PGGM, the Dutch healthcare and social work sector pension fund, and UWV, which operates the Dutch government’s social security schemes, founded in 2003 ‘Care for Work’, a pilot project with the aim of assisting and improving the reintegration of disabled healthcare workers. The project has three specific common goals: to achieve a substantial saving in disability costs (fewer invalidity pensions and contribution exempt members); to make more labour available to the sector, which will require experienced staff to resolve its long-term labour problems, and to identify the most effective ways of getting disabled employees back to work.
PGGM says the project is unique and outlines several reasons for this. It is driven by the common interests of PGGM and the Dutch government as well as designed to bring about substantial reductions in pensions contributions by PGGM and benefits costs by UWV. Its focus is on a specific group of disabled people within a single sector, healthcare and social work, to facilitate tailor-made solutions and is designed to address the sector’s long-term labour issues. It enjoys optimum involvement on the part of PGGM’s sector employers and uses the latest and best reintegration techniques. It has a major trial involving around 5,000 disabled people.
PGGM says the pilot scheme’s initial target was to get 450 disabled people from the 5,000-strong test group back to work, thereby saving PGGM on average €33,000 per person, the government €170,000 and the employer €16,000. The actual results however show the actual savings are exceeding the target by a factor of over 1.5, giving a net total value of some €22m.
PGGM says an employee who falls ill or becomes unfit for work costs money and productivity, with the employer obliged to pay all or most of the salary for the first two years. Thereafter, the employee receives the basic state disability benefit alongside a supplementary benefit from PGGM, which also pays the contributions whilst the employee is absent. If the incapacity continues beyond the two-year period, the employer pays an additional disability benefit contribution for the following five years. Hence, helping disabled employees return to work saves money for the government, PGGM and for the employer or former employer. Furthermore, PGGM points out that the healthcare and social work sector in the Netherlands has over 85,000 employees with a long-term illness or disability and, given the characteristics of the group, PGGM believes targeted efforts can be effective in reducing this number. Overall, disability and invalidity payouts in this sector amount to €7bn for the government and €443m for PGGM but it is a relatively small group of 20,000 disabled employees that take the bulk of the benefits and this group remains attractive to the labour market in terms of both age and education.
Still a pilot project, PGGM selected 5,000 from the aforementioned 20,000 disabled employees with UWV contacting them thereafter to explore the opportunities of reintegration. To help determine the most effective approach, the group was spread over five different regional projects with a different method, aimed at finding suitable permanent jobs, being adopted for each project. If successful, any one of these methods could be rolled out nationwide and involve much greater numbers – over 85,000 – of disabled employees.

A project website provides up-to-date information, news and results, and several brochures have been produced for employers, disabled employees and other groups involved in the project. Regional information meetings are also organised to keep local employers abreast of developments. PGGM says many employers still do not fully understand the value that this group of people, who are exceptionally motivated to return to work and who have considerable experience, can add to their organisation and can be sceptical about taking on someone who is not fully fit.
Running the project involves over 120 people with UWV responsible for primary reintegration, such as intake, intervention and support, and PGGM organisation, communication and evaluation. There is a steering group watching over their joint interests.
PGGM says the results up to mid-2004 have been good, though no conclusions can yet be drawn about the effectiveness of the different methods it is using. All methods appear to be working and clients appear satisfied with actual savings over 1.5 times higher than predicted. All that remains is to determine which method will be used nationwide, not just in the healthcare and social work sector but beyond.

Highlights and achievements
The highly ambitious ‘Care for Work’ scheme is a carefully planned and structured scheme that could potentially save the Dutch government millions as well as change the attitudes of thousands of employers and disabled people about just how effective this group can be in the economy.
PGGM’s scheme is unique and could ultimately save the government e7bn and e443m for PGGM itself as well as take care of the reintegration of some 85,000 employees with a long-term disability or illness.
Still in its infancy, the structure of Care for Work allows PGGM to play with several different reintegration techniques spread around the country with a limited target population. Such has been the plan’s success that PGGM says all the techniques are working, all parties are satisfied and savings are already 1.5 times higher than predicted. Furthermore, all the partners concerned are confident the scheme will go beyond just catering for the reintegration of the disabled in the healthcare and social work sectors in the Netherlands and will be applied to other sectors.

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