Systems of Delivery of Health Care for Persons with Developmental Disabilities: The Case of Belgium

Abstract

Belgium has an elaborate, but complicated and fragmented health and social care system that differs between regions. Looking at the system in the Dutch speaking community from a life course perspective, we see that many services are available, at low or no cost for the client, and developmental problems are often detected at a young age. However, the coordination between all services available is insufficient, and sometimes non-existent. Even though the number of services increased during the last decade, the waiting lists became longer. Also, people have difficulty finding their way in the system, which has a negative effect on accessibility. For adults with disabilities, the system of care is even more fragmented than for children, and the waiting lists are longer. Although it must be said that the government has made many efforts to ameliorate the situation, it still has not succeeded in overcoming these problems. Therefore, the Flemish government more and more opts for a demand-driven policy, in which the person in need of care receives a budget for care, instead of the organizations receiving subsidies directly from government.