Broken promises and/or techno dreams? The future of health and social services in Europe

Despite differences in political approaches and institutional frameworks, health and social services in all European Union (EU) Member States face similar challenges, notably the need to adjust to demographic ageing and to changing employment and family patterns. This article takes a closer look at some of those issues (drivers) that are likely to have significant implications for the future of the sector. On this basis, three diverging “integrated visions” for health and social services are presented. The first vision is a “best guesstimate” and assumes that current developmental targets, for example, on reducing cardiovascular disease, are generally met. The second vision is a “problem‐plagued” view of health and social services, where targets are missed and the current level of service generally stays the same or deteriorates. Finally, the third vision presents a more “visionary” picture of health and social services where services are largely transformed from what is known today. All “integrated visions” have been constructed from existing health‐care scenarios as well as the drivers identified earlier. The paper is rounded off with an account of some of the policy measures being implemented by the European Commission and Member States in addressing several of the areas highlighted as important for the future of the sector.