Discussion

Abstract

As Professor Parkhouse made very clear [Chapter 12], the problem of defining medical manpower need is an old one and difficult to solve if it can be solved at all. Exploring the art of the possible, as he called it, I would propose a different approach. In this approach it is essential that the different actors in the play of medical manpower planning are identified and that it is recognized that each actor has a specific set of objectives he, or she, hopes to be met at the end of the game. There are also a number of restrictions:

• 1. Health-care costs cannot increase any longer; they may even have to be cut down.

• 2. High unemployment rates (among physicians) might provoke serious social tensions in society.

• 3. A certain standard of quality of health-care provision should be maintained.

Now the problem of health manpower needs is reduced to finding a solution which meets these restrictions and is in line with the objectives of as many actors involved as possible. Of course one may allocate a higher weight on the objectives of one actor rather than on the objectives of another actor.