receive home care has risen much during the last few years. The growth of budget, however, has only increased slightly. Therefore, the home care organizations claim that the limit has been reached and that the only way in which they can manage financially is by a decline in quality of care.
Screen 43 (home care: quality)
As in hospital organizations, home care organizations spend a lot of energy on quality programmes. The idea is that everyone in the organization, in every function, is aware of his or her contribution to external quality. Besides these internal processes, most home care organization are a member of the National Association of Home Care. To enable this membership every organization has to fulfill certain quality demands. This is another way to establish quality of care.
This quality, however, is threatened, as the home care organizations say. The expectations are contradictory, they say. On the one hand they are expected to change from an organization in which the professional decides 'what is good for the client' into an organization in which the client decides what is good for him or her. On the other hand they do not have the necessary resources. There is, as they say, a gap between the quality, accessibility and the amount of home care that can be delivered and the scarcity of the financial resources. This situation results in waiting lists, a rationing of home care and increased work load for the employees. In a recently published book about Dutch health care it is as written as follows:
Screen 44 (home care: citaat)
