Outsourcing within the healthcare sector; comparing Belgium and The Netherlands
I recently red an article in a Belgium newspaper (‘De Morgen’) in which labour unions successfully blocked the proposed outsourcing of sterilisation services of hospital AZ Groeninge. After several weeks of protests by employees and labour unions the management of AZ Groeninge decided that outsourcing was off the agenda, now and in the future. Even though only 30 people were in scope of the outsource engagement did the management have no other choice but to kowtow to the workers and walk away from the idea.
In this post I want to write about two little countries within continental Europe, which share almost half their borders, but are different in many ways. One the differences is the way elements of market capitalism are adapted and outsourcing/shared services is used to improve effectiveness and efficiency. For those non-European suppliers who want to get a foothold here in Europe, it provides an idea of the complexity and cultural differences of the 20+ countries that make up the European Union (I could make it even more complex by including that there is no homogenous Belgium in terms of language and culture, but three different sub-area’s all using their own language and having their own culture, but I won’t do that as only Belgians themselves can really understand and appreciate their political and cultural complexity).
Anyway, outsourcing and shared services within Belgium is not a very popular subject within any sector that is (semi) government related. Outsourcing in the profit sector can however enjoy good adaptation levels with 76 % of respondents in an E&Y research (2008) outsourcing maintenance activities, 73% logistics and 68 % IT.
Where it comes to outsourcing and government Belgium however follows more the sentiments in France where politicians also find it hard to sell and implement the idea that the social welfare system created in the last 40 years becomes way too expensive to maintain and has to be amended. This also explains the higher penetration/support of labour unions among workers in Belgium compare to The Netherlands (plus Belgium has more blue collar workers than us, we have a more service oriented economy).
The role of politicians
The difference in views on outsourcing starts with the politicians. Where in the Netherlands the majority of the politicians see outsourcing and shared services as a useful means to improve productivity and is widely deployed, see many Belgium politicians it as a threat. There its is part of a trend leading to a more ‘commercialised’ healthcare and this is something many politicians with a socialistic background are against. This means that key figures of several political parties where marching among the workers of AZ Groeninge when they were demonstrating against the proposed outsourcing.
The result is that only a couple of Belgian government related organisations were able to outsource activities, including Belgacom (telecom) and the Vlaamse overheid (Flemish government). To pull this off the management teams had to spend a LOT of time with labour unions and workers counsels.
In the Netherlands is outsourcing and shared services a much more widely embraced phenomena at all government levels (from the Ministry of Defence to small local governments) and is it very rare that government workers organise strikes and marches to prevent them being outsourced. Some outsource examples from the Dutch heath care sector: hospital Viecuri in Venlo outsourcing the preparation of warm meals; Hospital Emmen outsourcing its logistics, AMC in Amsterdam outsourcing its logistics and sterilisation and Accounting Plaza providing financial services to Mediq, Leids Universitair Medisch Centrum and Rode Kruis Hospital.
What helped within the Netherlands was new legislation which allowed for profit and government organisations like hospitals to work together. These changes have been implemented only quiet recently so I expect more outsourcing and shared service related activities within the near future. Within Belgium the politicians are for the time being too busy discussing over the future of Belgium itself to have any time for serious reforms of their (healthcare) system.
My advise to foreign suppliers
For those foreign ITO and BPO suppliers aiming to penetrate the European health care market and wondering whether to start in The Netherlands or Belgium/France: the safest bet for now is The Netherlands, but do not forget that everything has to be in Dutch. No English allowed. Not a single word (I'm not kidding on this one). So teaming up with a local player or investing in setting up a local front office is the only way to penetrate this (lucrative and growing) market.
Still want to go for the Belgium market, please do but do not forget that every document there has to be in Dutch and French (and in the eastern parts of the country also in German). So make sure to include a reservation in your business plan for language lessons...
In this post I want to write about two little countries within continental Europe, which share almost half their borders, but are different in many ways. One the differences is the way elements of market capitalism are adapted and outsourcing/shared services is used to improve effectiveness and efficiency. For those non-European suppliers who want to get a foothold here in Europe, it provides an idea of the complexity and cultural differences of the 20+ countries that make up the European Union (I could make it even more complex by including that there is no homogenous Belgium in terms of language and culture, but three different sub-area’s all using their own language and having their own culture, but I won’t do that as only Belgians themselves can really understand and appreciate their political and cultural complexity).
Anyway, outsourcing and shared services within Belgium is not a very popular subject within any sector that is (semi) government related. Outsourcing in the profit sector can however enjoy good adaptation levels with 76 % of respondents in an E&Y research (2008) outsourcing maintenance activities, 73% logistics and 68 % IT.
Where it comes to outsourcing and government Belgium however follows more the sentiments in France where politicians also find it hard to sell and implement the idea that the social welfare system created in the last 40 years becomes way too expensive to maintain and has to be amended. This also explains the higher penetration/support of labour unions among workers in Belgium compare to The Netherlands (plus Belgium has more blue collar workers than us, we have a more service oriented economy).
The role of politicians
The difference in views on outsourcing starts with the politicians. Where in the Netherlands the majority of the politicians see outsourcing and shared services as a useful means to improve productivity and is widely deployed, see many Belgium politicians it as a threat. There its is part of a trend leading to a more ‘commercialised’ healthcare and this is something many politicians with a socialistic background are against. This means that key figures of several political parties where marching among the workers of AZ Groeninge when they were demonstrating against the proposed outsourcing.
The result is that only a couple of Belgian government related organisations were able to outsource activities, including Belgacom (telecom) and the Vlaamse overheid (Flemish government). To pull this off the management teams had to spend a LOT of time with labour unions and workers counsels.
In the Netherlands is outsourcing and shared services a much more widely embraced phenomena at all government levels (from the Ministry of Defence to small local governments) and is it very rare that government workers organise strikes and marches to prevent them being outsourced. Some outsource examples from the Dutch heath care sector: hospital Viecuri in Venlo outsourcing the preparation of warm meals; Hospital Emmen outsourcing its logistics, AMC in Amsterdam outsourcing its logistics and sterilisation and Accounting Plaza providing financial services to Mediq, Leids Universitair Medisch Centrum and Rode Kruis Hospital.
What helped within the Netherlands was new legislation which allowed for profit and government organisations like hospitals to work together. These changes have been implemented only quiet recently so I expect more outsourcing and shared service related activities within the near future. Within Belgium the politicians are for the time being too busy discussing over the future of Belgium itself to have any time for serious reforms of their (healthcare) system.
My advise to foreign suppliers
For those foreign ITO and BPO suppliers aiming to penetrate the European health care market and wondering whether to start in The Netherlands or Belgium/France: the safest bet for now is The Netherlands, but do not forget that everything has to be in Dutch. No English allowed. Not a single word (I'm not kidding on this one). So teaming up with a local player or investing in setting up a local front office is the only way to penetrate this (lucrative and growing) market.
Still want to go for the Belgium market, please do but do not forget that every document there has to be in Dutch and French (and in the eastern parts of the country also in German). So make sure to include a reservation in your business plan for language lessons...
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