Blog: Niet-gecontracteerde zorg: toekomstbestendig of achterhoedegevecht?

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Door Harry Woldendorp (partner bij PlatformVmZ)

Rond niet-gecontracteerde zorg zijn veel opvattingen. De meeste van die opvattingen worden geduid in termen van zorgprofessionals (zzp‘ers) worden niet serieus genomen bij de uitvoering van zorg buiten zorgcontracten en de keuzevrijheid van cliënten staat onder druk. Beide is feitelijk onzin.

In Zorgcommunity gaf Roos Wouters, de oprichter van de Werkvereniging, in ‘Keuzevrijheid in de zorg in ’t geniep verder afgebouwd’ aan dat er een wetsvoorstel ligt ‘om de vergoeding die patiënten bij niet-gecontracteerde zorgaanbieders krijgen te verlagen. Ten onrechte, vindt Wouters: ‘Het betekent alleen maar dat we straks minder te kiezen hebben. Wachtlijsten zullen toenemen en nog meer zorgverleners zullen het bijltje erbij neerleggen, omdat ze niet langer de kwaliteit kunnen garanderen waar ze voor staan. En het erge is: die zogenaamde kostenbesparing is nooit aangetoond. Er is nog nooit goed onderzocht of gecontracteerde zorg inderdaad goedkoper is dan niet-gecontracteerde zorg.’

Op basis van rapportages (onder meer Arteria), benchmarkdata en onze eigen werkpraktijk vanuit PlatformVmZ zien we dat niet-gecontracteerde zorg meestal niet adequaat is: lage kwaliteit (inzet te lage deskundigheidsniveaus; geen goede organisatie van zorg), hoge kosten (onnodige zorginzet; sturen op restitutiepolis) en nadruk op autonomie zonder een duidelijke verantwoording van de ingezette zorg.

Van ondernemers mag juist verwacht worden dat ze precies het omgekeerde doen: hoge kwaliteit, lagere kostprijs en maatschappelijk verantwoord ondernemen. Ondernemers hebben continuïteit als ze drie dingen doen.

  • Je levert iets waar iemand belang bij heeft en voor wil betalen
  • Je doet het beter dan de concurrenten 
  • Je zorgt dat de kosten lager zijn dan de opbrengsten

Het eerste is op de zorgmarkt geregeld: zorgvraag en betalen premie. Het laatste kun je goed bereiken met platformtechnologie (platformvmz.nl).

Het gaat dus om het ‘beter doen’. Cliënten hebben in de Nederlandse thuiszorgmarkt een enorme keuze. Zorgprofessionals die vanuit een eigen visie ondernemer willen zijn kunnen dat eenvoudig via ons doen. Je bent zelfstandig, je bent gecontracteerd en de kwaliteit en continuïteit van de zorg is geborgd. Maatschappelijk ondernemen gaat om onderscheidend zijn op kwaliteit en prijs. Dat is ontzettend leuk voor zorgprofessionals om mee bezig te zijn. De bij ons aangesloten zzp‘ers en organisaties kiezen ervoor onderscheidend te zijn binnen gemeenschappen, doelgroepen en hun eigen lokale context.

De energie die gaat zitten in het ‘zeuren’ over de ander (wet- en regelgeving, de gemeente, de zorgverzekeraar, het ministerie) kan beter besteed worden in het realiseren van innovaties op het gebied van adequate zorg. Daar zijn ondernemers mee bezig. Je kunt het ook zo zeggen: de groep die bezig is met eigen gelijk kan misschien beter in loondienst gaan; de groep die toekomstbestendig wil zijn gaat innoveren. Dat kan in de niet-gecontracteerd zorg, maar net zo goed in de gecontracteerde zorg. De meerwaarde van buiten kwaliteitseisen in de niet-gecontracteerde sfeer opereren is nihil. Het erover praten is een achterhoede gevecht.

Ook voor de Werkvereniging geldt dat je juist een hele goede bijdrage levert door ondernemend handelen in de zorg centraal te stellen en te laten zien wat daar de resultaten van zijn.

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