Kennisland is tackling this pressing problem by first identifying the many different perspectives, and subsequently organising concrete improvements, which can in turn be used to learn how the system can work more effectively.
Pushed out of salaried employment
The ++‘Working in Healthcare’ programmeThe labour market campaign ‘Ik zorg (I care)’, which at the time of writing can be seen on bus shelters throughout the Netherlands, is an important element of the ‘Working in Healthcare’ action programme. Looking at the practice and experience of healthcare professionals, we ask ourselves: if the campaign succeeds in attracting the thousands of new employees we require, how long can we retain them without improving the working conditions in healthcare? via the ‘Werken in de Zorg (Working in Healthcare)’ action programme. Healthcare organisations are doing their best to find and retain staff, but are forced to make increasing use of independent contractors and other external staff to fill schedules. At the same time, more and more people are choosing to move from salaried employment to self-employment. Often, they are forced to by circumstances. Workload, limited flexibility and a heavy administrative burden leave them feeling they have no choice but to take matters into their own hands. For a growing group of healthcare professionals, self-employment is the ‘escape capsule’ that allows them to continue working in healthcare in a way that is acceptable to them. These people don’t necessarily want to be self-employed, but definitely do want to work in healthcare without being plagued by excessive administration or impossibly restrictive shift schedules.These people don’t necessarily want to be self-employed, but definitely do want to work in healthcare without being plagued by excessive administration or impossibly restrictive shift schedules. There is also a growing group of young healthcare professionals who want to work in an environment where (career) change and development is possible. Stricter enforcement of the ++Independent Contractor StatusAssessment of Independent Contractor Status Deregulation Act (Wet Deregulering Beoordeling Arbeidsrelaties). Successor to the Declaration of Independent Contractor Status, (Verklaring Arbeidsrelatie, (VAR)), this allows employment contracts to be presented to the tax authority, which then assesses whether those concerned are independent contractors or employees. This law is intended to combat the common phenomenon of ‘bogus self-employment’ (i.e. where someone is self-employed on paper, but is an employee in practice). Read more (in Dutch) appears a logical step in tackling ‘pseudo self-employment’, but this enforcement would lead to an exodus of independent contractors from the healthcare sector in the short term, as they would lose the benefits of self-employment (tax benefits, flexible working hours).
The recently-publishedOrganisations are experiencing increasing difficulties filling shift schedules with permanent staff alone, and are forced to fall back on alternative solutions. ++ReportFinal report by the Regulation of Employment Committee (Borstlap Committee, which surveyed the operation of the current labour market). This considered the extent to which the rules that apply to employment in the Netherlands lead to the desired outcomes, both now and in the future, for working people, companies and society as a whole. Read more (in Dutch) , makes a number of radical proposals to reduce the differences between independent contractors and salaried staff. We are keen to compare the results of our own practical research with the findings in this report. The Dutch Government wants to solve this problem by focusing heavily on promoting salaried employment. But organisations are experiencing increasing difficulties filling shift schedules with permanent staff alone, and are forced to fall back on alternative solutions. And while professionals do want to work in healthcare, they want more flexibility and a lighter administrative burden. There are many different interests, which often clash.
Solve or approach differently?
Kennisland believes that change begins with an open mind. What is at stake? Which solutions have already been considered? What is the dominant frame? This immediately reveals who is already working on this problem, and the perspectives that may be missing. For example, the labour shortageWe intend to identify the living environment of healthcare managers, nurses in salaried employment and independent healthcare contractors, and to develop innovative ideas, plans and actions to organise working in healthcare better, and to make it more attractive. in healthcare means something different to the Dutch Government than to someone who has just switched to the sector in mid-career. This makes it even more relevant to approach the problem ++Flexible workingIn the ‘Flexible working in healthcare’ action research project, we are investigating the future of flexible working together with managers, regular staff and flexible staff. In various study teams, they develop a new way of working in their own healthcare context themselves.. Because ‘more of the same’ isn’t the solution for everyone. This is why we zoom in via case studies, to identify a variety of perspectives. This allows us to identify the living environment of healthcare managers, nurses in salaried employment and independent healthcare contractors, and to develop innovative ideas, plans and actions to organise working in healthcare better, and to make it more attractive.
Education as a catalyst
We strongly believe in forging connections with other sectors, including education. Because working in healthcare is not simply the domain of healthcare agencies, or the Ministry of Health, Welfare and Sport. One important question is how we attract, train and retain a new generation of healthcare workers. In the Learning and improving in nursing care action research project, we are designing the learning workplace of the future together with students, teachers, practical trainers and healthcare managers: a place where learning generally takes place while working (hybrid learning), teachers can be found closer to or even in practice, students feel connected to a healthcare organisation, and all those involved with healthcare work in a learning environment. This allows us to respond much more effectively to changing healthcare demands, which will increase the quality of healthcare.
In every action research project, we meet resilient, passionate healthcare professionals, whose knowledge and experience give them very valuable insights about how things can be done better.In every action research project, we meet resilient, passionate healthcare professionals, whose knowledge and experience give them very valuable insights about how things can be done better. Our intention is to continue to listen carefully to stories and experiences from practice, and thus to help those who work in practice develop solutions themselves. This approach also produces valuable insights that will help to shape policy at various levels (staff, organisations, regions, and the Netherlands as a whole).
Do you recognise the problems described above? Do you see yourself as part of the solution? And do you believe, as we do, in empathy for working people and the choices they want to make, in the necessity of taking a new look at work, and focusing on learning and education? Then let us know. We are always open to a fruitful conversation and opportunities to work together on perhaps the most important healthcare problem of our time.
Our population is ageing and becoming increasingly diverse. The healthcare system must continuously innovate to keep serving those who need it. Very often, innovation is simply an improvement to the existing system, and also an order “from above”. Citizens and professionals have little involvement in this process. What a shame! This wastes a great deal of valuable knowledge and experience. KL wishes to use the potential of innovators from across society to achieve good, future-proof and accessible healthcare.