2023-08-10 16:52:03
If you do not work because you have cancer, you will not receive a childcare allowance from the Tax and Customs Administration. As with home care, the municipality can then offer help. But that local approach causes incomprehensible differences, victims say to NU.nl.
There are various ‘pots’ at municipalities for home care and childcare allowance. The first is regulated by the Social Support Act (Wmo). The second is possible via a Social Medical Indication (SMI).
This allows municipalities to (temporarily) relieve families who are unable to care for their children for medical or social reasons by (partially) covering the costs of childcare.
“Being sick is really expensive too,” summarizes Cat Rose-Tran. In 2020, she was found to have breast cancer a few months after giving birth. “Being sick was just more than a full-time job. But not paid.”
After a tip from a friend and with a recommendation from the clinic – where she went with her newborn son – her SMI application was approved. She is “incredibly grateful” to her municipality and the consultation office, because her municipality has often extended the SMI.
How customization creates randomness
The Association of Dutch Municipalities (VNG) explains that the SMI is specifically intended for people who fall outside “direct legislation”. The national government deliberately imposes little so that municipalities are given the freedom to determine what citizens need.
But in practice this creates arbitrariness. In one municipality people are entitled to a maximum of four half-days of childcare, in another there is no maximum. In some municipalities the reimbursement is unlimited, in others it stops after a number of months. Some municipalities have income limits, others do not. It is also possible that an SMI application will be rejected if the funds run out.
“It is of course a bit strange that it matters where you live if you get sick in the Netherlands,” says experience expert Cathelijne Palmboom.
According to Palmboom and Rose-Tran, the fact that it matters in which municipality you live also applies to extra help at home, which is arranged through the Wmo. At Palmboom, the application was rejected, while a fellow sufferer from Tilburg in a similar situation did receive home care. “If your partner falls over, we can arrange something”, was the message. That happened to Rose-Tran, then she got an extra hour.
Now Palmboom also has home care, because someone from the municipality came by for another request for help. That person was surprised that the application was rejected and made inquiries. “Since then I have Wmo.”
‘It matters who you get on the line’
If you call the council and you get someone who won’t help, hang up and call again, advises Rose-Tran. According to her, it matters which official you get on the line. If you don’t fit the rules, it’s about whether the person on the other end is willing to give you “a extra mile to walk. It is and remains human work.”
How many SMIs are issued annually or how much money this costs on average is not centrally recorded. A research from the Ministry of Social Affairs and Employment from 2020 comes closest to that. The investigation was started after signals that the SMI is not sufficient in all cases and that there are (too) strong differences between municipalities.
Municipalities suspect that there is not enough SMI budget available. According to them, it would help if the government provided clarity about the available budget. However, it is not logical for the government to make statements about this, because the implementation and the choice are in the hands of the municipalities.
As a result of the report, no adjustments have been made to the SMI, the ministry said. However, families in which a parent has a permanent or temporary Long-Term Care Indication Act have been entitled to childcare allowance since that time.
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Still signals of arbitrariness
In the years following the study, signals of arbitrariness and rejected applications continued to be received by the patient organization Stichting Jongeren en Kanker. According to chairman Anneke Eikelenboom, it is comparable to Russian roulette. “I think it really feels that way to people.”
If you stop working because of cancer, you will first receive a childcare allowance from the Tax and Customs Administration. If that stops at some point, it is not 100 percent sure whether the municipality can take over. “If the jar is empty, then you’re just out of luck,” says Eikelenboom. “I get this signal several times a year.”
“You can’t pause childcare,” Rose-Tran explains. If you don’t have enough savings to bridge the time, “then you just lost your place”. The same applies to an extension request. That creates a lot of extra stress for families. “The relationship is under enormous pressure,” says Palmboom. “Everyone walks on their gums.”
An off-the-cuff calculation shows that every year 150 families have to deal with some form of benefit because one of the parents has cancer. But according to Eikelenboom, the group could be even larger. In principle, anyone who is declared (partially) unfit for work can rely on help from the municipality: from rheumatism to post-covid patients. Everyone, the network for people with a disability or chronic illness, does not receive any signals about this.
There does not seem to be a simple solution to arbitrariness within the SMI, because freedom is precisely the core of the regulation. There are other possibilities. For example, Palmboom thinks it is logical if childcare is arranged nationally, so that it does not matter where you live.
VNG wants free childcare for everyone
The VNG advocates free childcare for everyone. “If childcare becomes a public facility that is accessible to all children, regardless of whether your parents have a paid job, correction schemes such as the SMI, but also the VVE (VVE stands for early childhood education and concerns measures to prevent educational arrears , ed.) no longer necessary.”
A plan for this was deleted from the coalition agreement. The VNG advises the next cabinet to work on this.
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