1.3 Towards Speeding Up and Multiplicity of Transitions

Healthcare

Government has initiated the transition in healthcare. There is a shift from central to decentralized financing, and government is working on huge budget cuts in healthcare. The strong focus on costs and the corresponding bureaucracy turn out to negatively influence effectiveness and efficiency. Each year, costs in healthcare increase while the number of hands-on medical staff decreases. Overhead constitutes an increasing part of healthcare costs. 

It is time for a paradigm shift in healthcare. Various organizations have already started to act, in some cases successfully. But the sector has a long way to go. The transition will only be completed once the starting point is modified: 'away with systems thinking', more control for clients. This implies a change in the professionals' role, from leading to supportive. 

Human capital stems from cooperation and services are organized with the customer being the focus. The professional must be able to utilize his/her professional capacity whereby he/she is supported by the organization. The organization should limit the administrative burden. This means no policy documents and strict rules but straightforward frameworks.

This is driven by the idea that in practice it will result in cost reductions. In 2014, Holland spent about 90 billion Euro on healthcare. As a consequence of increased demographic aging and multiculturalism, demand on healthcare is rising. Healthcare costs have stabilized in the last few years. There is a growing unwillingness in society to pay these costs.

Healthcare has its own characteristics. Despite the fact that the individual relationship between practitioner and client is essential, a healthcare professional or his organization can hardly ever be regarded as an isolated unit. The professional is dependent on the input of others. It is very relevant to liaise with and transfer information to colleagues. No one (or no one part of an) organization can be held responsible for the elimination of waiting lists. There is a chain or rather a network of organizations/professionals. Only through cooperation and the transfer of information can one reach the desired level of performance and quality.

It is crucial that communities can make choices based on relevant indicators for quality of life. One of the issues here is that welfare professionals are not sufficiently equipped and trained to facilitate this development. In other words, these professionals lack the competencies and tools (especially where it concerns cooperation) and they don't know what new services they need to offer. Local government, healthcare professionals, and civilians all struggle to set priorities and to put cooperation into practice in a transparent and democratically responsible way.