12.000 additional care staff at work

Toespraak | 07-09-2011

Ladies and gentleman,

Thank you very much, doctor Takeda. I wasn’t expecting to be applauded. I came to applaud you, so I’m wrong footed completely but I’m very pleased and I think you pronounce my name perfectly. Very well done.

Royal highness, ladies and gentlemen and dear colleagues. It is an honor to address so many people from so many organizations from so many countries. Dedicated tot enhancing the care for the people I care for most. Today in The Netherlands we have approximately 230.000 people suffering from demention and by 2040, which is when I will be 87, this figure will be 500.000, one in every 35.

So, innovation in all aspects of care is very high on our agenda. We shall make smart use of new technology, we shall promote self-care and self management, we shall explore every alternative for enhancing efficiency and we shall share new knowledge and research, networking in Europe and across the world. These are all very important developments.

At the same we have a very high level of care. And here I would like to pay tribute to the care staff. The nurses and care assistants who are in every day contact with the patients. They know precisely how to interact with people whose mental faculties are failing, with people who sometimes inappropriate behavior, with people who, for want of a better word, can be awkward. I have immense admiration for our care staff. Tact and compassion, no matter how difficult and unresponsive the patients can be, they treat them with dignity and respect.

So I’m so happy that the Dutch government has long term care high on the agenda and I am very happy that I’m the person who is allowed tot spend this money. We increase the investment in the recruitment and training of care professionals with three quarters of a billion euro’s, starting in 2012. It’s a huge amount of money in a budget that is shrinking by the day and it’s a huge responsibility to spend it there where it’s going to take the most effect.

The budget is important but it’s also important that the field cooperates in innovation. And yesterday we reached a major milestone. All field parties and the vocational organization of nurses and I signed a convenant, setting out exactly how we’re going to spend the extra resources. Our target is ambitious. By the end of 2013 there will be 12.000 additional care staff at work, or at work being trained. This is not rocket science, it is simply the amount of extra investment divided by the mean, average, it’s mean as well, but it’s the average salary of a nurse, which leads to the number 12.000, the magical number.

But the convenant devotes attention also to the working practizisan, the standards in the field which we’re going to update and which we’re going to tune in to the needs of workers and of clients.

I’m going to end with a separate agreement with the professional federations, launching a number of pilot projects to test promising new approaches. All parties signing the convenant committed themselves to reducing regulations and paperwork, because nurses hate regulations and paperwork. And we think that professionals have enough grip on the essence of care to be allowed to take more room then they’re getting now.

So, the convenant amounts to the following very complicated intention. We’re going to spend it on half of it on nurses, the other half on nurses. If there’s any money left, we’re going to spend that on nurses and all the money we don’t know how to, disposal we’re going to spend on nurses.

Apart from that the care staff will be challenged to develop their own standards and I’m giving care staff a prominent role in the new quality institute for care, which will be open in 2013. I’m asking for all your commitment to help them and to put your estimable experience and tools, because this is a discipline that has no, or not a great academic tradition yet.

Ladies and gentlemen, as Mr. Takeda referred to, in the early eighties I began my career as a doctor in geriatric residential care and I had just graduated and I was full of knowledge and full of good intentions. And a moment happened that I’ll never forget and I’d like to share that with you. I had been called one morning to look at the rash on the bottom of a lady, a lady with advanced demention and I stood beside her bed.

The nurses were gently bading her, limp by limp, the bed clows were in a twist of soiled damp cotton, slightly warm and slightly smelly and I stood there and I thought: Oh heavens, how am I going to explain to the lady that I want to inspect her bottom ? She held a cup of coffee, the coffee sloshed on to the saucer and she was eating a stroopwafel. And a stroopwafel is a biscuit, two layers of biscuit with sirope in between and it’s sticky. And she was eating it with all her concentration, on this chewy biscuit, sloshed in coffee.

Then she noticed me and she looked at me and I looked at her and I looked some more and she looked at me and then I fell into her eyes. I let myself go and for a few seconds there was nothing and then she took out of her mouth a small piece of stroopwafel. It was wet and it left a little trail of sirope and she moved her hand slowly towards my mouth. And I opened my mouth and she put that little sticky wet piece of stroopwafel into my mouth and I accepted the honor.

The whole episode lasted a few seconds, a few seconds of reciprocity. Neurons, lost of function, they were unimportant, because I had found what was hidden deep inside of her and she had offered me reciprocity. I felt blessed.

I’m sure that everyone of you will recognize this feeling of the moment that you were hooked by the awkward and yielding, deeply moving and utterly rewarding field of professional expertise that is psycho-geriatrics and contributing to it now from another point, I hope to return and thank you for being here. I thank you for the reward and God bless your work.