Het PGB (persoonsgebondenbudget) zorgde sinds de invoering in 1996 voor een stevige innovatie in zorgland. Chronisch zieken kregen de mogelijkheid om zelf zorg in te kopen met een budget van de overheid. Daardoor ontstond de ruimte om thuis specifieke zorg te ontvangen in plaats van verplicht in een instelling. Door de invoering ontstonden initiatieven zoals de Thomashuizen, een franchiseformule waarin ondernemerskoppels een aantal gehandicapten kinderen onder de hoede nemen, en het ouderinitiatieven De Kroost, waarin ouders een eigen huis opgerichte voor hun verstandelijk beperkte kinderen.
Het PGB levert chronisch zieken drie voordelen op. Ten eerste kunnen ze zorg op maat geleverd krijgen. Het verplichte douche-uurtje behoort daarmee tot het verleden. En sterker nog, er kan zorg worden ingekocht die anders niet door een zorginstelling kan worden geleverd. Ten tweede is de zorgaanvrager zelf verantwoordelijk voor de kosten. Uit onderzoek blijkt dat aanvragers van het PGB verantwoordelijk omgaan met het budget. En ten derde hoeven geen dure instellingen worden bekostigd. Van overhead is nauwelijks sprake. Kortom, het PGB levert kwalitatief hogere zorg tegen lagere kosten.
Het kabinet Rutte ziet dat anders. Het PGB is een kostenpost en moet zo snel mogelijk worden verkleind. We moeten tenslotte bezuinigen en het succes (lees: hoge kosten) van het PGB was niet voorzien. Het argument is dat een aantal mensen voor de regeling geen aanspraak maakte op zorg – en nu wel. En dat kan natuurlijk niet, de drempel om geld te ontvangen van de overheid moet tenslotte zo hoog mogelijk liggen. Het leveren van kwalitatieve zorg is niet aan de orde.
Een ander argument is PGB-aanvragers sjoemelen met de budgetten. Het klopt dat er wel eens mee is gesjoemeld, maar gebeurt dit in elke sector? Er zijn altijd een aantal mensen die probeert te frauderen. Moeten we dan ook niet de volledige bijstand afschaffen? Het paradoxale is dat de overheid enerzijds zoveel mogelijk de autonomie legt bij de burger, maar hem anderzijds niet vertrouwd. En volgens mij is nog niet zo lang terug een schandaal aan het licht gekomen van een grote instelling, dat zijn toch andere bedragen dan een ‘individueel pgb-tje’ waarmee gesjoemeld wordt?
Of zou de gedachte zijn: ‘de instellingen staan er nu eenmaal en zijn niet van vandaag op morgen te sluiten, maar het PGB is wel makkelijk te stoppen.’ Klassiek gevalletje van kortetermijnplanning. Want uiteindelijk kost het inperken van het PBG ons alleen maar meer geld.
74 reacties
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