Allowances system reform to solve healthcare staff shortages

Bastiaan Starink Partner, PwC Netherlands 13/01/22

Allowances system reform to solve healthcare staff shortages

The coalition agreement of the new cabinet tackles many problems simultaneously. The cabinet will continue with labour market reforms and tackle staff shortages in healthcare and education. The benefits will also be reformed, taking into account the effects on the labour market, and work-to-work schemes will be encouraged. I think it is positive that the government is linking many dossiers together, says Bastiaan Starink, PwC expert and since 1 February extraordinary professor of Labour Market, Pensions and Taxes at Tilburg University. For instance, the labour shortage in healthcare and education is being tackled by reforming benefits in such a way that working more pays off.

Labour market still faces big challenges

The developments on the labour market also present the new cabinet with great challenges. The current situation is that unemployment is still high in the Netherlands and, at the same time, there is a huge staff shortage, especially in the public sector. Due to automation and the ageing population, this contrast will become stronger and remain a dilemma. The labour force is not increasing with extra money, despite investments in many areas and attempts to get people to work more hours. The key question remains: how do we ensure that there are enough working people in the Netherlands? On this point, I think we could do more to link up with immigration policy. But that is not happening enough at the moment.

The corona crisis has made the mounting problems even clearer 

There is nothing new about staff shortages in healthcare, education, the police and defence, but the coronacrisis has made the mounting problems even clearer. According to the latest labour market forecast of the UWV Employee Insurance Agency, the number of vacancies in these sectors is set to rise by 100,000 this year. In the meantime, jobs are being lost, especially in temporary employment agencies, the hospitality sector and industry. According to the UWV, that will take the count to almost 10.6 million jobs in the Netherlands by the end of 2021: a fall of 186,000 in two years.

Move people frome one sector to the other, but not without retraining them

Of course, we already know that digitalisation is having a serious impact on the labour market and that jobs are being lost or changing as a result, with other jobs arriving to replace them. That creates a need for retraining. We need to take a close look at the sectors, companies and organisations that will be shedding a lot of jobs in the near future, and where there is or will be a demand for labour. By building a bridge between those two groups, we can move people from one sector to the other, but not without retraining them.

Current retraining approach is too free and easy

I feel that a better approach could be taken to this. The government and employers are investing heavily in retraining, but the approach is too free and easy. Oversight is needed to make sure we only retrain people for sectors where there are jobs or for organisations that need those specific employees. Hans Borstlap of the Work Regulation Commission, which published its report on the future of the Dutch labour market just over a year ago, speaks in this context of 'new alliances' between the public and private sectors.

Start out from the needs of employers

I agree with Hans Borstlap that we should start out from the needs of employers. Where is there a demand for labour? Making a link between this and supernumerary labour makes it possible for us to start retraining people according to specific targets. And this should only be done if a new job is available for them and they have the motivation to accept it.

Link between the benefits scandal and staff shortages in the healthcare sector

This motivation is important and is what drew my attention to the link between the benefits scandal and staff shortages in the healthcare sector, which is now also reflected in the Cabinet proposal. The Ministry of Health, Welfare and Sport has calculated that 80,000 people will be needed in the healthcare sector this year. Government statistics also show that most care workers have part-time jobs. They work an average of 22 hours a week. It has already been calculated that the staff shortages in the healthcare sector could largely be solved if everyone worked an extra few hours a week.

Working a few extra hours does not make much difference to their net pay

So why don't healthcare workers do that? As well as the fact that the healthcare sector employs many women, who are traditionally more likely to have a part-time job, there is a financial reason. The problem is that working a few extra hours does not make much difference to their net pay. They stand to lose all or some of their care, rental or child allowance. In other words, there comes a point where there is barely any financial incentive for people to work extra hours.

Structure the system in such a way that the sectors with shortages become more attractive to work in

Given this and the fact that the outgoing cabinet has announced plans to shake up the benefits system, my advice is this: reform the system in such a way that it pays to work more hours. That means looking not only at taxation and social security, but also making sure that the system is structured in such a way that the sectors with shortages become more attractive to work in. By simplifying the tax system - including by phasing out the self-employed tax credit - you can limit flexible work. In addition, the collective labour agreements need to be revamped. We need to do better research into what people find important and use it in the collective labour agreements.

As well as offering better pay, we have to make the jobs more attractive

But this will take more than money alone. As I said, people's motivation is important, too. Employees are generally willing enough, but are no longer attracted by the work. As well as offering better pay, we have to make the jobs more attractive by reducing the administrative burden and computerising the repetitive tasks. That way, you ultimately end up with more nurses in the ward and police on the streets.

Our advice on the biggest challenges the Netherlands faces

The Covid-19 crisis has enlarged the role of the government and improved its ratings. This seems to be a reinforcement of the trend that has already started for corona. In our opinion, the government should take advantage of this momentum to tackle major social issues.

Read more >

Contact us

Bastiaan Starink

Bastiaan Starink

Partner, PwC Netherlands

Tel: +31 (0)65 375 58 28

Follow us