Det hollandske velfærdssystem under pres
DEBAT: Kombinationen af en stigende overvægt af ældre og færre medarbejdere i plejesektoren udfordrer det hollandske velfærdssystem. Det har indskrænket tilgangen til brug af velfærdsteknologi, skriver tre hollandske forskere.
By Gert Jan Gelderblom, Edith Hagedoren and Uta Roentgen
Henholdsvis seniorforsker og forskere på Zuyd University
The Netherlands has a long known tradition of generous provision of Assistive Technology Devices (ATD) aiming for independence and participation of its citizens.
Municipalities provided ATD's in support of elderly persons and persons with disabilities to increase their participation, like homes adaptation and mobility support. Mostly these were in-kind provisions, but also reimbursement was possible, possibly extended with own financial contribution.
However, just as in other Western European countries, the ageing of the population poses new challenges to society. Besides people growing older, increasing the demand for care, less persons are available to provide it. Together with the economic crisis this has led to a more restrictive attitude towards provision of ATD.
ATD as last option
As the current level of the provision system will no longer be affordable in the near future, a reorientation is ongoing, including one on the position of ATD. Problems in daily living and functioning will need to be primarily solved by citizens’ own material efforts and with support of their social network. If that is not sufficient, an appeal to informal care or support by volunteers can be made.
Then, communal services and facilities (e.g. for transport, daily activities or meals) are the next steps to consider. Only if these options are not appropriate to solve the problems, individual provisions such as ATD or assistance in housekeeping are considered. This stepwise approach of first considering the persons’ own efforts, informal care, communal services and ATD only as the last option, aims to reduce expenses.
Although the motivations to reconsider the current practice of societal support by means of ATD make sense, it is questionable whether the chosen direction will only lead to the improvements sought for.
The desired cost reduction may come true as a direct effect. Indirect effects, such as the economic impact of the increased demand for informal care, are less certain. Moreover the attention for the financial costs related to the provision of ATD is only highlighting one part of the impact of the use of ATD on individuals and society.
Non-financial benefits are neglected
Not relying on human support, but aiming for individual citizens to be as independent as possible, offers society and individuals a potential which should not be disregarded. In the current re-orientation in the Netherlands these non-financial benefits of ATD is by and large neglected. What’s worse is that the body of knowledge on the non-financial outcomes of ATD’s is small, not only in the Netherlands but throughout Europe.
Studies looking for the results of providing ATD services to individuals are very rare. Collecting such information in the context of ATD provision practice is non-existent in the Netherlands. It seems that the biggest virtue of ATD, its ability to support individuals in a tailored manner to overcome difficulties resulting from the ageing process or disability, is systematically neglected.
By increasing restrictions on ATD provision, chances for independence and participation are missed, despite the worldwide acknowledgement of the essential role of ATD's in this, as laid down in the UN Convention on the Rights of Persons with Disabilities.
Nyt debatpanel stiller skarpt på velfærdsteknologi i Europa
Behov for grænseoverskridende velfærdsteknologi
