The Ministry of Health (VWS) does not want to say where the 680 million euros will go that it wants to remove from district nursing and general practitioner care. The skimming off of the 600 million euros for district nursing and the approximately 80 million euros for general practitioners is contained in a leaked draft version of the Integral Care Agreement (IZA).
“The Integral Care Agreement focuses on strengthening primary care,” said a spokesperson for health care minister Ernst Kuipers. However, he does not explicitly say that the 680 million euros will actually go there. Primary care is care that anyone can go to without a referral. This concerns, for example, care from a general practitioner, dentist or physiotherapist.
The aim of the IZA is to keep the growth in expenditure within limits, the spokesperson emphasizes. “In addition, we want the money on the shelf to be spent effectively.” For years, the available budgets for both district nursing and general practitioner care have not all been spent, the spokesperson clarifies.
Integral agreement
More than four billion euros was available for district nursing in each of the last three years. For general practitioner care, this was more than three billion euros per year. These macro budgets were laid down in the 2019-2022 outline agreements for both healthcare sectors. The amounts do not include indexation for wage and price developments. The previous government also concluded similar outline agreements for other sectors. They all expire at the end of this year.
This cabinet no longer wants separate agreements per sector, but an agreement with all healthcare parties together. “We see an increasing demand for care everywhere. It must be approached in an integrated manner. That is why this cabinet wants an integral agreement,” says the spokesperson for Kuipers. He also does not want to comment on the content of the leaked piece, because that has yet to be discussed at the negotiating table. The cabinet wants to conclude an agreement with the healthcare sector next month.
Substantive agreements
In addition to financial, substantive agreements are also made. These include cooperation between municipalities – which are responsible for social support and youth care -, general practitioner care and mental health care. Agreements will also be made on the rearrangement of the healthcare landscape and the concentration of healthcare, as well as on digitization and data exchange.
However, the agreement must also generate money, Kuipers wrote to the House in May. It should lead to a cut of 1.3 billion euros by 2026.