1. HEALTH 2020 CANCER SURVIVORSHIP 01 December 2010

2. Wild Guess Informed guess Committee Plan Give up predicting Predicting The Future 101

3. PERSPECTIVE

4. Economic Workforce Demographics ethnic age geographic Quality Social expectation Disruptive innovation Drivers

5. The problem

6. The future … will be exactly like the past, only far more expensive. John Sladek The future … will be exactly like the past, only far more expensive. John Sladek

8. Economic Workforce Demographics - ethnic age geographic Disease patterns changing Disruptive innovation Drivers

13. Degree to which behaviour change is required MinimalExtensive Motivation to comply with best known therapy Strong: Consequences are immediate Weak: Consequences are deferred Myopia Hypothyroidism Psoriasis Chronic back pain GORD Coeliac disease Chron’s disease Obesity HIV Alzheimer’s Addictions Type 1 diabetes Bipolar disorder Type 2 diabetes Hypertension Asthma Hypercholesterolaemia Hyperlipidaemia Infertility Parkinson’s Depression Cystic fibrosis Chronic Hepatitis B Coronary artery disease Cerebrovascular disease Congestive heart failure Disease with deferred consequences Diseases with immediate consequences Behaviour dependent diseases Technology dependent disease

14. Workforce Business process Business models Care models Social networking E medicine Disruptive innovations

17. Talking of ‘innovation’ Innovation leadership: Structured investment in changing the way we deliver health services. Avoidance of critical issues Discussion leadership: A considered national and / or local discussion on what health services can be expected Politically driven funding allocation decisions Clinical leadership: Long term clinical leadership largely decoupled from the political process Expectation of leadership from the state Consumer leadership: Leadership from those close to the shop floor including New Zealand’s citizens FROMTO