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International Seminar on Social and Health systems in Europe organized by SITRA. Helsinki 7-8 September 2010. Presentation by Floris de Boer, Ministry of Health, Welfare and Sport.
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Personal budgets in the Netherlands
International Seminar on Social and Health systems in Europe organized by SITRA. Helsinki 7 – 8 September 2010.
Presentation by Floris de Boer (Direction Long term care).
Content
1.Introduction2.History3.Facts & figures4.Less satisfactory
developments5.Necessary
interventions to make the system future-proof
6.Upcoming developments
Voettekst3
I. Introduction
• An incident• Thanks & introduction• Content of the speech
Voettekst4
II. History
• 1991: “Working document innovation care for mentally disabled persons”. • 1995: “Care in your wallet”• Quango’s and politics
Voettekst5
Voettekst6
Voettekst7
III. Facts and figures
• Dutch peculiarities• Growth number budget holders and granted/available budget • Quality of care, made available by personal budgets
Voettekst8
(ZVW)cure
(AWBZ)
care
(WMO)Social support
Voettekst9
There is a whole world outside the long term care……
• PGB in the long term care• PGB in the Social Support Act (Wmo) for domestic home help, transport, wheelchairs, adjustment of house (for disabled people)• PGB for re-integration (finding a job after a period of inability to work)• PGB for (medical) aids such as hearing aids etc.• PGB for the cost of psychiatric treatment (cure)
Voettekst10
Year 2003 2004 2005 2006 2007 2008[1] 2009[2]
Number of budget holders
62.500 69.500 80.500 95.000 90.000[3] 110.000 130.000
Average increase pro month
1.042 583 917 1.208 2.000 1.700 1.700
Expenses in million Euro’s
635 764 922 1.136 1.455 1.846 2.220
[1] Ramingen[2] Ramingen[3] Zonder de Wmo zouden er circa 30.000 budgethouders meer zijn
Voettekst11
aantal pgb-houders
60000
70000
80000
90000
100000
110000
120000
Voettekst12
Way of supply
Target groups Care in kind Personal budgets
Both
Demented elderly people Elderly people with somatic disordersDisabled peoplePeople with psychiatric disorders
70.000 295.000 85.000 50.000
1.000 19.000 19.000 32.000
1.000 5.000 9.000 2.000
Total 500.000 71.000 18.000
Bronnen: bewerking op basis van gegevens zzp-bronbestand, NZA, CAK, CIZ en CVZ en VGZ.
Voettekst13
IV. Less satisfactory developments
• Intermediary agencies• Fraud • Inappropriate use: personal budgets as an unintentional choice
Voettekst14
V. Necessary interventions to make the system future-proof
• Re-thinking target groups• Temporary stop growth, expansion, personal budgets second half 2010
Voettekst15
Voettekst16
AWBZ in historic perspective
1968 1998 2008
CostsAWBZ-care1 (billion €’s)
< € 1 € 12,8 € 20,5
Number of clients Circa 55.000 Circa 900.000Circa 500.000 (excl. GGZ-extramural)
Circa 600.000
Premium AWBZ 0,41 % 9,60% 12,15%
1Exclusief kosten voor beheer en subsidies AWBZ.
Bronnen: VWS-begroting
Voettekst17
VI. Upcoming developments
• Reduction of target groups• Person budget ideology will influence regular “care-in-kind”• Personal remarks