‘The Dutch healthcare system is based on a set-up that is the opposite of Quebec and Canada: in the Netherlands, the primary goal is to keep people at home.’ This is the conclusion of journalist Sylvain Desjardins of Canadian public broadcaster Radio-Canada who visited the Netherlands this summer. He spoke to Vilans director Mirella Minkman and fellow healthcare professionals, and visited care organisation Alerimus.
Unlike Canada and Quebec, the Dutch model of elderly care focuses on support in the home, especially when we look towards the future. There are almost half as many beds for older people in publicly-funded care facilities in the Netherlands as in Quebec. The number of places in care centres for over-65s in the Netherlands is 2.5 beds for every 100 people. In Quebec, it is 4 beds per 100 people. But people in Canada also feel that this model is not sustainable in the long term due to a lack of people and resources.
Care at home
Radio-Canada writes about Dutch care: ‘With few exceptions, people at the end of life are monitored daily at home until their last breath by nurses or carers. Home care and social activities for sick older people are largely funded by the Dutch state (centrally or decentrally by municipalities) and, by one of the most generous insurance systems in the world. This was the conclusion by the Canadians after delving into our system.
The television report states that, like the Netherlands, Canada also wants to make the shift towards letting people live at home longer and highlighted care practices at the home care organisation, Alerimus. They also spoke to Alerimus director Trix van Os and Mirella Minkman of Vilans about the Dutch system.
When asked to explain the difference between the Canadian and Dutch models, Minkman replies in the report: ‘It is mainly a matter of philosophy and mentality that accounts for this difference. And also how we have traditionally always organised and financed healthcare. In the Netherlands, people value the concept of autonomy, being seen and being able to decide for themselves. Being able to do something and mean something to someone else also leads to better self-esteem. On the one hand, this is a risk if people cannot or dare not ask for help. On the other hand, it keeps us self-reliant for longer. But with all the challenges that exist now, we must learn to take better care of each other in our towns and villages to ensure that we age well. This ranges from doing something with and for each other, to the design of our home and living spaces.’