The market forces in youth care and the transfer to municipalities have had harmful consequences for children with serious problems. And that while the care is meant for them. Furthermore, due to the transfer, the costs got out of hand.
In a letter to the House of Representatives, State Secretary Van Ooijen of Public Health draws these far-reaching conclusions and therefore announces various interventions in youth care. This actually reverses part of the major youth care operation from 2015.
Care for children and young people with complex problems, such as anorexia or major depression, will now be regulated nationwide again, instead of per municipality. And youth protection measures are being transferred from municipalities to regional security teams. Too often, children at municipalities appear to be sent from the cabinet to the wall or there is no money for appropriate care.
Promises insufficiently fulfilled
“All in all, the promise of decentralization (appropriate help, close to home, family-wide, more efficient and with less costs) has not been sufficiently fulfilled,” writes Secretary of State Van Ooijen in his letter. More money than ever is being spent on youth welfare, but that is not noticeable in the results, the cabinet acknowledges.
Van Ooijen: “Youth care professionals are justifiably concerned. All of them very enthusiastic people, who are committed every day to help children, young people and families. They are often hit hard with criticism of what is not going well, while the context in which they work is mainly to blame.”
Part of the money shortage for the heavier therapy and counseling is caused by an increase in children receiving “light” care, such as because of learning or behavioral problems. One in eight young people up to the age of 18 receives a form of youth aid. That was still one in twenty-seven in 1997.
The number of small commercial healthcare providers who make big profits for light forms of care has increased enormously, says Van Ooijen. Recently, 1,500 have been added. They are now assigned assignments almost automatically, without looking at the affordability and usefulness of the treatments. Therapies sometimes continue without anyone assessing whether it is still really necessary.
The cabinet had included in the coalition agreement that municipalities should collectively save 500 million euros on youth welfare in the long term, especially by removing ‘unnecessary‘ care. Because municipalities protested against this and said that it is not feasible under the current circumstances, the cabinet is now taking on this austerity task.
Less market forces
As far as the cabinet is concerned, this means less market forces: more efficient tenders with smaller profits for the commercial healthcare providers. The cabinet is also thinking about introducing its own contributions for certain treatments. There may also be standards for each treatment type of treatment for how long the treatment may last. The cabinet wants to elaborate on the details about this in the coming months.
In addition, there will be a kind of recalibration of what youth care is exactly and when parents and children can get help there, instead of, for example, the school or the youth agent.
The cabinet also wants to improve the work situation and alleviate the workload of the youth aid workers and children judges who have to deal with serious situations such as out-of-home placements. There will also be a reorganization of the closed youth aid. The surgery is going to take months.