The Belgian union representing home nurses, ACV Puls, has called for a fairer pay system in home care.
According to ACV Puls sector representative Arne Deflo, the current system is outdated and arbitrary.
The union voiced these concerns following a major fraud scandal involving a home nurse in Houthulst, which has brought the pay structure in home care under scrutiny.
Currently, home nurses are paid per task, with the value determined by the Katz scale based on the patient’s abilities.
Deflo highlights that many tasks performed by home nurses are not included in this system, leading to unpaid work becoming a structural part of the profession.
ACV Puls advocates for an hourly pay system instead.
They suggest this approach would ensure fair compensation for longer visits to patients with significant care needs, in comparison to multiple short tasks such as administering insulin.
Furthermore, the union believes this system would make it easier to account for unpaid administrative work, which both self-employed and employed nurses often handle outside of their working hours.
A more transparent pay system could create fairer conditions for all home nurses, says ACV.
Deflo stresses that despite recent scrutiny fuelled by the Houthulst scandal, the vast majority of home nurses work ethically and provide excellent care for their patients.
The White-Yellow Cross, a leading home care organisation, echoed this sentiment, urging for an end to the "witch hunt" targeting the profession.
The National Institute for Health and Disability Insurance (RIZIV) has also questioned whether the current methodology is due for an overhaul.
It plans to launch a pilot project in March 2026 to test a new pay structure. ACV Puls is encouraging home nurses to volunteer for the study.
