healthcare providers. According to the report, citizens’ self-reliance will be further stimulated by the government, healthcare providers, health insurers and the citizens themselves by 2025. Ideally the patient will first look at his own available means to, for example, continue to live independently for longer. Support can be offered close to home; by the GP, the district nurse or social worker. Citizens and patients are responsible for their own health. They always need to be able to receive care from the right healthcare providers, at the right time and at the right place. Politicians, policy makers, hospital administrators, healthcare professionals and health insurers are therefore also taking responsibility for their tasks in order to realise this in the community. We need to note the fact that healthcare will have become much more complex by 2025, both where the organisation as well as the content are concerned. Using means like checklists in healthcare will help to support and monitor the execution of medical treatments. Plus checklists also contribute to a culture which is based on team work, where personal attention for the patient is at the top of the list of priorities. Focus on prevention Major benefits can certainly be had from a stronger commitment to prevention and health promotion. As better prevention will lead to increased employment participation and reduced absenteeism levels, the healthcare costs will inevitably go down too. The young healthcare professionals feel the responsibility for a good prevention policy lies with the government. New and promising preventative interventions are now being scientifically justified and research is both encouraged and (financially) supported. However, a joint implementation of the policy by local authorities, social organisations, health insurers, employers and healthcare providers is essential. Collaborations are taking place between the patient and healthcare provider, but also in the
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