Home Care Reform in the Netherlands. Impacts on Unpaid Care

Introduction In the Netherlands, about half a million people make use of home care, that is, formally arranged, and publicly financed home care services. Until 1 January 2007, Dutch home care provisioning used to be supplied by relatively small, profit and non-profit home care organizations. The majority of home care organizations catered for only one town or region, and only since a few years, some organizations have merged, within and across regions, in a strategic move to prepare for the 2007 market liberalization policy. Home care was financed through national level social insurance and allocated at the national level through local home care providers. The demand for home care has increased steadily over the past years, largely due to the aging population, while increased demand is also due to a steady increase in female labour force participation, which puts pressure on the availability of unpaid home care1. Nevertheless, the level of unpaid care is very high in the Netherlands, compared with other European countries, as Bettio and Plantenga (2004) have shown with their care index for European countries. The increased demand for home care has resulted in waiting lists for home care already since the 1990s.