The care depends on self -employed people, but now most of them are no longer allowed to work there

There is 'pressure on healthcare' and there are insufficient 'hands on the bed'. That while there are more and more people who need care in the midst of the large staff shortages, because of the aging population. It is expected that the shortage will increase, especially in hospitals and nursing homes.

A complication has been added since 1 January. Because the Tax and Customs Administration this year more actively maintains false independence – activities that should actually be performed as an employee – many healthcare institutions stop cooperating with healthcare staff that can be hired as a self -employed person, often also when it comes to real self -employed people. They simply do not want the risk of additional taxes.

This causes problems in the workplace and headaches in the board rooms, because many care employers have become highly dependent on the self -employed. The ZZZP people fill holes in grilles by catching up when colleagues fail. They are part of the 'flexible shell' where many organizations have set up their personnel policy. Nice for the care institution, and for the self -employed, because they can organize their own time. They have become used to a high net amount in their account, because employers do not have to pay social contributions for the self -employed.

My work sometimes looks like factory work: it all has to be fast-fast. I like to provide customized care, but that doesn't always work

Stopping self -employed people is not that simple. Various healthcare institutions that first wanted to stop hiring as of January 1 will continue to work with self -employed people – but with the announcement that it must be over in a few months. Other institutions hire personnel through mediation constructions, which often costs them more money. With great fear, healthcare institutions are looking forward to next summer, when many healthcare workers go on holiday. Will it be possible to get the grilles around without self -employed people?

Great worries

The professional organization of nurses and carers Nu'91 found earlier this week that there are great concern about the new situation among care workers. More than half of the respondents indicate that the quality of care is negatively influenced by the loss of self -employed persons and found a higher workload for permanent employees. The professional organization states that carers and nurses pay the price of 'an ill -considered approach'.

Out figures from the Chamber of Commerce It appears that the number of self -employed people in health care has been declining since December, which is a trend break after years of increasing flexibilisation. In December 2024, the healthcare sector lost 1,700 self -employed people, nearly 2,000 in January of this year. It is not yet known where they ended up: employed, at a mediation agency or in another sector. Large care dome indicate that it is too early to draw conclusions, so spoke NRC Four (former) ZZZP people about the impact of the new situation on their professional life.

Karin de Graaf (57, maternity caretaker)

« I have been a maternity nurse since I was nineteenth and since 2017 I have been doing that as a self -employed person. That was a solution for me, because I have health problems and as a self -employed person can decide when I work. I work in a delivery center in the hospital, but also for a midwifery practice. In addition, I have my own network around births and I help at the first start -up at home. I think the births in the Government Center are the most beautiful: the dynamics and adrenaline of multiple births at the same time. Every birth I look at where I can best support, so that the birth runs well for all involved.

« The regularity and defined services of the Government Center are ideal for me, I do five to six services a month there. If you go to a birth at home, you never know when you're done. At the end of last year I heard from the delivery center that I could work as a self -employed person until March. In the Government Center there is a permanent team of maternity nurses with four freelancers. We self -employed people can be used well if a service is released due to a colleague's illness.

« We have been offered a zero -hour contract, but I announced in January that March is too fast for me. If I were employed, I would earn much less. Fortunately I have a partner with a good income, but for what I now earn at the Government Center, I would have to run more than twice as many services. So I will have to do more other work outside the delivery center to retain the same income as now. I really have to think about how I'm going to fill it in. « 

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Fara Eleonora (46, nurse in the night)

« I have been self -employed for four years now. When I worked in paid employment, what I did for 25 years, I missed flexibility. After some years in a department, I noticed that I was losing my motivation and I wanted something different. A friend came up with the idea of ​​starting for myself. I initially wanted to combine my work in paid employment with work as a self -employed person, but when I indicated that I was immediately transferred to another department. Where I was going to earn less. I was not amused And I submitted my resignation. Then I started full -time as a self -employed person.

« I am a single mother and as a self -employed person I can choose to be home with my children during the weekend, during the holidays and holidays. When I was still working as a coordinator, I took my work home. Instead of being available to my children, I was making reports and preparing consultations.

« The new approach to self -employed people causes a lot of unrest. Many of my regular clients have stopped hiring self -employed people. Every week I get three to four night shifts from institutions that still dare to hire self -employed people, but it is becoming increasingly scarce. That is why I am proactively looking for other clients. I grab everything I can grab. I don't pay attention to the money, as long as I have work. I don't have any stress yet. Whatever happens: I am not going to be employed. I don't know if I will save my pension. « 

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Liesbeth Huiskamp (48, recently left care)

« I have worked as a nurse in different hospitals and a private clinic for thirty years, of which fifteen years as a self -employed person. My husband and I had four children in six years. After the third I started as a self -employed person, inspired by neighbors who did that too. It was not to me for the money, but for the flexibility. I have always played almost all services, because I don't think it is collegial as a self -employed person not to play weekend shifts. Only on Sundays I preferably didn't work. Then I prefer to be active in the church.

« As a care worker I missed appreciation. For example, I think it is very cru that a teacher earns more than a nurse. Not that a teacher does not do an important work – on the contrary. But a nurse has such irregular working hours. It's really tough. In recent years I worked evening shifts at the Emergency Department and they were so intensive that I always had to recover a day.

« The whole hassle about false independence has been the last drop for me to leave care. I just met the conditions for working as a self -employed person, but I noticed that my clients were afraid. If that had not been the case, I would have liked to stay in healthcare for a few years. These developments are not good for the sector. You are going to get shortages and the employment agencies will benefit from this. I don't know yet what I'm going to do now. First a sabbatical of six months. « 

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Reynold Pinas (65, psychogeriatric and somatic care)

« I used to want to become a medical laboratory technician, but that was not possible in Suriname. That is why I started in Healthcare in Paramaribo. It was not a conscious career choice.

« I worked full -time for a housing corporation for many years, and I made a bit of it. To be able to provide the elderly palliative care, I registered with a mediation agency 25 years ago. This required a registration at the Chamber of Commerce. In 2011 I decided to quit at the housing association and – initially for bridging, the idea was to work full -time in healthcare. But I kept hanging in it. The profession gives me a good feeling, most people are grateful for the time and attention you give them. I can't change the world, but helping people gives satisfaction.

« But sometimes I regret my choice for care. The good feeling I had first is disturbed by recent developments. More and more is being cut on staff, which means that the quality goes down. My work sometimes looks like factory work: removing people out of bed, giving food, it all has to be fast-fast. I like to provide customized care, but that doesn't always work.  »

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