Living at home longer, but less home care – is that possible?

On Tuesday evening, she received one after the other hospital nurse ‘on the line’, says D66 MP Wieke Paulusma. They were pleased that the cut of 165 million euros at their retraining and further training is. But at the same time they also felt ‘super -elongated and burdened’ that the cutback is now in their colleagues in the neighborhood nursing.

“As a minister you have been able to think about a solution for months, and then you come up with this,” says Paulusma. “At a time when people live at home longer, general practitioners are extremely busy and people need home care for palliative care.”

Minister Agema (Public Health, Welfare and Sport, PVV) made Tuesday in a letter to parliament It is known that she wants to cut back on the budget for neighborhood nursing, or home care. It is the alternative to a cutback plan from December last year on training from healthcare staff in the hospital, such as nurses. There was a lot of commotion about this. Agema called that controversial cut a “accident”, the coalition parties a “mistake.” A chamber majority called on Agema to look for an alternative. She has found that now. She is ‘happy’ with the solution, she writes on LinkedIn.

Longer at home

Yet it is a striking cut. The previous cabinet decided that the elderly should continue to live at home longer – and therefore need more home care. In 2022, then Minister Conny Helder of Zorg (VVD) presented the program Living, support and care for the elderly (Wozo). The core: the elderly must become more self -reliant, make more use of digital care and they receive care at home for as long as possible. Neighborhood nursing plays an essential role in that development.

Living at home longer seems inescapable due to the double aging (there are more elderly people who are getting older and older). Many elderly people want it themselves, and it is also cheaper. Care homes are hardly anymore, for a place in a nursing home there is a waiting list of around 25,000 people. Care at home costs less than in a nursing home and at home, for example, an older person simply pays his own mortgage or rent.

The current cabinet has not deviated from this longer-home-living development, although there is also an investigation into the return of retirement homes, as a kind of intermediate form between living at home and the nursing home.

Money that is intended for district nursing must actually be drawn up. But now it has been going back to the treasury a few years ago and it is not used for healthcare

Back to the treasury

Nevertheless, Minister Agema finds the cutback on the neighborhood nursing ‘justified’, because there is ‘structurally’ ‘under -exhaustion’. In other words: less money is spent than is available. A spokesperson for the Ministry of Health, Welfare and Sport is therefore not talking about a cut but about ‘realistic windows’. Of the jar of between 3.5 and 4 billion euros per year, around 800 million has been left for a number of years. That money flows back to the treasury.

That under -exhaustion is due to a shortage of staff, but also because nurses are fewer hours with an older person because more people can look at what people can do themselves. Under depleting is often sensitive. “That 165 million will soon be gone,” says Paulusma of D66. Actiz, the trade association of care organizations, writes on its website that Agema “leaves elderly care and the neighborhood nursing in the cold”. According to ActiZ, the underfooting is not because there is not enough demand for neighborhood nursing. According to them, regulations ensure that no money should be put into, for example, new technology and training: “There is the money that is now being given away for.” MP Julian Bushoff (GroenLinks-PvdA) speaks of “a weird order.” “First see if you can use that money to accept more people, make the work more attractive, and for employees who cannot make ends meet. Then you will see if you still have money left – or not.”

Bianca Buurman, chairman of the professional association for carers and nurses (V&VN), has ‘a whole double feeling’ about the saving, she says. “Money that is intended for district nursing must actually be made up. But now it has been going back to the treasury a few years ago and it is not used for healthcare.” She is especially relieved that the saving at the after-training and further training for hospital nurses is off the job. But, she says, Agema must also go out money for nurses and carers in the neighborhood nursing, just like for elderly care and mental health care, who now have no structural money for training at all. “The minister must come across the bridge.”

Do we want to keep an entire budget of 110 billion euros for an amount of 165 million euros?

Senate to move

The VWS budget has already been approved by the House of Representatives, but with its proposal, Agema will meet the Senate. He has still not agreed to its budget, because of the uncertainty about how that 165 million austerity is filled in. The budget treatment is now scheduled for 1 April. The question is whether the Senate will still be bothering. In February, a majority of the Senate in a debate already said that it wanted to make speed – despite the uncertainty that was still there about the alternative cut. “Our responsibility is to determine the budget on time. Let’s go a bit speed,” said Senator Marian Kaljouw (VVD) then. And Janny Bakker-Klein (CDA): “Do we want to keep an entire budget of 110 billion euros for an amount of 165 million euros?”

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