Time to pitch in? Netherlands moves to the fore of rethinking welfare

When Sonja van Wijk's father moved into a nursing home two years ago, she became a daily fixture there, serving coffee, cooking meals, washing plates, or simply chatting with the six other residents living in his wing.

But there is a difference now: As of last year, these tasks, always done from the heart, are now mandatory for the family members of each senior citizen who secures a spot here. If families refuse to volunteer, they are told that this center, called Wilgenhoven, is not the place for them.

In practice, the hours asked are minimal. Each family or network of friends is asked to volunteer four hours a month, and they provide nonmedical services such as meals. And Wilgenhoven's community is small, just some 28 people drawn from the tiny village of Stolwijk and its surroundings.

But the move, which Wilgenhoven's owner, strategic holding company Fundis, has made permanent in three of the group's facilities and now is planning to expand, still stoked controversy in principle – raising questions that went all the way to the Dutch parliament and eliciting telephone calls from around the globe, says Rik Remmerswaal, a nurse who works at the home.

It is an example of a larger overhaul taking place within one of Europe's most comprehensive welfare states, transitioning it into what King Willem-Alexander called a "participation society" – a place where, in the interests of both community and government belt-tightening, its members do more to help each other before turning to the state for aid.

How the Dutch experiment fares could reach well beyond domestic borders, shaping Europe – and its welfare systems – as the Continent struggles to recover from its debt crisis.

"It is probably the way we are going in the coming years in the whole of Western Europe," says Mathieu Segers, a European integration expert at Utrecht University in Utrecht, Netherlands. "There has to be some trimming down of social policies."

At its heart, the Dutch movement is a bid to set people up for a mind shift in what they expect from their government.

Europe's welfare problem

"The classical welfare state is slowly but surely evolving into a participation society," the Dutch king told the nation last fall. "Everyone who is able will be asked to take responsibility for their own lives and immediate surroundings."

Aging societies across the developed world have presented a worrisome problem to policy experts for decades. Europe has seen multiple efforts to reform its post-World War II welfare systems, which have grown – and in some cases bloated – in years since.

Sweden went through a major welfare overhaul in the 1990s, including a revamping of its pension system. In 2010, British Prime Minister David Cameron proposed his still-unrealized "Big Society" plans, which include volunteer work in exchange for unemployment benefits. The Netherlands has been tweaking unemployment payments and health-care subsidies for the past decade. The retirement age there, as it is in many parts of Europe, is rising to 67 (from 65).

Europe's debt crisis, which caused banks and governments alike to collapse, brought the issue to the fore for the political class – and gave them the urgency, and stomach, to go through with unpopular spending cuts.

Indeed, the Dutch experiment comes as part of a package of cuts aimed at keeping the Dutch deficit within the European Union target of less than 3 percent of gross domestic product.

Critics of center-right Dutch Prime Minister Mark Rutte say that this is nothing more than budget slashing packaged in a tidy philosophy.

But many in the Netherlands see Wilgenhoven, located in central Netherlands just outside the town of Gouda, as, for better or worse, a window onto what a "participatory state" might someday look like.

Mr. Segers says that he believes the government has created a "label" more than a revolution, a way to dress up the reality of budget cuts. At the same time, he says the new paradigm is "very real."

The "participation society" concept means many things, such as family or friends taking responsibility for the care of older people – driving them to medical appointments or helping them clean their homes – before seeking out state support at later stages. The unemployed are being asked to clean streets or parks in exchange for their benefits, a program on track to become a national law this summer. New proposals at the national level include asking the elderly and chronically ill, at least those well enough, to also volunteer in exchange for their social security payments.

It's a marked shift for the Dutch, who have traditionally enjoyed one of the most generous welfare states in Europe, and it has earned praise from some unlikely corners. Michael Boskin, an economic adviser to former US President George H.W. Bush, praised Mr. Rutte's direction in a recent commentary:

"They deserve an orange-hued salute for innovative reforms that governments worldwide might usefully emulate in the interest of maintaining a targeted, effective, and affordable safety net," he wrote. "Reforms in one European Union country could spur policy innovations elsewhere in the EU and around the world. And contagious successful policy reforms are precisely what Europe and most of the world need."

Punishing the vulnerable

But many Dutch disagree, and Rutte's popularity is hurting because of it. The government has been blamed for punishing the most vulnerable – such as the unemployed – and insisting on the "free" work of volunteers, giving them chores that have nothing to do with their future employment possibilities.

"This kind of policy is extremely unpopular," says Chris Aalberts, a researcher in political communication at Erasmus University in Rotterdam. "It is a disaster."

But at the same time, Mr. Aalberts notes that abstaining from cutting is not an option. "There is no budget anymore for the system that was there in the past."

Part of the overhaul includes transferring some national welfare policies to municipalities. In The Hague, the city is overseeing a program put in place in 2012 to get its unemployed into mandatory service work. The man in charge of it, Henk Kool, an alderman from the center left, is careful with his words, emphasizing such work as a chance to gain skills that would make candidates "fitter" for the job market.

Of the 40,000 unemployed in The Hague, 20,000 are longtime unemployed, and of those, more than 3,000 are enrolled in volunteer work in exchange for their benefits. Mr. Kool aims to get the number up to 4,000 by the end of this year. Yet he is against a countrywide plan that would require that all of those able to do volunteer work start doing it for benefits by July 1.

"We do have a welfare state, and we take care of people who are unemployed. So now there is a crisis going on, and people need it, and now we say we don't have enough money," he says.

Ibo Gülsen is a city councilor on the right, and he says 4,000 is much too low a number – that more people should be doing more to pitch in, although he also underscores that the emphasis should be on what the unemployed have to gain from volunteer work.

"The principle of doing something in exchange for your welfare, we've neglected that for too long. It can't continue like this; it is not sustainable," he says. "The left says we want to punish people in need." But Mr. Gülsen says it is in the interest of the unemployed "to be active in society again."

A social worker in a working-class neighborhood of The Hague, who asked for anonymity because he was not authorized to talk on the record, says that as of Jan. 1 his organization has said he can only see patients – who seek his help on issues from financial to family problems – five times. There used to be no limit. His work is private, so it's not a government mandate, but he says the mentality of the "participation society" is trickling down into all spheres.

"As a social worker, I believe everyone should do what he or she is able to do. I'm not going to solve your problem if you can do it yourself. I agree with the concept of the participatory state. The fear is, though, there are some things in life you can't ask of your neighbor," he says.

"We should help each other; who would disagree? If you are unemployed sitting at home, that's a shame. You should be out helping an old neighbor with groceries," he says. "But where is the line? Should you wash your neighbor? Not everyone can do that."

'We have to do it together'

Ms. Van Wijk is of two minds about the "participation society." She believes it's right that families should be asked to care for their older members. She spends far more than the four hours mandated to be with her father, cooking meatloaf and beets or bringing fish from her store on Fridays, even during the hectic summer months when she travels from town to town to sell herring and fried filets at fairs.

She worries, however, about the direction that the country is heading for those most in need. It's just a small example, but when the government-provided cleaning service cut back from 2-1/2 hours a week to 2 hours every two weeks for her 78-year-old mother, she took it as a sign of something more ominous. Because the state has said it's up to society to care for its older people, it has raised the bar on access to nursing care, so much so that her own father might not secure a spot today, she says.

"It is only a matter of time before living in jail, where you have guarantee of food and [a] shower, is better," she adds.

Mr. Remmerswaal says the program in Stolwijk has been a huge success, with the patients themselves benefiting the most from a family-friendly atmosphere – which was the main reason it was implemented, he says.

Still, when it was first announced it sparked controversy, especially in cities where the pace is more harried. Family members wanted to know exactly what would be asked of them and how much time they'd have to give. One family decided to opt elsewhere. But in their studies of the three nursing homes currently participating, 96 percent of families or networks had the capability to volunteer. If they cannot, other solutions can be found.

Jeroen van den Oever, the president of Fundis, which owns 15 other nursing homes aside from Wilgenhoven, says that when Fundis first announced the pilot program he was targeted on the Internet, with Dutch people saying that a person can't be forced to volunteer and that citizens have paid into the system their entire lives and have the right to care when they grow old.

But the health minister of the Netherlands was a fan, visiting Fundis's facilities.

"They have a political problem," Mr. Van Den Oever says. "And the way out is to have a new culture in the Netherlands with people taking their own responsibility as much as possible."

The program is being expanded to all of Fundis's facilities, which house about 1,000 seniors.

On the larger issue of a participatory society, Remmerswaal largely agrees. His wife cleans homes for a living for those who can't do it for themselves, but with cutbacks in such privileges, she lost her job recently. She'd welcome a chance to volunteer, even if it's work she'd normally be paid for, he says.

"I look at it from a different perspective. When I'm older, I'm glad that there will be someone there to help me," Remmerswaal says. "It's not like it used to be. We have to do it together."

For now, these are the questions that dominate Dutch dinner party conversation. But Gülsen in The Hague city council expects they'll simply be part of the mind-set in the years to come.

"In 10 years' time, people will live according to it," he says. "People will think it's just normal."