JULY 2021 | 7
NATIONAL
Dutch municipalities to receive 1.3 billion extra for youth care Dutch municipalities will receive 1.3 billion additional euros next year to improve youth services under an agreement reached with the national government. The support will augment the 300 million euros already promised for 2022 to address budget shortfalls. As a condition of the additional funding, the municipalities agreed to decrease spending on youth services by 200 million euros in the coming year by implementing additional cost-saving measures. Still, until 2028, municipalities will continue to spend more than the 3.5 billion euros allocated to youth services by the national government. The accord resolves a longstanding disagreement between the national government and the municipalities over the reimbursement of funds spent on the provision of youth services. A mediation committee headed by Richard van Zwol was appointed to resolve the dispute after discussions between the national government and the municipalities over the funding had reached an impasse. The municipalities sought repayment of the extra 1.7 billion euros they had spent since 2015, when local entities took over responsibility for youth services from the national government. Costs for youth services have been steadily rising since 2005. Expenditures increased by 250 percent between 2005 and 2015, ultimately reaching 3.75 billion euros. Under the assumption that municipalities would be able to provide services more
cost-effectively, local authorities assumed responsibility for the delivery of youth services in 2015, and the budget was reduced by 425 million euros. However, the allocated funding quickly proved insufficient. Average spending on youth services reached 12,000 euros per child in 2019, with a great deal of variation between municipalities. Some communities spent upwards of 24,000 euros per individual, others approximately 8000 euros. The committee found that the youth care budget should be increased by 1.9 billion euros in 2022 and 1.6 billion euros in 2023 and 2024. According to the committee’s plan, that total would be gradually reduced to 800 million by 2028. Although the municipalities will receive less than the 1.9 billion euros suggested by the committee, Jan van Zanen, head of the Vereniging van Gemeenten (VNG), thinks the agreement is faithful to the mediators’ guidance.
The survey included almost 2000 respondents and was held in the first quarter of 2021. The data shows that the older and higher educated the respondents, the higher their willingness to be vaccinated against corona, age being directly proportional with readiness to be vaccinated. Whereas 81 percent of people over 75 are willing to be vaccinated, just 64 percent of people between 16 and 30 are willing. Out of people between the ages of 30 and 45, 66 percent is willing; for people between 45 and 60, 72 percent are; and for the group aged between 60 and 75, the number is 75 percent. When the willingness to be vaccinated was filtered by education level in people under 25, 77 percent of respondents with higher education, defined as higher vocational (HBO) and academic (WO), showed intention to be vaccinated, compared with 69 percent of respondents with only high school or lower vocational (MBO) education. The report showed no significant difference between men and women with regard to intention of being vaccinated, which was 72 percent and 70 percent, respectively.
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So far, the municipalities’ plans to save money by the decentralization of 2015, which aimed to focus on prevention of mental health issues, failed spectacularly, resulting in high demand for intensive interventions and uncontrolled costs. Waiting times increased and the quality of care declined as a result of the reorganization and austerity measures implemented by municipalities. Many children in need of urgent, specialist or intensive mental and social care faced extended waiting periods, often up to a
year, for their treatment. In addition, many patients experienced treatment disruptions due to budget issues, a high turnover of staff leading to chaotic provision, and a lack of appropriately trained caregivers. Measures designed to reduce costs effectively drove some facilities into bankruptcy, reducing the number of available treatment providers. Both the municipalities and the cabinet agree on the importance of lowering costs and shortening waiting periods — goals that will require structural changes. A decision regarding the future funding and structure of youth services has not yet been made. “A new cabinet will have to decide about the structural finances and necessary adjustments to the youth care policy,” suggests Paul Blokhuis, outgoing Minister of Public Health, Welfare and Sport. Written by Lorre Luther
Before the promise of reimbursement, many municipalities faced the specter of being forced to close other public facilities such as libraries and swimming pools, just so they could pay for youth services. The additional funding has provided a bit of breathing room. “Municipalities now have clarity for 2022. That provides relief,” says Van Zanen. Treatment providers, however, while encouraged by the additional funds, argue the delivery of high-quality care will require a complete reorganization.
Vaccination willingness in the Netherlands is on the rise According to a report published by Statistic Netherlands (CBS) on 27 May, 70 percent of the population over the age of 16 are willing to be vaccinated against corona virus. This includes the 4 percent who were already vaccinated at the time of the survey. The report also found that around 15 percent are still in doubt about being vaccinated, and an additional 14 percent either disagree or strongly disagree with the statement “I plan to be vaccinated against the Coronavirus.”
“There is certainly a lot of money needed to keep the youth care services afloat, but most of all, it has to be different,” suggest Elnathan Prinsen and Arne Popma of the Dutch Psychiatric Association (NVvP). They argue that urgent and specialist youth mental health services should be organized and funded regionally instead of by municipalities.
Although 30 percent of the population is not yet sure or certainly not willing to be vaccinated, 6 out of 10 respondents consider that the vaccines used against corona are safe. This is the case for 81 percent of the people who are willing to be vaccinated, 16 percent of the people who do not plan to be vaccinated, and 15 percent of the people who are in doubt. And as to the perception of the importance of vaccination to combat corona virus, about 80 percent of all respondents consider it important or very important, including 42 percent of the people who are not actually willing to be vaccinated. It seems, however, that many people have become more enthusiastic about the corona vaccines as the results become visible. Now that the number of cases is dropping fast and the hospitals are emptying, the willingness to take the vaccine is rising. The latest survey by the national health authority RIVM reported that about 85 percent of people is now willing to take the vaccine. There are some differences between vaccines, however: most people would prefer the Pfizer or Moderna vaccines, followed by Janssen, with AstraZeneca trailing behind: only 53 percent of respondents would take this vaccine. Overall, it seems that vaccination willingness is high enough to reach herd immunity, meaning ‘normality’ is a step closer.
Written by Juan Alvarez
Corona passport to be implemented for summer holidays The EU Digital COVID Certificate, essentially a corona passport for travelling within the EU, became a reality on 20 May, when the European Parliament, the European Commission and Member States reached an agreement for its implementation starting on 1 July. The document, which will be available on paper and digitally and will be free of charge for its holders, will make travelling easier between EU Member States. It consists of a QR code containing the holder’s their Covid-19 status, and will provide exemptions from travelling restrictions in three situations: when the person has been vaccinated against Covid-19, when the person has a negative PCR test taken within 72 hours before travelling, and when the person has recovered from Covid infection and has antibodies. The certificate will be accepted in all EU Member States, and according to the European Commission, “will help to ensure that restrictions currently in place can be lifted in a coordinated manner.” A centralized system has been put into place so the certificate’s information can be verified across the EU. The system will safeguard the security and privacy of the user’s data, which will not be accessed, stored or retained in another Member State, beyond the verification of the validity and
authenticity of the certificate. However, the Dutch Ministry of Health has expressed some privacy concerns about the amount of personal information in the certificate, including which Covid vaccine the person was given, Trouw newspaper reported. As part of the agreement for its implementation, Member States will retain the right to apply additional national measures, provided they are necessary and proportionate to safeguard public health, in the event of a negative development in the epidemiological situation. It was the intention of the European Parliament to make all pre-travel testing free of charge, but some Member States, including the Netherlands, declared that this should remain a national decision. Ultimately, a compromise was reached to make the tests affordable, through a €100 million investment to provide tests for Member States. An early adopter of this type of “passport” certificate, the EU paves the road for other states to implement their own systems for post-pandemic global travel. As of 1 June, seven EU Member States have already put into place the certificate: Bulgaria, Croatia, Czech Republic, Denmark, Germany, Greece and Poland. Written by Juan Alvarez
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