News item | 13-05-2022 | 16:30
State Secretary van Ooijen (VWS) wants to implement major reforms in youth care to improve care for children, young people and families who need it. Properly organizing care for children with the most complex problems has the highest priority and that requires more control and professional space. The current system mainly encourages lighter forms of care. The State Secretary wants a clear delineation in the law of what falls under youth care, with the aim of being able to help children who really need it better and faster. He also wants to reduce market forces and remove perverse incentives from the youth care system, for example by tackling excessive profits and curbing the growth in the number of youth care providers. Together with the Minister Weerwind (Legal Protection), he informed the House of Representatives about his plans to improve youth care and make it more financially manageable.
State Secretary Van Ooijen: “Fighting for every child, with that commitment I started working as State Secretary in January. Since then I have spoken to many children and parents who have to deal with youth care and I hear too often that they do not receive the right help at the right time. I also speak to many care providers, and they also get stuck in the system. That touches me enormously and motivates me to implement major reforms. More and more money, time and energy is being spent on lighter forms of aid, while we all desperately need it to take better care of the most vulnerable children. There are all kinds of bad incentives in the system, we have to get rid of that. By curbing market forces, we are moving closer to a system that is really focused on helping children. I am happy to work with municipalities and other parties involved to jointly improve youth care.”
More control and professional space for the most complex care
In youth care reform, the availability of appropriate care for the most vulnerable children is the top priority. This includes children who have to deal with a highly complex care requirement, such as an eating disorder, a chronic condition or a youth protection measure. They too often end up on waiting lists and are unable to find their way in a chaotic healthcare system. That is why there must be more control and professional space for the most complex forms of care. This care, which only a relatively small number of children need throughout the country, must be purchased and organized more centrally. Aid workers must be given the space to do the right things on the basis of their professional expertise. In addition, the regional procurement of specialist care will be mandatory. There will be more control over a logical division of these regions in terms of division and size, so that they can fulfill this role as effectively as possible.
Care available when it’s really needed
Where in 1997 1 in 27 children made use of youth care, in 2015 this was 1 in 10 and in 2021 even 1 in 7. Children who really need help or care should of course always be able to claim this. But now the system works in such a way that the offer of lighter forms of help in particular continues to grow and that children find themselves in it too easily. It is important that care remains available to children who really need it. When allocating youth care, more account must therefore be taken of the nature and seriousness of the problems and what solutions are already possible in the child’s own environment. This is more clearly defined in the law.
An end to perverse incentives for market forces
The imbalance between complex care and light care in the system is one of the consequences of market forces in youth care. Youth care should be about helping children, not about maximizing profit. The State Secretary wants to put an end to the perverse incentives that encourage this, among other things by maximizing profits. The growth of providers is curbed by limiting so-called ‘open house’ tenders. These are tenders in which every provider who meets the conditions automatically receives a contract. In addition, real rates must be paid that match the type of care that is provided, so that it no longer pays to offer only light, cheap care. The law lays down how these rates must be calculated.
Reform agenda resumed
Some of these reforms are detailed in the Reform Agenda. All parties would like to take their responsibility to improve youth care. Earlier this year, municipalities suspended their cooperation in the Reform Agenda in response to the proposed savings of €511 million in youth care. Now that the cabinet has decided that these savings are a central government responsibility, municipalities are once again committed to jointly arrive at the Reform Agenda. In concrete terms, this means that it is up to the national government to take additional measures that will lead to savings.