Aukje de Vries' Diary Day 27

The Mea Vita story continues, the large home care organisation in The Hague and some other cities, which is about to go bankrupt, and where the Ministry of Health is stepping in, to prevent the users of home care to be left without help. The situation is complicated, not only because the organisation has become unmanageable through size and scope, but also because personal care and nursing come under the long term care insurance but domestic care (in ordinary language house work) is the responsibility of the municipality.

I read in the local weekly that it is likely that the municipality will enable Mea Vita to continue its house work in The Hague in spite of the fact that Mea Vita is highly indebted.

The organisation is now joining forces with another organisation in a town some 20 km from The Hague, with the fancy name of Facilicom/Axxicom. This is not Dutch, not English, nothing, ghastly. And why again involve another organisation? I thought structures were going to be simplified.

On Saturday the national newspaper has a commentary about Mea Vita and neighbourhood care (buurtzorg). Mea Vita has now become the denominator of large, bureaucratic, management dominated home care organisations. There are many of them all over the country with fancy names such as: Carans, Careyn, Archiatros, Lentis, Axenza, Trivium, Vivium or Alysis and they work according to the principles of Michael Porter, explained in the book Redefining Health. A team of twelve Dutchmen has adapted this book to the Dutch situation and written a pamphlet about it under the title: Towards value creation in care. The former as well as the present Minister of Health seem to believe in this approach. The author of the commentary ridicules the way in which the large organisations are run and then also describes buurtzorg and how they work. Not only are they much cheaper than the large organisations, they serve clients much better. Buurtzorg is about values, not about value and is highly preferable, he concludes.

I am glad to see such an article in a leading newspaper. It is time to give care back to care professionals and to let professional values prevail over management values!