“For the record, this is not about income for the GP,” emphasizes Van de Goor. “Years ago we stuck our necks out and hired nurses en masse to keep and take over care from the hospital. Now the payments of the practice nurses are being squeezed below the level for which we can still pay them.”
Van de Goor also states that the consultations that are reimbursed, for example for elderly people with multiple disorders, are also inadequate. To be financially viable, the support worker must see at least two patients per hour for eight hours a day. While the treatment of the chronically ill is often more complex and takes more time.
“That can be dangerous,” says Van de Goor. “There is a chance that a lot of attention will soon be paid to minor cases. The difficult cases may soon receive insufficient care because it is not billable or takes time that is no longer available.”
Professional association LHV shares the concerns. Spokesperson Luuk Elzinga states that the new financing system forces GP practices to reconsider which care practice nurses provide in order to be able to claim a salary at all. “Partly due to a financial incentive, it is determined which care the GP will provide. That money will determine which care you can and cannot provide, which is a very unhealthy development.”
Calculation tool
According to Christine Rompa, spokesperson for Zilveren Kruis, the unrest arose when GPs had completed a calculation tool developed by the insurer and saw an alarming loss of income.
“45 practices have contacted us. We see that in most cases the tool has not been completed or not completely filled in correctly. We are currently looking at whether we can further improve the information on our website and are helping the practices that have reported to us with the calculation.”
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