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Long-Term Care in the Netherlands

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Long-Term Care in Europe

Abstract

With the coming into effect of the Exceptional Medical Expenses Act (Algemene wet bijzondere ziektekosten, Awbz) in 1968, the Netherlands were seen as the first country to have introduced long-term care insurance. However, as the name of the act already indicates, the Awbz was not a long-term care insurance pur sang: entitlement to provisions did not primarily depend on the duration of the need of care. In fact, it was meant to cover the high costs of nursing, treatment and personal care that were not covered by health care insurance and that were generally not affordable by individuals. The services provided under this act included, in broad outlines: care for disabled persons, care for the chronically mentally ill, and care for the elderly. Typically, these kinds of care are most often provided for a prolonged period of time. As a part of an extensive reform in the fields of long-term care, social support, and youth care, the Awbz has been abolished as of 1 January 2015 and replaced by the Long-Term Care Act (Wlz). The personal scope of this act is restricted to persons who are in need of intensive care and support around the clock on a permanent basis.

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Notes

  1. 1.

    Exceptional Medical Expenses Act (Algemene wet bijzondere ziektekosten, Awbz), 14 December 1967.

  2. 2.

    Long-Term Care Act (Wet langdurige zorg, Wlz), 3 December 2014.

  3. 3.

    Social Support Act 2015 (Wet maatschappelijke ondersteuning 2015, Wmo 2015), 9 July 2014; Health Insurance Act (Zorgverzekeringswet, Zvw), 16 June 2005.

  4. 4.

    Income According to Work Act (Wet inkomen naar arbeid), 10 November 2005.

  5. 5.

    OECD (2008), Colombo et al. (2011), p. 39; European Commission (2008), pp. 3–4.

  6. 6.

    Activities of Daily Living (ADLs) are self-care activities that a person must perform every day such as bathing, dressing, eating, getting in and out of bed or a chair, moving around, using the toilet, and controlling bladder and bowel functions; these include Instrumental Activities of Daily Living (IADLs), which are activities related to independent living and include preparing meals, managing money, shopping for groceries or personal items, performing housework, and using a telephone, European Commission (2008), p. 3.

  7. 7.

    For example: SER (2000), College voor Zorgverzekeringen (2003), Raad voor de Volksgezondheid en Zorg (2008), Werkgroep Langdurige Zorg (2010), Raad voor de Volksgezondheid en Zorg (2005).

  8. 8.

    TK (2000–2001), pp. 19–24; Sauter (2009), pp. 7–8.

  9. 9.

    Mot (2010), pp. 55–56.

  10. 10.

    TK (2013–2014), pp. 104–106.

  11. 11.

    EK (2014–2015), p. 99.

  12. 12.

    Schut and Van den Berg (2010), pp. 412–413; SER (2008), p. 139.

  13. 13.

    State Secretary for Health, Welfare and Sport (2008), pp. 4–5; Schut and Van den Berg (2010), pp. 415–425; SER (2008), pp. 140–141.

  14. 14.

    For a description of the development, see: Van der Most (2009), Pruijssers (2004).

  15. 15.

    Schut and Van den Berg (2010), pp. 417; SER (2008), p. 63.

  16. 16.

    State Secretary for Health, Welfare and Sport (2011).

  17. 17.

    Article 5 of the Awbz and Article 2.1.1–2.1.1 of the Wlz regulate the personal coverage of the insurance; Noordam and Vonk (2010), pp. 141–146.

  18. 18.

    Awbz, Art. 6(1), lapsed on 1 January 2015 (unofficial translation).

  19. 19.

    Besluit zorgaanspraken Awbz (Governmental Decree on Care Entitlements Awbz) of 25 October 2002, lapsed on 1 January 2015.

  20. 20.

    Wlz, Art. 3.2.1.

  21. 21.

    For the indication procedure, see Sect. 3.5.

  22. 22.

    Beerepoot (2010), pp. 46–52.

  23. 23.

    Governmental Decree on Care Entitlements Awbz, Art. 4, lapsed on 1 January 2015.

  24. 24.

    Governmental Decree on Care Entitlements Awbz, Art. 5, lapsed on 1 January 2015.

  25. 25.

    Governmental Decree on Care Entitlements Awbz, Art. 6, lapsed on 1 January 2015.

  26. 26.

    Governmental Decree on Care Entitlements Awbz, Art. 8, lapsed on 1 January 2015.

  27. 27.

    Governmental Decree on Care Entitlements Awbz, Art. 15, lapsed on 1 January 2015.

  28. 28.

    Governmental Decree on Care Entitlements Awbz, Art. 9, lapsed on 1 January 2015.

  29. 29.

    Governmental Decree on Care Entitlements Awbz, Art. 9a, lapsed on 1 January 2015.

  30. 30.

    Governmental Decree on Care Entitlements Awbz, Art. 10, 11, 12, 17, 18, lapsed on 1 January 2015.

  31. 31.

    Beerepoot (2010), pp. 60–61; SER (2008), pp. 147–148; Klosse and Noordam (2010), pp. 404–407.

  32. 32.

    The different packages and the corresponding amounts are published on the website of the Dutch Health Care Authority (NZa.nl). For clients with an indication dated before 2015, this method retains in place during the transition period.

  33. 33.

    See, for example: NZa (2011).

  34. 34.

    NZa (2009), Schut and Van den Berg (2010), p. 431.

  35. 35.

    The categorization and policy regulations are published on the website of the Dutch Health Care Authority (NZa.nl).

  36. 36.

    Letter of 27 June 2014 from the Minister of Health, Welfare and Sport to Parliament (2014), p. 2.

  37. 37.

    Wlz, Article 3.3.1.

  38. 38.

    See, for example: Beerepoot (2010), pp. 57–58; Mot (2010), pp. 38–41; SER (2008), pp. 149–151; SCP (2011).

  39. 39.

    Regulation AWBZ subsidies (Regeling subsidies AWBZ), 5 December 2005, para. 2.6, lapsed on 1 January 2015.

  40. 40.

    SCP (2011), pp. 17–18.

  41. 41.

    Zorginstituut Nederland, Exploitatie AWBZ 2002-2014 (Exploitation AWBZ 2002–2014), available on the website of the Zorginstituut. The total Awbz expenses in 2010 amounted to 24,472.7 million euros.

  42. 42.

    Wlz, Article 3.3.3.

  43. 43.

    Financing of Social Insurance Act (Wet financiering sociale verzekeringen) of 16 december 2004, Art. 89.

  44. 44.

    Awbz, Art. 1(c) in conjunction with Zvw, Art. 1(b). See also: Beerepoot (2011), pp. 13–14.

  45. 45.

    Wlz, Art. 6.1.1.

  46. 46.

    Facilities for Handicapped Persons (Wet voorzieningen gehandicapten) of 1994; Welfare Act (Welzijnswet) of 1994.

  47. 47.

    Sijtema (2009), pp. 15–16; Klosse and Noordam (2010), pp. 419–420.

  48. 48.

    Robinson (2007), Scot (2009).

  49. 49.

    Putters et al. (2010), p. 33.

  50. 50.

    Klosse and Noordam (2010), p. 419.

  51. 51.

    Wmo, Art. 1, lapsed on 1 January 2015; Sijtema (2009), pp. 16–18.

  52. 52.

    Wmo 2015, Art. 2.1.1 sub 1.

  53. 53.

    Wmo 2015, Artt. 1.2.1 and 1.2.2.

  54. 54.

    Wmo 2015, Art. 2.1.2 sub 4.

  55. 55.

    Wmo 2015, Art. 2.1.1.

  56. 56.

    CRvB 10 December 2008 (LJN: BG6612, 08/3206 WMO).

  57. 57.

    Wmo 2015, Art. 2.3.5 sub 3.

  58. 58.

    Wmo 2015, Art. 2.1.2.

  59. 59.

    Model Regulation Wmo (Modelverordening Wmo), published on the website of the Association of Dutch Municipalities (VNG.nl).

  60. 60.

    Van Rooij and Boersma (2011), pp. 38–44; Sijtema (2009), pp. 106–108.

  61. 61.

    Explanation to the Model Regulation Wmo; Van Rooij and Boersma (2011), pp. 51–55; Sijtema (2009), pp. 69–73.

  62. 62.

    Explanation to the Model regulation Wmo; Van Rooij and Boersma (2011), pp. 104–106; Sijtema (2009), pp. 44–50.

  63. 63.

    Wmo 2015, Art. 2.3.2.

  64. 64.

    Wmo, Art. 1(1)(b), lapsed on 1 January 2015.

  65. 65.

    Oudijk et al. (2010).

  66. 66.

    Oudijk et al. (2010), p. 3.

  67. 67.

    De Boer and de Klerk (2013), p. 19; De Boer et al. (2013), pp. 151–154.

  68. 68.

    State Secretary of Health, Welfare and Sport (2015), p. 2.

  69. 69.

    TK 2012–2013, 33400 XVI, No. 1, National Budget 2013, p. 10.

  70. 70.

    Decree on the Social Support Act 2015, Art. 3.8.

  71. 71.

    Noordam and Vonk (2010), p. 138; Pennings (2009), p. 57.

  72. 72.

    Zvw Art. 2.

  73. 73.

    Zvw Art. 10.

  74. 74.

    Health Insurance Decree (Besluit Zorgverzekering) of 28 June 2005.

  75. 75.

    Health Insurance Decree, Art. 2.4–2.15. It should be noted that these elements of health care are not specifically parts of the long-term care system as such; they are however relevant for people in need of long-term care.

  76. 76.

    Zvw, Art. 16–18.

  77. 77.

    Health Care Allowance Act (Wet of the zorgtoeslag) of 16 June 2005.

  78. 78.

    As of 2013, the allowance is not only depends on income, but also on assets.

  79. 79.

    Zvw, Art. 41–57; detailed information available on the website of the Dutch Government (rijksoverheid.nl, mainly in Dutch).

  80. 80.

    Zvw, Art. 19–22.

  81. 81.

    In contrast with the previous system of the Sickness Fund Act under which the insurers were required to contract all qualified out-patient Health Care providers, see: Westert et al. (2010), p. 208.

  82. 82.

    SER (2012), pp. 9–10; Commissie Evaluatie Risicoverevening Zvw (2012).

  83. 83.

    Health Care Institutions Admission Act (Wet toelating zorginstellingen) of 20 October 2005.

  84. 84.

    Health Care Institutions Admission Act, Art. 3.

  85. 85.

    Health Care Institutions Admission Decree (Besluit toelating zorginstellingen), Art. 1.2.

  86. 86.

    Care Institutions Quality Act (Kwaliteitswet Zorginstellingen) of 18 January 1996; Individual Health Care Professions Act (Wet op de beroepen in de individuele gezondheidszorg) of 11 November 1993.

  87. 87.

    Regulated in the Co-determination Rights of Clients of Care Institutions Act (Wet Medezeggenschap Cliënten Zorginstellingen), applicable to all care institutions that are financed on the basis of the Wlz, Zvw, Wmo, or funded by the Ministry of Health, Welfare and Sport, municipalities or provinces on the basis of other regulations or subsidies.

  88. 88.

    For an overview of quality control, see: Legido-Quigley (2008), pp. 150–156.

  89. 89.

    Until 1 April 2014, the Dutch Health Care Institute was named Health Insurance board (College voor Zorgverzekeringen).

  90. 90.

    See, for example: Van Beek and Hübner (2008), Otto et al. (2011), Inspectie voor de Gezondheidszorg (2011), Sauter (2009).

  91. 91.

    Health Care Institutions Admission Act, Art. 36.

  92. 92.

    For more information on private and public supervision, also differentiated as internal and external supervision, see, for example, Van Beek and Hübner (2008), pp. 16–18.

  93. 93.

    See, for example, Sauter (2009), pp. 11–13.

  94. 94.

    Sections 7.2 and 7.3.

  95. 95.

    Co-determination Rights of Clients of Care Institutions Act (Wet Medezeggenschap Cliënten Zorginstellingen) of 29 February 1996.

  96. 96.

    Robben et al. (2012), p. 19.

  97. 97.

    For example: SER (2012), p. 11.

  98. 98.

    Health Act (Gezondheidswet), Art. 36.

  99. 99.

    Ngo et al. (2008), pp. 9–18. For a critical appraisal of the Inspectorate, see: Ketelaars (2011).

  100. 100.

    Inspectie voor de Gezondheidszorg (2008), p. 6.

  101. 101.

    Individual Health Care Professions Act (Wet op de beroepen in de individuele gezondheidszorg) of 11 November 1993.

  102. 102.

    See the website of the Health Care Inspectorate (IGZ.nl, ‘enforcement measures’).

  103. 103.

    That is to say, only care professionals who are registered on the basis of the Individual Health Care Professions Act, which is obligatory for doctors, dentists, pharmacists, health care psychologists, psychotherapists, physiotherapists, obstetricians, and nurses.

  104. 104.

    Market Regulation Health Care Act (Wet marktordening gezondheidszorg) of 7 July 2006.

  105. 105.

    See Sect. 2.1. Sauter (2009), pp. 14–19.

  106. 106.

    Sauter (2009), pp. 14–15.

  107. 107.

    Sauter (2009), p. 16.

  108. 108.

    Kraus et al. (2011).

  109. 109.

    Peters (2010).

  110. 110.

    Letter of the Council of the Judiciary (Raad voor de Rechtspraak) to the State Secretary of Health, Welfare, and Sport of 4 September 2013.

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  1. Utrecht University School of Law – International and European Law, Utrecht, Netherlands

    Tineke Dijkhoff

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    Ulrich Becker

  2. Fulda University of Applied Sciences, Fulda, Germany

    Hans-Joachim Reinhard

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Dijkhoff, T. (2018). Long-Term Care in the Netherlands. In: Becker, U., Reinhard, HJ. (eds) Long-Term Care in Europe. Springer, Cham. https://doi.org/10.1007/978-3-319-70081-6_8

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