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In mid-March 1998, the social partners involved in healthcare in the Netherlands unanimously decided to adopt measures to reduce waiting lists. This marks a serious effort to prevent the development of a two-tier healthcare system and was strongly supported by the Minister of Health, Welfare and Sports. However, the next dispute - over the forthcoming collective bargaining round in the sector - already looms on the horizon.
In mid-March 1998, employers and employees in the healthcare sector joined forces to adopt a "waiting list action plan" to prevent a rift from developing between employed and unemployed people in terms of healthcare. The Minister of Health, Welfare and Sports was enthusiastic about the plan and promised financial support. Similarly, the permanent parliamentary committee on public health promised to ease rapidly the legally imposed rigidity of the financial regulations.
The plan intends to remove some of the obstacles in the short term, while, in the long term, indicating that more specialists and nurses must be trained to meet the increasing demand for healthcare. The plan focuses on increasing cooperation and coordination, and concentrating specialised knowledge of work-related disorders in separate outpatient clinics. Waiting lists will also need to be registered, and patients must have access to this information so that they can choose the hospital with the shortest waiting list.
It is worth noting that the plan drew support from both Mr Krol, the chair of the employers' association in the healthcare sector and from Mr Blankert, the chair of the umbrella employers' association, VNO/NCW. The latter is now openly opposed to a two-tier healthcare system, and pointed out that employers do not want to pay twice for sick employees - once for the health insurance fund premia and again for wages paid during unnecessarily long absences. However, Mr Krol will soon exchange one negotiating table for the next as tensions mount over the imminent collective bargaining rounds in the healthcare sector.
Like his fellow employers in the public sector, Mr Krol must negotiate twice: first with the minister who sets the budget and then with the personnel. The results of the first round have been interpreted differently. The minister feels that a 3% pay increase is feasible, but Mr Krol has indicated that, given such factors as efficiency savings and hiring new personnel to reduce waiting lists, pay cannot be increased by more than 0.5%.
Although the trade unions agree with Mr Krol's calculations, the largest union involved, AbvaKabo, after many years of moderate "market-based" pay increases, is demanding that additional employees be hired and extra daycare facilities be provided to alleviate the workloads. Current vacancies and the decreasing popularity of nursing courses demonstrate that the healthcare profession is losing its appeal - at a time when it is generally accepted that "more hands on deck" are needed.