Evaluating Health Futures in Aotearoa

This article describes a high-level evaluation of a scenario exercise that took place in the New Zealand health sector in 1997 and derives some lessons for future evaluations. By extension, such an evaluation tests the efficacy of scenario development and futures thinking (foresight) in general. Context for the evaluation is provided by a brief reflection on scenarios as a technique, both generally and in the health field. Then a discussion of the process used in 1997 to develop five scenarios is followed by a description of the logic and methodology for the evaluation itself. Findings suggest that the process used to develop the 1997 scenarios was valuable in opening up decision-makers’ minds to possibilities without them needing to feel threatened or defensive, but it may not have been inclusive enough for the New Zealand context. Using criteria identified by Schoemaker the scenarios themselves were relevant, credible, and coherent, but not particularly archetypal or long term. Their impact on strategic decision-making was short-lived, but they were prescient in many respects and have been referred to within academia. Future considerations of health futures should be clearer as to purpose, get more explicit buy-in of key decision-makers and draw on a more diverse range of inputs. We also suggest that rather than being carried out during a discrete time period, scenario development should be a continuous and constantly updated process.