Dutch often don't get the care they need, Ombudsman says

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People in the Netherlands often do not get the care they need and are entitled to, National Ombudsman Reinier van Zutphen said in a report about the new healthcare system introduced in the Netherlands in 2015, NOS reports.

The new system gave municipalities more responsibilities when it came to healthcare. The idea behind that was that municipalities know their residents better than the national government, and therefore would also know better what care their residents need.The intent was to make healthcare more accessible and more customizable.

But this has not happened, according to Van Zutphen. Citizens often don't know whether to go to their municipality or insurer to get the care they need. And the insurers and municipalities sometimes don't know either. As a result, citizens are sent from one office to the next.

According to Van Zutphen, the rules of the new system are too complicated and citizens are faced with a bureaucratic mess. As a result, citizens don't - or hardly - manage to arrange care for themselves and thereby fall by the wayside.  "That in-the-box thinking continues to hamper access to care. Authorities often still miss what citizens really need in their situation. As a result, citizens do not receive adquate care. This has been the case for far too long, it can and must improve quickly", the Ombudsman said, according to NOS.

The Ombudsman used a well known example of elderly people with dementia who still live at home and end up on a waiting list for a nursing home. As long as they live at home, their day care, domestic aid and district nursing are paid for by the municipalities and health insurers. Once they go to a nursing home, they fall under the Long-term Care Act, which is the responsiblity of the central governent. This also applies if there is no room in a nursing home, and people end up on a waitng list.

The result is that municipalities and insurers stop paying for day care and help in the household as soon as the elderly person is on a waiting list. Which means that the patient doesn't get the care he or she needs while waiting for a space to open in a nursing home. The Ombudsman suggests that people in this situation should get money to bridge that gap. 

Van Zutphen is not the first one in the Netherlands to say that the new healthcare system makes it too difficult for citizens to get the care they need. Similar concerns were previously raised by interest group Ieder(In), social and cultural planning office SCP, and the Council fo Public Health and Society.