Successful Integration Process
Blog by Lucas S.
Introduction
Migration is and has been a controversial topic of political discussion in the Netherlands these past years. With a population of nearly 18 million people (17,93) as per 30 October 2023 according to the central bureau of statistics (Centraal Bureau voor de Statistiek, 2023), the population density per square kilometre reaches an astonishing number of 529 people per square kilometre (Vzinfo.nl & CBS-StatLine, 2023), with some urban areas having more than 2000 inhabitants per square kilometre.
In accordance with the current prognosis, the Dutch population will continue to expand to 20,7 million inhabitants by the year 2070. The Dutch population will mostly increase due to immigration and an expended life expectancy (Centraal Bureau voor de Statistiek, 2023). So, migration currently is and will be playing an important role for the Dutch society. Migration gets a lot of news coverage by the Dutch media.
To evaluate the impact of immigration on my own field of studies (nursing) and the future workforce in my country I did some research about Dutch immigration. The next paragraphs present my findings.
Statistics
The five most common countries from where immigrants arrive in the Netherlands are Turkey, Morocco, Suriname, Dutch Caribbean, and Indonesia. From all of the 15 to 75-year-olds in the working population with a Dutch background only 2.7 percent were unemployed. This is less than among those with a Western migration background (4.0 percent). The unemployment rate among people of non-Western background (6.0 percent) is highest in the Netherlands (Centraal Bureau voor de Statistiek, 2021).
Motives
People have different reasons and motives for coming to live in the Netherlands. For example, labour migrants come to the Netherlands to work, and study migrants follow training in the Netherlands. According to European law, all EU/EFTA citizens can work in an EU country without a work permit (Centraal Bureau voor de Statistiek, 2023a).
The reasons for migrating to the Netherlands can vary depending on where a migrant comes from. In 2021, work was the most common reason for migration for 38,860 immigrants from the EU/EFTA. For 29,350, family was the reason for migration. For 21,125 EU-EFTA citizens, study was the reason for going to the Netherlands. For 28,240 EU/EFTA citizens it is not known for what reason they immigrated to the Netherlands. Among non-EU/EFTA citizens, family was the most common reason for migration for 29,615 people. Asylum (21,505 people) and study (18,465 people) were also important reasons for people outside the EU/EFTA to migrate to the Netherlands (Centraal Bureau voor de Statistiek, 2023a). For non-EU/EFTA citizens family, asylum and studies were the most common reason to move whereas work and family were the most common reason to move for EU/EFTA citizens.
So now the question is how the Dutch society can make optimal use of these immigrants while taking their wishes into consideration.
Immigration Related to Healthcare
In the Netherlands, there is a healthcare crisis going on. With an increasing amount of the population that is getting older the demand for healthcare is increasing faster than the economy and the labour force can keep up. And for several years there has been a shortage of healthcare personnel.
The Dutch government wants to increase the amount of healthcare workers in a short amount of time to keep up with the demand of care (Ministerie van Volksgezondheid, Welzijn en Sport, 2022). For the Dutch government to make this goal a reality the government has conducted research about how the Dutch healthcare system can be future-proofed. Their findings and advice have been published online (Ministerie van Algemene Zaken, 2022).
The three takeaway points to future-proof the Dutch healthcare system is: financial sustainability, social sustainability, and personnel sustainability. Financial sustainability focuses on expenses the Dutch government makes in the healthcare sector. Considering the demographics and technological developments, it is expected that healthcare expenditure will increase faster than economic growth in the future.
So predicts the Dutch government (RIVM) in a preliminary study. It is predicted that healthcare expenditure will continue to rise by an average of 2.8 percent per year until 2060, compared to the 1 to 1.5 percent volume growth for the economy as a whole. This is mainly because of the stagnation of the productivity in the Dutch healthcare sector.
According to the Dutch government (Ministerie van Algemene Zaken, 2022) there are only 3 solutions available on how to subsidize these increasing expenditures:
– (1) reducing the share of other public expenditure by the government
– (2) increasing the collective tax burden
– (3) increasing the national debt
The “TAZ” programme focuses on personnel sustainability. “TAZ” has been started in 2022. “TAZ” is short for “Toekomstbestendige Arbeidsmarkt Zorg & welzijn” which translates to “Future-proof Labor Market Healthcare & Welfare”. The percentage of people working in the Dutch healthcare system has increased since the early 1970s from 7 to more than 15 percent.
Momentarily about one out of every seven employees in the Dutch labour force works in the healthcare sector. In about forty years this should be one in three employees to be able to meet the healthcare demand. It is therefore imperative that the people that work in the healthcare sector stay as employees in the healthcare sector. Personnel sustainability focuses on this point (Ministerie van Algemene Zaken, 2022).
To keep healthcare workers within the Dutch healthcare system some changes for healthcare workers have been proposed. These are, for example, that employees are already involved in healthcare innovations during the training, that there is good internship guidance and an attractive (learning) work program that allows them to do what they have been trained to do they are given the opportunity to develop further, so they spend less time on it administrative burdens, that they have access to new working methods and technology to increase job satisfaction and that they have a say in the way the work is done equipped. All this contributes to ensuring that the healthcare and welfare sector is, and remains, a good sector to work in.
Social sustainability focuses on the views the Dutch population have about the healthcare system and how much they are willing to pay for their healthcare. In the Netherlands insurance is mandatory. If insurance prices rise people are forced to pay the fees and will be dissatisfied. Social sustainability is the general opinion about the healthcare (e.g., accessibility and quality) and the financial support the Dutch population can (and wants to) give to their healthcare system.
Personal Thoughts
Can immigration contribute to financial, social, and personnel sustainability? Let us explore the options together. Firstly, as mentioned in the “Immigration related to healthcare” paragraph, it is important to maintain the personnel sustainability by keeping personnel working in the healthcare sector and attracting new healthcare workers.
Why is it, with an estimated shortage of 130.000 healthcare workers in the healthcare labour force by 2023, so hard for immigrants to find work in the healthcare sector? This is often due to the processes immigrants need to take part in. For example, immigrants waiting for their asylum application are not allowed to start working quickly and are not sufficiently guided towards suitable work or training that is compatible with work in healthcare.
People who worked abroad as doctors or nurses often must go through a complex and expensive process in the Netherlands. For doctors trained outside the European Economic Area (EEA), this process takes at least four years. Besides, once at work, migrants who work in healthcare have to get used to the culture in the workplace.
It is important for the quality of care, team spirit and the effectiveness of the healthcare workers to have systems in place that check the proficiency and skill of migrant healthcare workers before they enter the Dutch healthcare workforce. Jeopardizing the quality of care, team spirit or the productivity of healthcare workers by hiring unqualified, unintegrated, and unskilled migrant healthcare workers would result in the degradation of the Dutch healthcare system.
However, there might be a way for migrant healthcare workers to start working in the Dutch healthcare quicker and with less administration. I would recommend for the Dutch government to do research in streamlining the process for migrants that want to work in the Dutch healthcare sector. Check for example if the government can accelerate and simplify the process of recognizing foreign diplomas. There might be other countries (like America, Canada, Australia, and New Zealand) where the quality of care might be comparable with the Dutch quality of care. Also, since these are considered western countries, some of their healthcare policies and protocols will be based on western research institutes. Not to mention that the western culture is the most prevalent in the
Netherlands, therefore the culture shock for non-European immigrants with a western culture might be less extreme than for non-western immigrants.
Secondly, what if the productivity can be increased in the healthcare sector? By increasing the productivity of healthcare personnel less people need to work in the healthcare sector and unnecessary expenditure can be prevented. Immigrants can share ideas and technology might increase productivity.
Therefore, high-skilled healthcare immigrants that can work in or contribute to the Dutch healthcare sector could be a part of the financial sustainability point. Therefore, it is important to differentiate between “high skilled” and “low skilled” immigration. Some high skilled immigrants might get more prioritization than others to keep the Dutch healthcare system working. Since some immigrants already get more advantages than others my estimate would be that this should be legally possible.
Giving good guidance to immigrants is the key not only to get them to work in the healthcare sector, but also for good integration and participation in society. Proper financial, language, cultural and psychological aid should be provided so people feel safe and at home. I am convinced that helping your fellow human is a moral obligation we all share.
Sources
Centraal Bureau voor de Statistiek. (2023, October 30). Bevolkingsteller. Centraal Bureau Voor De Statistiek. https://www.cbs.nl/nl-nl/visualisaties/dashboard-bevolking/bevolkingsteller/
Centraal Bureau voor de Statistiek. (2023a, January 3). Hoeveel immigranten komen naar Nederland? Centraal Bureau Voor De Statistiek. https://www.cbs.nl/nl-nl/dossier/dossier-asiel-migratie-en-integratie/hoeveel-immigranten-komen-naar-nederland
Centraal Bureau voor de Statistiek. (2021). Werkloosheid naar migratieachtergrond. Centraal Bureau Voor De Statistiek. https://www.cbs.nl/nl-nl/visualisaties/dashboard%20arbeidsmarkt/werklozen/werkloosheid-naar-migratieachtergrond
Hoorntje, R. (2023, July 4). Meer immigratie dan ooit: wie komen er naar Nederland? NOS. https://nos.nl/artikel/2481473-meer-immigratie-dan-ooit-wie-komen-er-naar-nederland
Ministerie van Algemene Zaken. (2022, June 22). Kiezen voor houdbare zorg. Mensen, middelen en maatschappelijk draagvlak. Rapport | WRR.
https://www.wrr.nl/publicaties/rapporten/2021/09/15/kiezen-voor-houdbare-zorg
Ministerie van Volksgezondheid, Welzijn en Sport. (2022, October 20). Programma
Toekomstbestendige Arbeidsmarkt Zorg en Welzijn. Rapport | Rijksoverheid.nl. https://www.rijksoverheid.nl/documenten/publicaties/2022/09/30/programmatoekomstbestendigearbeidsmarktzorgwelzijn
Niewold, M. (2023, October 28). Van asielstop tot spreiding: dit willen partijen met migratie. RTL Nieuws. https://www.rtlnieuws.nl/nieuws/politiek/artikel/5414701/van-asielstop-tot-spreiding-dit-willen-politieke-partijen-met
Vzinfo.nl & CBS-StatLine. (2023, October 9). Bevolking | Regionaal. www.vzinfo.nl. https://www.vzinfo.nl/bevolking/regionaal
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