Going Dutch: Not-for-profit Netherlands healthcare

Buurtzorg Image copyright De Twentsche Courant Tubantia
Image caption Jos de Blok's patient care system has no managers

The founder of a Dutch care system has travelled to Scotland to speak to health professionals and the Scottish government about his not-for-profit care company.

While many elderly and disabled people in the UK are used to visits of just 15 minutes from a carer, Buurtzorg employs qualified nurses who stay as long as they think is necessary.

"We focus on craftmanship," said the founder and director of Buurtzorg, Jos de Blok.

"If you, as a nurse, have a good education then you know how to organise your work yourself. In a team with 10-12 nurses you can be responsible for all the patients in a neighbourhood."

'You are human'

There are no managers and patient satisfaction is the highest for any care organisation in the country. The costs per client are 35% less than the Dutch average. Buurtzorg has also been voted the Netherlands' best employer three years in a row.

"Before they introduced me to Buurtzorg, I was with another organisation and that was rubbish," said 83-year-old Fred de Smet, from Utrecht.

He has been receiving care from Buurtzorg nurses for several years following a stroke, heart problems and leukaemia.

"They treat me well, they take care of me. You are a human with them and they don't start saying, we only have X amount of hours or so many minutes to change my support stockings or shower me."

As well as organising social care, some of the nurses in Amsterdam run a radio show, called Radio Steunkous - which translates to "radio support stocking".

'Bound to houses'

"Our motto is that everyone can be each other's support stocking," said nurse and presenter Ellie Lakerveld.

"Our goal is to provide another form of healthcare. A lot of people we visit are bound to their houses or their beds, and radio plays an important part in their lives."

Radio Steunkous runs features which might be of interest to those receiving care, mingled with classic songs from previous decades.

Buurtzorg itself recreates a system from a past era.

"This is the way I worked in the 80s," says Jos de Blok, who was a community health nurse.

"We didn't have management then. We were responsible for everything. Give trust to the nurses, they have intrinsic motivation."

'Vicious circle'

Mr de Blok hopes to encourage other countries to adopt his model. He arrives in Scotland only a few days after returning from Japan, which also has a care system based on short visits.

"I understand how these systems developed through the years because it's what we had in Holland.

"But it becomes more and more difficult for nurses to do the work in a way they are satisfied. The way it's organised with many management layers makes it even worse. Then you get this vicious circle. Control becomes more. The pressure on costs becomes higher. It's not the solution."

Buurtzorg started in 2007 with four nurses but now has 9,300 nurses in 800 locations across the Netherlands.

"They make full use of the time they've got with you," said Mr de Smet. "They have time to have a coffee with you. It's very cosy and very good. I wouldn't want it any other way."

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