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Public Sector Ageing in the Netherlands Gertjan Baars Anneke Offereins 1 © Reed Business, Amsterdam 2010 © PricewaterhouseCoopers, Amsterdam 2010 Cover design: Gerda Mulder BNO, Arnhem, The Netherlands Cover photo: PricewaterhouseCoopers Basic design inner pages: Mariël Lam BNO, ’s-Hertogenbosch, The Netherlands Photos inner pages: Inbeeld reclamefotografen, Driebergen (page 16); Stijntje de Olde (page 22); Arjan Bronkhorst (page 30); Ineke Oostveen ( page 36 left); Mark van Herpen (page 36 right); Robert Elsing (page 40); P. Smaal (page 46); © provincie Utrecht (page 52); © VNG (page 58); Marcel Rob (page 64); Eric Fecken (page 70); Firma Woods (Peter van Hout); Eindhoven (page 74); Ingmar Timmer (page 80); Janita Sassen (page 84); © Menzis (page 88); Bert Beelen (page 94); Lucien de Souisa (page 100); Jeroen Oerlemans( page 106); mw. L. Wouda (page 110 left); J. Hendriks (page 110 right) ; Michel Campfens (page 116) Reed Business bv, P.O. 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ISBN 978 90 352 3167 2 NUR 882 Ageing in the Netherlands The point of view of decision-makers in the public sector Ageing tomorrow, innovation today Gertjan Baars Anneke Offereins PricewaterhouseCoopers 3 Preface With the baby boom generation moving into retirement from 2011 onwards, Dutch society will soon start to show the effects of population ageing. Whereas the causes of population ageing can be deduced logically, its effects and their urgency and severity are often subject to many different interpretations. We can, however, be sure that decision-makers in the Dutch public sector will be facing some daunting challenges. On the one hand, social and administrative responsibilities oblige them to develop a vision on ageing. On the other, they will be confronted with changes in the demand for public services, changes in their production capacity and having to develop new forms of service delivery. Within the next few years, significant changes can be expected in sectors such as healthcare, local government, education, housing, justice and law enforcement. Pension funds and insurance companies will also be affected. In our experience, discussion on the subject of ageing tends to be fairly one-dimensional. More often than not, decision-makers tend to focus on how ageing might affect their own organisation in terms of knowledge drain and loss of production volume, or how they can prepare for an ageing workforce. Surprisingly, there is not much discourse on how ageing is going to change society as a whole and what this will entail for the future tasks public sector organisations will be asked to perform and the products and services they will be required to provide. In order to verify our observations and make a positive contribution to population ageing awareness, we asked Dutch decision-makers for their points of view on this issue. Using the thought model we have developed, we interviewed nineteen leading decision-makers from various sectors on their insights, experiences and concerns with regard to population ageing and dejuvenation. These sessions produced a lot of fresh concepts and reflections, as well as a call to all concerned to step up to the plate and act upon ideas that have been circulating for quite some time. Above all, the interviews provided food for thought, which is why we would like to share them with you, the reader, by means of this booklet. We would like to thank all interviewees and PwC staff who contributed to this booklet. On behalf of the PwC Ageing Taskforce, we wish you happy reading. Gertjan Baars and Anneke Offereins February 2010 PricewaterhouseCoopers 5 Contents Preface 5 Introduction 10 1 Housing corporations 12 “The care sector talks about ‘occupants’, whereas senior citizens tend to think of themselves as ‘residents’”. 13 Peter Boerenfijn’s point of view “People make their own choices about where they want to live, we are all individual consumers.” 16 Ton Selten’s point of view 2 Healthcare 20 “Among ethnic groups, ageing might result in an interesting shift in demand patterns.”21 Petra van Dam’s point of view “The demand for geriatric care and disabled care is converging.” 24 Ton Capsers and Alfons Klarenbeek’s point of view “Care organisations need to think about how they want to position themselves in the market: do they want to adopt a discount or a high-street format?” 26 Albert Arp’s point of view “We should no longer think in terms of living longer, but in terms of growing old healthily.” 29 Huibert Pols’ point of view 3 Local and regional governments 32 “Ageing can be compared to climate change and swine flu in the sense that everyone knows it’s coming, but people are slow to swing into action.” 33 Herman Sietsma’s point of view “The challenges municipalities will be facing are going to require a lot of creativity.” 36 Ralph Pans’ point of view “Self-reliance is destroyed once municipalities start pampering their citizens.” 39 Frans Mencke’s point of view 6 PricewaterhouseCoopers 4 Justice, law enforcement and safety 42 “Ageing should be a more prominent issue within the Rotterdam Rijnmond Security Region.” 43 Don Berghuijs’ point of view “Projections estimate that half of our current staff pool will have left the service by the year 2017.” 45 Leon Kuijs’ point of view “Expectations are we won’t have to make significant alterations to our service delivery concepts to serve the ageing target group.” 48 Hans van der Vlist’ point of view 5 Health insurance companies and pension funds 50 “Ageing is going to cause labour shortages.” 51 Martin van Rijn’s point of view “When it comes to care, part of the responsibility and initiative should be handed back to the public.” 53 Roger van Boxtel’s point of view “GPs will continue to play an important role in the community, but they will have to start concentrating on their core tasks.” 56 Martin Bontje’s point of view “Staff shortage problems in the care sector are not yet acute.” 59 Jeroen van Breda Vriesman’s point of view 6 Education 62 “When it comes to staff recruitment, we are already having to look abroad more and more often.” 63 Dymph van den Boom’s point of view “Ageing will create an ever growing demand for care-related training programmes.” 66 Hermien Hendrikx and Simone Blenk’s “For the education sector, one of the most pressing aspects of ageing is the fact that young people are increasingly moving away from rural areas.” 69 Pieter Boekhoud’s point of view Final words: the future has already begun 71 About the authors 75 PricewaterhouseCoopers 7 Introduction We all know the Dutch population is ageing. Better healthcare, improved working conditions WHAT? and shorter working hours have been increasing Market shifts life expectancy ever since the 1920s. Another in demand and supply important factor is the steep decline in births patterns since the early 1970s. As a result, the number of over-65s is rising while the working age population is slowly declining. When ageing reaches its peak in the mid 2030s, the old age dependency ratio ((i.e. the proportion of citizens aged 65 or over to citizens of working age) is expected to rise to between 42 and 46 percent HOW? WHO? Organising Innovating (as compared to 24,5 percent in 2010). production service delivery capacity concepts An integral approach During our discussions with public sector organisations, What: Market shifts in demand and supply we have often observed a tendency to look at the ageing patterns issue from a rather narrow point of view. Whereas decision-makers often identify staff shortages and The precise effects of an increasingly elderly population knowledge drain as significant effects of ageing, they are are hard to estimate. One of the few certainties is that failing to ask some related, equally important questions. most elderly citizens will have more time to spend on How is client demand going to change and how can we leisure activities after partially or completely retiring from prepare for this by adjusting our products and services? the labour process. They often do volunteer work. As What opportunities does this present? How will ageing they no longer have dependent children, the position they affect our service delivery? How should we plan our occupy in society is fundamentally different, and their production capacity and what will it take to keep average disposable income has been increasing steadily production volume up? over the years.

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