Boer & Croon/Public SPACE Congress National Foundation for Homecare 8th June 2001 Drs. S.P.M. de Waal Strategic management in homecare

1 0.1/RPC/AAAAA The current steering of care  Lots of regulation, little room for maneuver at a decentral level  Planning of supply independent of the demand for care  Scarcity orientated and designed with frugality due to non- care related political reasoning (i.e. limiting the collective burden)  Sector itself is extremely collective  Increasing public sceptisism  Demotivated personnel  Systemic changes occur too slowly  New policy is ‘too little, too late’

2 0.1/RPC/AAAAA Strong forces affect the system More private money requires more private differentiated entrepreneurship Care is not only cost but also investment: Employers Prevention Modern patient wants different type of care (consumerism) Competition on the labor market is fierce Real purchasing power for care is increasing: Pensions New pensionplans Current steering of care

3 0.1/RPC/AAAAA Macro-scenario’s according to the DNA-model In a growth market there are few losers Now is the time to choose!!! SystemMarket  Muddling through  Chaos & turbulence  “Planned” change  “Blueprint” change  Having to fight for personnel  Having to fight for health insurers  Having to fight for the client

4 0.1/RPC/AAAAA Split personality management Growth Demand Scarcity Provision  Willing care insurers  Private initiatives  Widening offer of products  Emergence of concurrenten  Increase of collective premium  Explaining painful rationing  Managing workload  Standaardization/ McDonaldization  Personnel more important than clients and quality Monopolist: ‘Customers will come, regardless’ Domain keeper: ‘If you can’t beat them, join them’ Innovator: ‘There are always opportunities’

5 0.1/RPC/AAAAA Wat can we learn from Dutch railway reform? Privatizing too early, too quick while carrying over public scarcity and restrictions ProCon  Increasing profitability  Citizen Charter  Portfolio strategy (public/private national/international)  Redefining core- competencies  Loosing support of fanclub  Having to be listed on stock exchange  Corporate PR/legitimization  Communication with travellers  Neglecting lobbing with government  Management indured damage to public image

6 0.1/RPC/AAAAA Strategic advice Merge only with powerful parties unless there is both public need and goodwill to do different Make extremely small-scale, flexible structures with top-of- the-line ICT Communicate rationing policy and responsible entrepreneurial actions Avoid pathological entwining of organization (I.e. the downside of the Dutch “Polder”model) Systematic creation of competitive benefits (people, reputation, systems, embedding) Be in touch with demand (-developments), more so at least than the care insurers