In mid-June, Nicki Pouw temporarily interrupted her training as a geriatric specialist to return to The Hague. There, as outgoing State Secretary for Long-term and Social Care, she was able to work on her dream: the return of care homes (old people’s homes). Until last Friday the calculations of the Central Planning Bureau (CPB) showed that many parties want to cut billions in healthcare. Also in elderly care, also in nursing homes.
What did you think when you saw that?
“My courage sank. I was shocked by the gigantic cuts.”
Two years ago, as a Member of Parliament, together with then PVV MP Fleur Agema, Pouw submitted a private member’s bill to bring back the almost disappeared care homes. The Schoof cabinet allocated 600 million euros for this. The proposal still has to be submitted to Parliament, probably in the spring. But the CPB calculation shows that CDA, D66, VVD and JA21 want to scrap that money.
Your child is in danger of dying.
“As State Secretary, I hope to be able to take a few big steps, to lay the figurative first stone. When you see how people enter a nursing home these days… In a serious condition, often emergency admissions. The nursing home is almost becoming a hospice. I really feel like doing something about that.”
I always thought: there is a political majority, that should work out fine. That bottom now suddenly disappears
Until last Friday…
“Until a few parties that I saw as supporters suddenly said: ‘Empty that pot.’ Henri Bontenbal [CDA-lijsttrekker] was rather positive about it in an opinion article in it A.D. JA21 even has it on the site are listed – I have checked it – and also in the election manifesto. I always thought: there is a political majority, that should work out fine. That bottom now suddenly disappears.”
Are you angry about that?
She sighs. “I don’t get angry very easily. But I am disappointed that they do not stand behind their promise. CDA and JA21 say one thing, but allow the other to be calculated. That shocked me the most. I find the CPB calculations a frustrating process anyway. It sounds very cynical, but what use are people to election manifestos?”
Isn’t scrapping just a way to save money?
“Money had to come from somewhere and then healthcare is easy. It is a large budget, many parties already think the healthcare costs are too high. And it is lucrative: if you take money away now, it will continue to work in the coming years.”
Pouw says that “everyone in the House sees the need” to do something about the ‘gap’ between home and nursing home, which includes people who are too poor to stay at home, but too good for a place in the nursing home. Her proposal is not about a return to the old-fashioned retirement home, she says, “but about independent living arrangements with communal areas, where a pacesetter organizes things, a community nurse or caregiver is available, and a physiotherapist visits half a day a week. Intended for people who do not yet have a nursing home indication. This has been discussed for years and there is a lot of demand for it. I was very happy that we finally had money for this.”
Even your coalition partner VVD is now pulling its weight, according to the calculations.
“I expected that. Certain parties, such as the VVD and D66, think differently about elderly care and want to curb healthcare costs. I don’t agree with that, but they have always been honest in what they want.”
You will still be in a coalition with the VVD in the coming months. Will they stop your plan from coming to fruition?
“I have no idea, I have never been in a caretaker cabinet. But in my experience the VVD stands for its signature.”
The calculations showed that many parties want to make even more cuts in healthcare. Less money is going to improve the quality of nursing homes and the personal contribution is increasing. The deductible is not halved, but remains 385 euros, or even increases. New treatments and medicines are no longer automatically included in the basic package.
There is a good chance that it will again lead to harrowing stories, the House will become angry and repair measures will follow
What do you think of those plans?
“Frustrating. Take the basic package. We recently decided to reimburse the shingles vaccine. This not only prevents shingles, but also reduces the chance that you will develop dementia later. Are we not going to do that anymore? You should not cut back for the sake of cutting.”
Healthcare costs are already high and continue to rise…
“It is certainly possible to cut back on healthcare, but not by picking a little here and there because you need money. That is penny wise pound foolish. There is a good chance that it will soon lead to all kinds of distressing stories, that the House will become angry and that repair measures will follow again. Now come up with a bigger plan, with a vision. Do much more on prevention, so that you avoid higher costs. Reduce the regulatory burden. And if you really want to save a lot of money, you must also ask yourself whether you want to maintain the accessibility of care. Or do you only want the essentials and have people pay extra for the rest? I’m not in favor of it myself, by the way.”
Do you still have something to do after the elections when many parties want to make cuts?
“CDA and JA21 seem to be getting quite big, so I’m preparing for a difficult period. I’ll have to talk like Brugman, I’m afraid.”
Also read
If it were up to the PVV and BBB, the old people’s home would return: ‘People over 60 think: what will happen in 2040?’
NEW: Give this item as a gift
As an NRC subscriber you can subscribe every month 10 items give as a gift to someone without an NRC subscription. The recipient can read the article directly, without a paywall.