Blind to a Known Future — Statecraft

Executive Summary

By 2040, a quarter of the Dutch population will be older than sixty-five. That is roughly 4.8 million people. The figure has been available in essentially unchanged form since 2010 at CBS, SCP, WRR and RIVM. The housing stock has not been adapted to it. The healthcare labour market has not been scaled up to meet it. The Long-term Care Act (Wlz) budgeting remains reactive. The mobility and amenities architecture in ageing regions has been built around the old population curve. Four files, one shared institutional condition: a structural blindness to futures that are entirely knowable.

This signature essay names the pattern behind five earlier reverberations. Dutch public administration rarely fails against what it could not have known. It fails against what it has long known. The diagnosis is administrative, not technical. The control horizon of an average minister, around four years, fundamentally does not fit planning horizons of fifteen to thirty years. The rotation of the Senior Civil Service (ABD) shortens the ownership horizon of senior officials to a term shorter than the lead time of many investment decisions. The planning and control cycle forces budgeting into annual instalments that make anticipation technically impossible. The way forward calls for a redesign of ownership, not for better forecasting tools. There is no shortage of those.

§ 01 A Familiar Number

In June 2010, Statistics Netherlands (CBS) published a population projection in which the share of those aged sixty-five and over in 2040 was estimated at roughly a quarter of the Dutch population. The most recent version, the Core Projection 2025-2070, gives the same figure essentially unchanged: 25 percent in 2040, with further rise to 26 percent by 2070.¹ Between those two publications lie fifteen years, six cabinets, three Ministers of Health, and four Ministers of Housing. During that period the figure was not contested, not revised, and not unexpected. It is, in every sense of the term, a known future.

In the same period, the Dutch housing stock has barely been delivered with life-cycle accessibility. The healthcare labour market has not undergone anticipatory scaling: in 2026 over fifty thousand healthcare vacancies are structurally open, and the shortage is growing faster than the inflow.² Wlz budgeting is increased year on year in response to overruns, not in anticipation of the demographic distribution that has long been settled. In the regions where ageing is most pronounced, Zeeuws-Vlaanderen, eastern Groningen, southern Limburg, the Achterhoek, the level of services is shrinking at roughly the inverse rate of what the population composition demands.³

What is striking is not the figure. It is the absence of administrative movement against a figure that has been on the table for half a generation. That absence has no technical cause. It is institutional.

§ 02 The Pattern Behind the Earlier Reverberations

The five preceding papers in this series each described a separate reverberation of institutional dissociation into society. The Illusion of Capacity dealt with physical space as an institutional description of peaks in time and place. The Silent Expropriation with a shift in ownership across seven sectors at once. The Citizen Without Recourse with a constitutional state that works in every link and is impenetrable as a whole. The Pressure on the Weakest with cost shifting between domains that lands selectively on those least able to organise. The Vanishing Fabric with a social substrate that does not appear as a target variable in any of the separate policy frameworks.

Five domains, five mechanisms. And one shared time signature that becomes visible the moment the papers are placed alongside one another: in each file, the core development was known years in advance, and in each file public administration did not scale up on that knowledge. The housing-market impact of the Box 3 wealth-tax reform has been modellable since the Supreme Court ruling of December 2021. The income drop on the transition from the Wajong disability scheme to social assistance has been documented in SCP evaluations since the Participation Act came into force in 2015. The erosion of social fabric in car-light new-build neighbourhoods has been known in the literature since Jane Jacobs in 1961. The lack of legal protection for sub-national governments against evident errors in advisory chains has been signalled in evaluations of the Joint Arrangements Act (Wgr) for two decades.

The pattern that runs through the five papers is not a lack of forecasting. It is a lack of organisational memory capable of holding a forecast beyond the next cabinet change. What was described in each individual paper as sectoral failure proves, on aggregation, to be a time signature: structurally short-sighted action against structurally knowable outcomes.

§ 03 Four Files, One Signature

The four files in which the demographic projection cuts deepest illustrate the mechanism.

Housing stock without life-cycle accessibility. The CBS figure for 2040 was already available in 2010. The average lead time between a housing decision and delivery in the Netherlands lies between six and twelve years, depending on procedural weight. Anyone who had read the demographic curve seriously in 2010 could have tilted the composition of new construction from 2015 onwards toward a higher share of accessible, single-storey homes near amenities. That did not happen. Production between 2015 and 2025 was largely focused on closing the absolute housing shortage, not on the composition mismatch that unfolds after 2030. The stock with which the Netherlands enters 2040 is largely already built. The margin for correction is now limited to what can still be added in ten years. The choices not made then will, in fifteen years, deliver a housing stock that by definition does not fit its residents.

Healthcare labour market without anticipatory scaling. The Netherlands Scientific Council for Government Policy (WRR) calculated in 2021 that, without structural change, by 2040 one in four working people will need to work in healthcare to meet demand, rising to one in three by 2060. The current ratio is one in seven.⁴ The figure was no surprise. The arithmetic of ageing multiplied by care intensity per age cohort is a calculation that takes ten minutes. The Ministry of Health has been publishing annual labour-market projections since 2018 that, within margins, show the same pattern. Scaling up vocational and applied-sciences healthcare programmes, practical supervision, international recruitment, and care-technology implementation, requires a lead time of eight to twelve years before the first cohort of new entrants noticeably eases the workload. Anyone starting in 2026 delivers capacity around 2034. Actual scaling since 2018 lies structurally below what the projection requires. The shortage that will bite in 2030 can no longer be closed.

Reactive Wlz budgeting. Pressure on the Long-term Care Act manifests itself in two ways at once: in rising expenditure, and in a waiting list which, despite a recent slight decline, holds structurally above the threshold of twenty thousand persons. On 1 January 2024, 21,762 people with a Wlz indication for nursing and care were on the waiting list, out of a total of nearly 194,000 indications. More than ninety percent of them were already receiving bridging care at that moment.⁵ A year later, on 1 January 2025, the waiting list had fallen to 19,971 persons, a slight improvement that should not be read as structural: in July 2025 the figure was already back to 20,304.⁶ Counting the so-called precautionary waiters, a group of nearly twelve thousand people waiting at home without an active intake request, brings the figure even to over thirty-one thousand persons in view at the regional care-purchasing offices.⁶ Compared to January 2020, when ActiZ recorded a nursing and care waiting list of 18,600, the waiting pressure has therefore risen by roughly ten percent in five years, an increase that appears modest, but takes place against a backdrop of substantial capacity expansions and intensification of home-based care.⁷

At the same time, Wlz expenditure is growing at a pace that comfortably outstrips macroeconomic growth. Gross Wlz spending rose from 19.5 billion euro at the introduction of the act in 2015 to 25.6 billion in 2020, and according to CBS to 33.7 billion in 2024 in Wlz benefits alone.⁸ In 2024, Wlz expenditure rose by eleven percent according to CBS.⁹ The Ministry of Health and the Court of Audit confirm this picture: real growth of net Wlz expenditure was 7.1 percent in 2024, well above real GDP growth of around two percent.¹⁰ Cumulatively, the Wlz budget has nearly doubled in nominal terms in ten years, while GDP grew by roughly half over the same period. Projections for the coming decades confirm the sustainability question. The WRR calculated in 2021 that the care quote for the Wlz alone rises from 2.6 percent of GDP in 2019 to 5.1 percent in 2040, a doubling that is unsustainable absent sharp choices.¹¹ The Interdepartmental Policy Review Doing Nothing Is Not an Option estimates that expenditure on elderly care, under unchanged policy and constant prices, will rise from 20.0 billion euro in 2021 to 39.3 billion euro in 2040.¹² The Ministry of Health budget regime works in annual instalments. Anticipatory provisioning for expenditure that the demographic curve has long established does not fit within the budgetary system of the Ministry of Finance. The result is a pattern of overrun followed by political intervention and supplementary cash shifts, followed by the next overrun. The substantive question, how much care the Netherlands can and wants to deliver institutionally in 2040, remains structurally unanswered in that rhythm, because the political moment for such a question is not itself created in any budget year.

Mobility and amenities in ageing regions. The PBL/CBS projection foresaw that by 2035, a large share of municipalities in Zeeuws-Vlaanderen, southern Limburg and the Achterhoek will exceed thirty percent over-sixty-fives.¹³ In the same period, regional public-transport coverage in these areas has been scaled back, regional hospitals have merged or closed, GP practices have quietly disappeared, and local shops and cash machines have ended up at considerable distances. The decision-making behind each individual reduction was locally or sectorally rational: too few passengers, too costly to operate, too small a patient base. The sum total is a residential and care infrastructure that structurally fails to serve demographic gravity. In practice, the older person who no longer drives and no longer receives informal care ends up in a village that offers her no alternative, and then moves to a regional centre where the housing stock for her age category does not exist. The pattern is closed. And it was knowable.

§ 04 Comparable Cases Beyond Demography

The signature operates not only against ageing. Three cases show the same pattern on different planning horizons.

Grid congestion was, from the 2013 Energy Agreement and certainly after the 2019 Climate Agreement, an arithmetically certain outcome of electrification. Adding up the desired generation curves for solar and wind, the planned transition to electric transport, and the electrification of industry yields an inevitable load curve that the existing infrastructure cannot bear. The lead time for high-voltage substations and cable corridors is eight to fifteen years. Whoever had started in 2014 would have had capacity by 2026. In early 2025, more than 14,000 large-consumer applications for grid capacity were on the waiting list, alongside nearly 8,600 applications for feed-in capacity, figures that rose further in 2025 to over 15,000 and 8,700 respectively.¹⁴ From 1 July 2026, reserved capacity for small consumers in congestion areas lapses, which means households and SMEs in heavily loaded regions such as the province of Utrecht will likewise queue under the societal prioritisation framework of the Authority for Consumers and Markets (ACM).¹⁵ The hundred billion now being invested in grid expansion to 2030 will only deliver tangible relief from 2028 onwards. Waiting times for non-priority businesses are lengthening to five to ten years. The energy transition to which the Netherlands publicly committed itself cannot, in its physical execution, take place in the immediate years ahead, because the infrastructure now needed should have been built earlier than was politically wanted at the time.

Climate adaptation follows a comparable line. The Delta Programme has been institutionally embedded since 2010 and, with the Delta Commissioner, holds one of the rare long-term ownership functions in the Dutch administrative architecture. The programme works precisely because it has been deliberately removed from the annual political cycle. But municipal and regional climate adaptation, for stormwater overflow, heat stress, and drought damage to foundations, falls largely outside the Delta framework. There the standard logic of budgeting applies: respond only when damage is visible. The Association of Netherlands Municipalities has signalled since 2015 that the local adaptation task is a multiple of what the municipal fund makes available, with the consequence that cities and smaller municipalities do not adapt vulnerable neighbourhoods until damage has occurred. That is reactive policy on a future that is knowable.

Infrastructure maintenance is the third example, and it is here that the signature is most sharply quantifiable. The Court of Audit calculates in its 2024 Accountability Audit that the gap between estimated budgetary need and available funding for the maintenance of the main road network has risen to 20.5 billion euro over the period 2024-2038, while the same shortfall for all three networks managed by Rijkswaterstaat together, main roads, main waterways and main water system, is estimated at 34.5 billion euro.¹⁶ The shortfall increased between 2024 and 2025, partly because some renewal needs were not included in earlier estimates and because Rijkswaterstaat currently has more work in preparation than the organisation can absorb. The Court of Audit has emphasised since 2014, in its own words, that the minister should give priority to maintenance over construction of new infrastructure, a line which eleven years later still is not conclusively anchored in policy.¹⁷

The background is an inescapable age effect. A large share of the civil infrastructure managed by Rijkswaterstaat, around 3,700 bridges and viaducts and roughly 650 hydraulic works, was built in the 1950s, 60s and 70s with a design life of sixty to eighty years. The total replacement value of bridges and viaducts in state ownership alone is estimated by TNO at sixteen billion euro; civil infrastructure in the Netherlands as a whole represents a replacement value of around 350 billion euro.¹⁸ The replacement curve, absent intervention, peaks between 2030 and 2040. The problem is concretely visible in a series of structures. The Merwedebrug on the A27 was abruptly closed to freight traffic in October 2016 after hairline cracks were found in the support beams; in retrospect its remaining life at that moment was marginal. The Velsertunnel from 1957 was fully closed for nine months between April 2016 and January 2017 for renovation. At the Suurhoffbrug from 1972, a temporary parallel arch bridge was floated into place in 2021 to relieve the original bridge; full replacement is foreseen around 2030.¹⁹ The Van Brienenoordbrug, with around 230,000 vehicles per day the busiest bridge in the Netherlands, suffered a failed tender in January 2024, after which the cost estimate rose from 380-600 million to a range of 1.5 to 2 billion euro, with construction now scheduled between 2029 and 2035.²⁰ At the Haringvlietbrug, the Heinenoordtunnel, the Galecopperbrug and the Velsertraverse viaduct, large-scale renovations have been carried out or emergency measures taken in recent years following unexpected damage. To free up resources, the cabinet reprioritised over 1.2 billion euro within the Mobility Fund in the 2024 Draft Budget. As a result, construction projects such as the A67 Leenderheide-Geldrop, the A4 Haaglanden-N14, the Hoevelaken interchange, the A9 Rottepolderplein and the extension of the Noord/Zuidlijn metro to Hoofddorp have been paused, with the latter reservation reduced by 1.35 billion euro.²¹ The Multi-Year Maintenance Plan 2025-2030 aims to grow Rijkswaterstaat’s annual production volume from around 2 to over 3 billion euro per year, and even in that scenario a list of objects remains for which preparation has begun but no budget is available.²² The conclusion is unavoidable: Dutch infrastructure is in a phase in which the maintenance task is structural, cannot be closed within a single cabinet term, and on current cash schedules will only stabilise by 2038.

§ 05 The Diagnosis

In Mark Moore’s Strategic Triangle, public value is only one of three corners that must be served in coordination. The other two are operational capacity and political legitimacy.²³ For the known-future files, public value is usually clear and broadly shared. Nobody wants older Dutch citizens to find themselves without suitable housing or care in 2040. Nobody wants infrastructure that closes ad hoc. The legitimacy corner is, at the level of the ultimate goal, no bottleneck in these files. The bottleneck sits in operational capacity, and more specifically in the time horizon over which that capacity can be built.

The control horizon of an average minister sits below two years between taking office and the first reorganisation of the department, and rarely above four years in total. The Senior Civil Service has long applied a career rhythm in which senior officials remain in a position between three and seven years, with a statutory maximum appointment term of seven years for the Top Management Group. In response to criticism of knowledge loss, the Minister of the Interior announced in July 2025 the intention to extend that term to nine years, or to link it to a five-plus-five system; the WRR confirmed in Expert Government that civil-service dissent in the Netherlands is insufficiently institutionally anchored, and that selection and rotation policies for senior officials in fact lead to knowledge loss.²⁴ The average tenure of municipal chief executives is likewise declining. In 2024, 225 local executives stepped down temporarily or definitively, the highest number since the introduction of dualism in 2002. Political votes of no confidence (94), personal reasons (44) and health complaints (38) were the main causes.²⁵ The planning horizon of a high-voltage substation, an elderly-care facility, a life-cycle-accessible neighbourhood, a Wlz system reform, a healthcare workers’ training pipeline, or a tunnel replacement, lies between eight and thirty years. Control horizon and planning horizon are out of step by a factor of three to ten.

In this discrepancy lies the actual cause of the blindness. Not incompetence, not ignorance, not indifference. An institutional control structure in which no one within the system personally bears the consequences of what plays out in ten years, and in which the incentive structure rewards minister and senior official for what is demonstrable within their own term. The system reliably responds to urgency within the annual budget. It does not respond to certainty about outcomes twenty years hence.

Mancur Olson predicted this pattern as the logical outcome of long-term stability without an external shock: vested interests accumulate, reform coalitions fragment, the system reproduces its own paralysis.²⁶ What Olson did not make explicit, and what becomes visible in the Dutch context, is that such a system also has a specific time signature. It responds faster than ever to the shortest signal, a media storm, a political sensitivity, a file that threatens to spin out of control, and slower than ever to the longest signal, a demographic curve that has been known for a generation.

§ 06 What Becomes Visible in the Practice Itself

In an interim assignment at a regional centre municipality in an ageing region, around 2022, I was asked to formulate a multi-year plan for the Social Support Act (WMO). The client population would double over twenty years. The workforce was shrinking through retirement. The procurement cycle for regional youth care and WMO support worked on four-year contracts. The college of mayor and aldermen had a horizon of two years to the next election. The municipal chief executive was newly arrived, the third in four years.

What was technically needed, a multi-year investment in labour-market development, a contracting landscape scaled out to ten years, a real-estate strategy for district nursing and shared housing forms, and an inter-administrative conversation with the regional centre municipality and the care-purchasing office about who would absorb what, fell outside the authority horizon of everyone at the table. Not one of the politicians was facing the problem they would have to solve ten years later. Not one of the officials would still be in that position six years from then. The multi-year memorandum that was eventually adopted described what had been worked out well, and remained silent on the cost lines for which there was no room within four years. The key decisions were pushed forward to the next college.

This is not a reproach to those politicians and officials. They did what the system rewards. The observation is that the system produces precisely this pattern when someone tries to act anticipatorily. Anyone with the courage to submit a multi-year memorandum that hurts in six years’ time delivers a fine gift to her successor and little to nothing to her own reputation. The incentive is asymmetric. Anticipation goes unrewarded. Postponement is low-risk.

§ 07 The Way Forward

The pattern cannot be broken with better forecasting tools. There is no shortage of those. CBS, SCP, WRR, RIVM, PBL and CPB have for decades produced a continuous stream of projections that describe the known futures in ever sharper form. The problem does not lie in the seeing. It lies in being able to hold what has been seen beyond the first political cycle.

Three interventions can change the time signature.

Anticipatory budgeting. The Wlz, the healthcare labour market, the composition of the housing stock, stormwater management, grid capacity, and asset maintenance are files in which the expenditure curve over fifteen to thirty years is predictable within narrow bounds. The budgetary system of the Ministry of Finance works in annual instalments with multi-year estimates that function nominally as reservations but are in practice renegotiable in every coalition agreement. An institutional separation between anticipatory budgets, accountably fixed over a rolling fifteen-year horizon and adjustable only via a heavier procedure, and discretionary budgets, which follow the normal regime, would break the reactive cycle. The Delta Fund and the work of the Delta Commissioner prove this can be done in the Netherlands. Extending that approach to other known-future files is an institutional choice.

Long-term ownership with a person-bound safeguard. The British system has, in the figure of the accounting officer, a developed, person-bound safeguard against irresponsible public spending. The accounting officer, almost always the permanent secretary of a department, carries personal responsibility to the House of Commons under HM Treasury’s Managing Public Money for the regularity, propriety, value for money and feasibility of departmental expenditure.²⁷ For major projects in the Government Major Projects Portfolio, a written Accounting Officer Assessment is moreover required, with publication of the summary.²⁸ If an accounting officer cannot reconcile a proposed decision with these standards, he or she requests a ministerial direction, a formal written instruction from the minister that is published and copied to the National Audit Office and the Public Accounts Committee. Political responsibility thereby rests explicitly with the minister.²⁹ Between 1990 and early 2026, 107 such directions have been made public, in 2025 including those concerning state support for British Steel and for Jaguar Land Rover.³⁰

In the Netherlands, the State Commission on the Rule of Law in its report of 10 June 2024, The Broken Promise of the Rule of Law, takes a different route. Improvement Proposal 2 calls for the selection of senior officials on rule-of-law awareness, alongside expertise and strategic talent, and for the inclusion of rule-of-law leadership in the Senior Civil Service curriculum.³¹ Improvement Proposal 3 introduces a red card for executive agencies when policy is unworkable or contrary to the rule of law.³² The Schoof cabinet largely adopts the first line, with a mandatory induction programme for new senior officials since May 2025 and a personal public leadership plan from 2026, and has taken the red card under further investigation.³³ A Dutch equivalent of the British direction procedure, that is, a personally mandated senior official with a formalised, public escalation duty toward parliament and the Court of Audit, remains absent. The WRR confirmed in July 2025 in Expert Government that civil-service dissent in the Netherlands is insufficiently institutionally anchored, and that selection and rotation policies for senior officials in fact lead to knowledge loss.³⁴ The intervention required goes beyond what the State Commission has proposed: personal responsibility of a senior official for chain outcomes over a horizon of eight to fifteen years, with legal protection for critical advice, a written escalation duty when the minister wishes to pursue a course outside the assessment criteria, and the loosening of the Senior Civil Service career rhythm for the position on which this function rests. That is a break with the Senior Civil Service logic as it has functioned since 1995. Without that break, the structural short-sightedness cannot be lifted.

Personal responsibility for chain outcomes. For specific files with a clear planning horizon, elderly-care infrastructure, grid expansion, main-road maintenance, housing-market composition, an institution can be set up after the British model: a commissioner with constitutional independence, a multi-year mandate that overrides the electoral cycle, an own budget line, and a reporting duty to the lower house that does not run via a department. This is not techno-democracy. It is institutional protection of the long-term public interest against the short-sightedness of the democratic process as it operates in annual cycles. The Court of Audit already operates on this basis. The Delta Commissioner operates on this basis. For the known-future files where the planning horizon far exceeds the electoral horizon, extending that institutional logic is the most workable intervention.

§ 08 Conclusion

In the first five papers of this series I described a specific mechanism through which institutional dissociation reaches into society. This signature essay names something that runs through all five mechanisms: a shared time signature in which Dutch public administration structurally responds to the shortest signal and structurally fails to act on the longest signal, even when that longest signal has been on the books for twenty years.

The diagnosis is administrative. Dutch polder governance is optimised for consensus, for balanced decision-making within sight of the voter, and for administrative agility under political pressure. That optimisation has a price. The price is that everything outside view has no pressing voice in the administrative conversation. The pensioner of 2040 is not a voter in 2026. The not-yet-built substation makes no sound. The resident of a neighbourhood that has not yet become unaffordable does not yet complain to the council. The system responds to voices, and what has no voice gets no room.

This is not an immutable law. It is a design feature that can be institutionally corrected. The three interventions proposed here, anticipatory budgeting, long-term ownership with a person-bound safeguard, and personal responsibility for chain outcomes over horizons of eight years or more, are not technocratic proposals. They demand a political choice that says: there are files where the democratic process in its annual form structurally underperforms, and there we build institutional protection that does not leave the long term to the favour of the next cabinet.

That is a choice that, in the current political condition, is hard to formulate aloud. It comes too close to the recognition that the democratic process in its day-to-day form cannot do certain things. But the recognition has long been factual. The only question is whether it is translated into institutional design, or whether we continue with a pattern in which, every five to ten years, we are publicly surprised that a future that was always knowable has now overtaken us.

This signature essay is a building block for the next paper in this series, Behind on the Speed, which names a second time signature: not the structural short-sightedness toward known futures, but the structural pace asymmetry against exogenous changes that overtake government at speed. The two signatures together, blindness to what is already knowable and lag behind what presents itself, form the time signature within which all five reverberations become fully intelligible. The synthesis paper The Frozen Zeitgeist will connect both with cumulative electoral and cultural outcomes.

In Chapter 9 of The Direction of the Movement I develop sustainment as the primary KPI of interim work, with the proposition that success is measured by what remains standing after departure. At the institutional level on which this paper operates, the corresponding question is whether the institutional architecture has any memory at all that lasts long enough to act on a known future. In the absence of such memory, sustainment at the organisational level is a meaningful intervention; at the systems level it is a gesture against the wind. This paper formulates what is missing in that systems memory and what should institutionally take its place.

Colophon

Jacob Huibers is an interim manager with over twenty years of experience in the Dutch public sector. He has worked as cluster manager, cluster director and lead reorganiser at municipalities ranging from fifty thousand to over two hundred thousand inhabitants, and at regional cooperative bodies in the social and physical domains. Statecraft is his platform for strategic reflection on public execution.

This paper is the sixth in the Statecraft series Reverberation, an eight-part diagnosis of the external symptomatology of institutional dissociation. Blind to a Known Future is the first of two signature essays naming the time signature that runs through the five form papers. The next paper, Behind on the Speed, addresses the complementary pace asymmetry. The closing paper, The Frozen Zeitgeist, brings form and signature together in a synthesis on the cumulative deposit at the level of society.

The series builds on the corpus in which The Direction of the Movement: Interim Management in the Public Sector (manuscript in preparation, 2026) supplies the practice layer, All Displaced the human layer, and Decline and Revival the civilisational time layer.

Contact and subscription: Statecraft.nl/en/contact

Sources and Notes

Footnotes

¹ CBS, Core Projection 2025-2070: 20.6 million inhabitants expected in 2070, Statistical Trends longread, 16 December 2025. The share of those aged sixty-five and over rises from 21 percent at end-2025 to 25 percent in 2040 and further to 26 percent in 2070. In absolute numbers, the over-sixty-fives rise from 3.8 million at end-2025 to 4.8 million from 2040 onwards and 5.4 million in 2070. For regional distribution see PBL/CBS, Regional Population and Household Projection 2022-2050. Earlier CBS and PBL projections from 2010 onwards predicted the same curve within margins.

² VGZ Cooperative, Healthcare Personnel Shortage, ongoing monitor 2024-2026, based on AZW figures and CBS vacancy statistics; Social and Economic Council, Valuable Work: Agenda for the Labour Market, 2023, which substantiates the need for two million healthcare workers in 2040 on the basis of the WRR projection. The vacancy rate in care and welfare in 2024-2025 was structurally around 44-46 per thousand jobs, highest in mental healthcare and rising fastest in youth care.

³ PBL/CBS, Regional Population and Household Projection 2022-2050, in particular the regional analysis for Zeeuws-Vlaanderen, eastern Groningen, southern Limburg and the Achterhoek; SCP, Regional Differences in Amenities, ongoing monitor; Court of Audit, Shrinking Regions and Administrative Attention, 2023.

⁴ WRR, Choosing for Sustainable Care. People, Resources and Public Support, report number 104, September 2021, in particular Annex 3 with the calculation methodology. The projection that by 2040 one in four, and by 2060 one in three, working people must work in healthcare to meet demand assumes unchanged policy and has been confirmed within margins by RIVM, SCP and the Ministry of Health in subsequent years.

⁵ Health Insurers Netherlands and the National Health Care Institute, National Report Waiting Lists Nursing Care (Wlz) Q4 2023, May 2024, https://www.zn.nl/app/uploads/2024/05/Q4-2023-Rapport-Wachtlijsten-Verpleeghuiszorg.pdf.

⁶ Health Insurers Netherlands and the National Health Care Institute, National Report Waiting Lists Nursing Care (Wlz) Q4 2024, April 2025, and Q2 2025, October 2025, https://www.zn.nl/app/uploads/2025/04/Rapport-Wachtlijsten-Verpleeghuiszorg-Q4-2024-definitief.pdf and https://www.zn.nl/app/uploads/2025/10/Rapport-Wachtlijsten-Verpleeghuiszorg-Q2-2025.pdf. Since 1 January 2021 the Health Care Institute has used four waiting statuses: urgent placement, active placement, waiting on preference, and precautionary waiting. The precautionary group, around 11,826 persons on 1 January 2025, is not counted in the official waiting-list figure.

⁷ ActiZ, How Are the Waiting Lists for Nursing Homes?, consulted 28 April 2026, https://www.actiz.nl/hoe-staat-het-met-de-wachtlijsten-voor-verpleeghuizen.

⁸ Ministry of Health, answers to budget questions 2021, table on Wlz expenditure 2015-2020; CBS, Government Spending Heading Toward 500 Billion Euro, longread 2025, https://www.cbs.nl/nl-nl/longread/diversen/2025/overheidstekort-toegenomen-in-2024-schuld-relatief-laag/3-uitgaven-overheid-richting-500-miljard-euro.

⁹ CBS, Healthcare Spending Rose by 8.1 Percent in 2024, press release 27 May 2025: total healthcare spending (international definition) rose by 8.1 percent to 113.5 billion euro; within that release the Wlz rise is flagged at 11 percent. https://www.cbs.nl/nl-nl/nieuws/2025/22/uitgaven-gezondheidszorg-stegen-in-2024-met-8-1-procent.

¹⁰ Ministry of Finance, Draft Budget Health 2024, paragraph 6.4, https://www.rijksfinancien.nl/memorie-van-toelichting/2024/OWB/XVI/onderdeel/2111874; Court of Audit, Accountability Audit 2024 — Report on the Annual Report of the Ministry of Health, 21 May 2025.

¹¹ WRR, Choosing for Sustainable Care, WRR report 104, 15 September 2021, https://www.wrr.nl/publicaties/rapporten/2021/09/15/kiezen-voor-houdbare-zorg.

¹² Ministry of Finance and Ministry of Health, Interdepartmental Policy Review on Elderly Care — Doing Nothing Is Not an Option, 2021. Supporting projections in RIVM, Public Health Future Forecast 2024 — Choosing for a Healthy Future, June 2024, https://www.rivm.nl/bibliotheek/rapporten/2024-0110.pdf.

¹³ PBL/CBS, Regional Population and Household Projection 2022-2050, ageing chapter; the projection for 2035 foresees for central Limburg a share of over-sixty-fives of 30.9 percent, and in a large part of municipalities in eastern Groningen, Delfzijl and surroundings, the Achterhoek, Zeeuws-Vlaanderen and southern Limburg, a share above thirty percent.

¹⁴ Netbeheer Nederland, Implementation Status Q1 2025, March 2025, https://www.netbeheernederland.nl/sites/default/files/2025-03/stand_van_de_uitvoering_q1_2025_1.pdf; Implementation Status March 2026 as cited in Third Progress Report National Action Programme Grid Congestion, April 2026.

¹⁵ ACM, Priority for Societal Projects Remains Possible Under New Prioritisation Framework, December 2025, https://www.acm.nl/nl/publicaties/acm-voorrang-maatschappelijke-projecten-blijft-mogelijk-met-nieuw-prioriteringskader; TenneT, press release 21 April 2026 on planned connection moratorium for small consumers in Gelderland, Utrecht and Flevoland from 1 July 2026.

¹⁶ Court of Audit, Results Accountability Audit 2024 Ministry of Infrastructure and Water Management, 21 May 2025, https://www.rekenkamer.nl/publicaties/rapporten/2025/05/21/vo-2024-ienw; confirmation in Annex Acts 2025-2026, no. 682.

¹⁷ Court of Audit, press release Rijkswaterstaat Maintenance Shortfall Larger Than Thought, 21 May 2025, https://www.rekenkamer.nl/actueel/nieuws/2025/05/21/tekort-rijkswaterstaat-voor-instandhouding-groter-dan-gedacht.

¹⁸ Rijkswaterstaat and Iv-Infra, Forecast Report Replacement and Renewal 2022; Inventory of Civil Structures, Parliamentary Document 31200-XII-5-b1; De Ingenieur, Deferred Maintenance: Who Will Repair the Bridges?, 2024, https://deingenieur.nl/en/artikelen/achterstallig-onderhoud-wie-knapt-de-bruggen-op.

¹⁹ Rijkswaterstaat, project page A15: New Crossing Suurhoffbrug, https://www.rijkswaterstaat.nl/wegen/projectenoverzicht/a15-nieuwe-oeververbinding-suurhoffbrug.

²⁰ Rijkswaterstaat, Higher Costs for Renovation of the Van Brienenoordbrug, May 2025, https://www.rijkswaterstaat.nl/nieuws/archief/2025/05/rijkswaterstaat-rekent-op-hogere-kosten-voor-renovatie-van-brienenoordbrug.

²¹ House of Representatives, Parliamentary Documents 36410-A, nos. 2 and 8, https://zoek.officielebekendmakingen.nl/kst-36410-A-8.html.

²² Minister of Infrastructure and Water Management, Letter to Parliament on Multi-Year Maintenance Plan RWS Networks 2025-2030, 1 July 2025, https://www.rijksoverheid.nl/documenten/kamerstukken/2025/07/01/meerjarenplan-instandhouding-rijkswaterstaat-netwerken-2025-2030; Annex Acts 2025-2026, no. 682.

²³ M.H. Moore, Creating Public Value: Strategic Management in Government, Harvard University Press, 1995. For application to Dutch interim practice, see Chapter 3 of The Direction of the Movement: Interim Management in the Public Sector (manuscript in preparation, 2026).

²⁴ Minister of the Interior, Letter to Parliament on Follow-Up to the Reform Agenda for the Slimming of the Senior Civil Service, 11 July 2025, Parliamentary Document 31490, no. 388, https://www.rijksoverheid.nl/documenten/kamerstukken/2025/07/11/kamerbrief-over-opvolging-hervormingsagenda-voor-versobering-van-de-algemene-bestuursdienst-abd; WRR, Expert Government, WRR report no. 113, 8 July 2025, https://www.wrr.nl/site/binaries/site-content/collections/documents/2025/07/08/deskundige-overheid/WRR-Rapport+nr.+113+Deskundige+Overheid.pdf.

²⁵ De Collegetafel, Local Executives Survey 2024 — Record Number of Aldermen Stepping Down, commissioned by Binnenlands Bestuur, January 2025, https://www.decollegetafel.nl/2025/actueel/wethoudersonderzoek-2024-recordaantal-wethouders-weg/.

²⁶ M. Olson, The Rise and Decline of Nations: Economic Growth, Stagflation, and Social Rigidities, Yale University Press, 1982. For the Dutch application of Olson’s institutional sclerosis thesis, see also Decline and Revival and the chapter on the Jan Salie mentality as a contemporary manifestation of administrative inertia.

²⁷ HM Treasury, Managing Public Money, June 2025, chapter 3, https://assets.publishing.service.gov.uk/media/684ae4c6f7c9feb9b0413804/Managing_Public_Money.pdf.

²⁸ HM Treasury, Accounting Officer Assessments: Guidance, updated 12 June 2025 (DAO 02/25), https://www.gov.uk/government/publications/accounting-officer-assessments.

²⁹ HM Treasury, Managing Public Money, June 2025, section 3.4; HM Treasury and Cabinet Office, collection Ministerial Directions, https://www.gov.uk/government/collections/ministerial-directions.

³⁰ Institute for Government, Ministerial Directions, explainer, last updated 17 February 2026, https://www.instituteforgovernment.org.uk/explainer/ministerial-directions.

³¹ State Commission on the Rule of Law, The Broken Promise of the Rule of Law. Ten Improvement Proposals With an Eye to the Citizen, 10 June 2024, p. VI: “A special responsibility lies with senior officials and managers within departments and other government bodies. They in particular must embody the rule of law and be capable of giving direction to it.”

³² Idem, Improvement Proposal 3.

³³ Ministers Uitermark (Interior), Van Hijum (Social Affairs), State Secretary Struycken (Legal Protection), Cabinet Response to the Advisory Report of the State Commission on the Rule of Law, 4 July 2025, Parliamentary Document 29279, no. 981, https://www.rijksoverheid.nl/documenten/kamerstukken/2025/07/04/kamerbrief-kabinetsreactie-op-adviesrapport-staatscommissie-rechtsstaat.

³⁴ WRR, Expert Government, WRR report no. 113, 8 July 2025, https://www.wrr.nl/site/binaries/site-content/collections/documents/2025/07/08/deskundige-overheid/WRR-Rapport+nr.+113+Deskundige+Overheid.pdf.