This report aims at: (a) providing an overview of the European policy framework for health services; (b) providing a comparative analysis of this service market across the EU; and (c) performing a comparative analysis of the situations and trends in the health care sector in the eight RE-InVEST countries, so as to identify the approaches they take to health care. Finally, we provide some policy recommendations, in order to develop a rights-based/capability-oriented approach to health care. This report mixes qualitative and quantitative research methods. First, we analyse the scientific literature and policy documents (especially documents drafted by EU institutions). Second, we perform a quantitative analysis of relevant indicators from a variety of data sets.@en

The Dutch recessions of 2009, 2012 and 2013 kicked off a series of spending cuts, which were, among others, achieved by reforms of the social security system, as well as the long-term health care system. The Netherlands placed an increasing emphasis on incentives for people to find employment, whilst access to care facilities was made more difficult, in part by making access requirements more stringent or making access more expensive. As a result, both the number of social assistance benefit recipients and the numbers of citizens having difficulties with making ends meet rose. This RE-InVEST Workpackage 6 country report analyses existing market regulations in the Netherlands reflecting social (dis)investment in relation to human rights and capabilities in five basic service sectors using two approaches. The first –a macro– approach articulates how the recent reforms in four service sector (early childhood education and care, health care, financial services and drinking water services) impacted on the Dutch population. The analyses are mostly based on a literature study, which was kicked off by our RE-InVEST sector experts and completed by the authors of this report.@en

This report provides an overview of social investment for early childhood education and care (ECEC) in Europe in general and in eight of the RE-InVEST partner countries in particular - Belgium, England, Ireland, Italy, the Netherlands, Portugal, Romania, and Scotland - employing a review of the literature, European-wide statistical analyses and two country case studies. Especially when it is high quality, ECEC has a great effect on the learning potential of all children. It is especially effective as a preventive (rather than curative) measure for disadvantaged children who risk getting stuck within the vicious cycle of intergenerational disadvantage and lower SES. It also enables paid work to be combined with parenthood and helps working mothers prevent career breaks.@en

After the Netherlands in 2009 landed in the first of three recessions, the government, which took office in 2012, announced that spending cuts had become inevitable. Government deficits and government debts were increasing and the country no longer complied with the requirements for a stable currency union in Europe. Therefore, the Netherlands has implemented substantial spending cuts which were, among others, achieved by reforms of the social security system. An increased emphasis was placed on incentives to find work, whilst access to care facilities was made more difficult, in part by making access requirements more stringent. Now that the recessions of 2012 and 2013 are also behind us, society is confronted with an increase in both the number of social assistance benefit recipients and those living at risk of poverty. Increasing numbers of citizens are having difficulties with making ends meet (payment arrears and debts). In Rotterdam, the city heading the municipal poverty list, 17.2% of the households must survive on a low income and six per cent had had a low income for at least four consecutive years. This study articulates the experiences of ten of Rotterdam’s residents who found themselves in a finan-cially vulnerable position at the beginning of this study. They shared their experiences via three group ses-sions and two in-depth interviews. It may be assumed that these experiences, within the context of the broad spending cuts implemented in the Netherlands and the resultant increases in financial problems, are relevant not only for vulnerable households in Rotterdam, but also in the Netherlands.@en

Toen Nederland in 2009 in een eerste van drie recessies belandde, konden volgens de in 2012 aangetreden VVD-PvdA regering bezuinigingen niet uitblijven, omdat overheidstekorten en overheidsschulden opliepen en onder meer niet meer voldeden aan de eisen van de stabiele muntunie in Europa. Nederland voerde omvangrijke bezuinigingen door waarbij het systeem van sociale zekerheid werd hervormd. Er kwam een sterkere nadruk te liggen op het stimuleren van werken en het moeilijker maken van de toegang tot zorgvoorzieningen mede door het aanscherpen van de voorwaarden. Met de recessies van 2012 en 2013 ook achter de rug, zijn in de praktijk de aantallen uitkeringsontvangers toegenomen en is ook de armoede gestegen. Het aantal mensen dat moeite heeft om de eindjes aan elkaar te knopen (betalingsachterstanden, schuldtoename) stijgt. In Rotterdam, de stad die de gemeentelijke armoedelijst aanvoert, moet 17,2% van de huishoudens met een laag inkomen rondkomen, en zes procent had tenminste vier jaar achtereen een laag inkomen. Dit onderzoek verwoordt de ervaringen van tien Rotterdammers die in een financieel kwetsbare positie leven. Deze participanten deelden hun ervaringen in drie groepssessies en twee diepte-onterviews. Aangenomen mag worden dat deze - in de context van bezuinigingen die in Nederland in den brede zijn doorgevoerd met als gevolg een toename van financiële problemen en armoede - een inkijk geven in de positie van financieel kwetsbare huishoudens, niet alleen in Rotterdam, maar ook meer algemeen in Nederland. Als analysekader gebruiken we de capability benadering, mede op basis van algemeen aanvaarde mensenrechten die de belangrijkste criteria van welzijn en goed leven uitdrukken. Capabilities geven de mogelijkheden of vrijheden van mensen weer om te kiezen voor een bepaald leven rekening houdend met de beschikbare middelen, de vaardigheden en de sociale normen en instituties.@en