Community care providers say they are struggling to stay afloat because of a combination of rising costs, high staff sickness and inadequate compensation from insurers.
The Volkskrant surveyed 11 companies that offer domiciliary care to elderly people, all of which expected to make a loss this year of between €1.7 million and €5 million.
Payments from insurers have failed to keep up with the actual costs of providing care, they said, while high levels of sickness – more than 10% of care workers are currently on sick leave – mean they have to find replacements from agencies at higher rates.
Aafje, based in Rotterdam and one of only two organisations prepared to speak on the record, said it was anticipating a loss of €5 million this year on a turnover of €40 million.
Manager Peter Ploegsma told the Volkskrant that replacement staff accounted for 18% of working hours. ‘We’ve really crossed the line,’ he said. ‘I feel ashamed on their behalf for the robbery we’ve committed against our own staff.’
Organisations also say the fixed hourly rate they are paid by insurers is no longer enough to cover expenses such as training, innovation and partnerships with other care providers.
‘Race to the bottom’
‘This race to the bottom has been going on for years,’ said Arjan Bandel of Laurens, based in Rotterdam. ‘But this year we’ve seen the vicious circle widen and accelerate.’
He went on: ‘Our healthcare staff have to decide on a daily basis which of our elderly clients get care at home and which do not. We should really say: this far and no further.
‘But if we don’t sign a contract with a health insurer we can only provide non-contractual care, for which much lower rates apply. So it’s in the interests of our clients and our staff for us to accept rates that we can’t meet our costs with.’
The insurers’s association Zorgverzekeraars Nederland said insurers had a duty to make sure remained affordable and accessible, and providers should let them know if they are experiencing financial difficulties. ‘If it is in the interests of the insured party, health insurers will work with care providers to find a suitable solution.’
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