News feature | 13-05-2022 | 16:30
Secretary of State van Ooijen (VWS) wants to implement major reforms in youth care to improve the care of children, young people and families who need it. Proper organization of care for children with the most complex problems has the highest priority, and it requires more control and professional space. The current system mainly encourages easier forms of care. The Secretary of State wants a clear demarcation 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 will also reduce market forces and remove perverse incentives from youth care, for example by tackling large profits and slowing the growth of the number of youth care providers. Together with Minister Weerwind (Legal Protection), he briefed the House of Representatives on his plans to improve youth care and make it more economically manageable.
Secretary of State Van Ooijen: “In the fight for every child, with that commitment, I started working as Secretary of State in January. Since then, I have talked to many children and parents who have to deal with youth care, and I hear too often that they do not get the right help at the right time. I also talk to many carers and they also get stuck in the system. It touches me enormously and motivates me to implement major reforms. More and more money, time and energy are being spent on easier forms of assistance, while we all desperately need it to take better care of the most vulnerable children. There are all sorts of bad incentives in the system that we need to get rid of. By slowing down market forces, we are moving closer to a system that “I am really focused on helping children. I like to work with municipalities and other parties involved to jointly improve youth care.”
More control and professional space for the most complex care
In the youth care reform, the availability of appropriate care for the most vulnerable children is a top priority. This includes children who have to deal with a very complex need for care, such as an eating disorder, a chronic illness or a youth protection. All too often, they end up on waiting lists and cannot find their way into a chaotic healthcare system. Therefore, 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, needs to be purchased and organized more centrally. Auxiliary workers need to have space to do the right things based on their professional expertise. In addition, the regional purchase of a specialist 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 handle this role as efficiently as possible.
Care available when really needed
Where 1 in 27 children in 1997 made use of youth care, in 2015 it was 1 in 10 and in 2021 even 1 in 7. Children who really need help or care must, of course, always be able to demand 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 it all too easy. It is important that care remains available to children who really need it. When allocating youth care, more consideration must therefore be given to the nature and seriousness of the problem 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 the market forces in youth care. Youth care should be about helping children, not about maximizing profits. The Secretary of State wants to put an end to the perverted incentives that encourage this, among other things by maximizing profits. The growth of providers is slowed down by limiting so-called ‘open house’ tenders. It is a tender in which each tenderer who meets the conditions automatically receives a contract. In addition, real tariffs must be paid that match the type of care provided, so that it can no longer pay to offer only light, cheap care. The law determines how these tariffs are to be calculated.
Reform agenda resumed
Some of these reforms are described in detail in the reform agenda. All parties want to take their responsibility to improve youth care. Earlier this year, the municipalities suspended their cooperation in the reform agenda in response to the proposed savings of 511 million euros in youth care. Now that the government has decided that these savings are a state responsibility, the municipalities again undertake to jointly reach the reform agenda. Specifically, this means that it is up to the national government to take further measures that will lead to savings.