Abstract

In order to keep our healthcare system accessible, affordable and of good quality, change is needed. The Ministry of Health, Welfare and Sports therefore started a ‘movement’ towards the Right Care in the Right Place in 2018, together with a variety of care and support service providers. The goal is that fewer people need care (prevention), that care and support are provided closer to the patient (relocation), and that care is provided digitally when possible (replacement).

The National Institute for Public Health and the Environment (RIVM) has evaluated what this movement towards the Right Care in the Right Place led to between 2019 and 2023. Its findings show that effective steps have been taken, but at the same time there is still a long way to go. Care and support service providers notice that the current healthcare system has its limitations, such as legal restrictions and the way financial flows are organised. According to these organisations, this is why actual transformation of the system in practice runs up against these limitations. They reiterate that real change requires patience.

Around 2019, many new partnerships between care and support service providers, municipalities and health insurers were set up, but actual transformation of the health care system requires more time. Furthermore, there is a lot of room for improvement when it comes to involving citizens in these partnerships in order to specify their exact needs and consequently adapt services to these needs. So far, program managers experience little change in terms of actually integrating and reorganising services for citizens.

RIVM concludes that the ‘movement’ towards the Right Care in the Right Place should be seen as the first phase of a larger-scale transformation in care and support services, which takes a lot of time. During this transformation, the focus should move from treating disease towards maintaining health. Health care and medication are not always the answer to people’s actual needs. Sometimes a lifestyle coach or support from the social domain or community services are a better fit. Moreover, it is important to inform citizens and patients more clearly about changes in the healthcare system and what they can expect in terms of care and support services in the near future.

In addition, all stakeholders need time to learn from each other and to be open to other perspectives besides the medical perspective. Lastly, RIVM recommends to expect change not only from the stakeholders in the field; help from the national government is needed to tackle the limitations of the current system, such as financial flows between sectors and between the medical and social domains.