The employers in the healthcare and taxi transport sector have made a final offer for a new collective labor agreement as of 2023, with an ultimatum up to and including Tuesday 25 October. The trade unions CNV and FNV allowed this ultimatum to expire, effectively suspending the historically high wage offer of more than % and negotiations. Chairman of the employers’ delegation Martijn Kersing finds it incomprehensible that the unions have not yet accepted the final offer: “We attach great importance to a new collective labor agreement, which provides peace and clarity for everyone. With their attitude, unions are threatening to blow the nose of the much-desired wage increase of 8% as of 1 January.”

During the negotiations, employers were increasingly the signal that for most of their employees an increase in salary was the most important thing, while unions made additional demands and conditions. To test this, KNV prepared a survey that was distributed by the employers among their staff, in which the employees could indicate whether they agree with the employer’s proposal. This survey was completed more than 3200 times and more than 25% of the respondents (of which 90% driver) could agree with employers’ proposal. The survey was anonymous and voluntary and could only be completed once. Employers could not see which employees completed the survey or view the results. If an employee did not like the final offer, he could also indicate why not and this was therefore used by more than 25% of the respondents.

Employers are surprised that the unions have not yet presented the final offer to their supporters themselves, all the more so because their own staff know very well that the corona crisis and the current high costs are not doing the industry any good and therefore there is certainly a good final offer. On the part of employers, that is really not an option.

The expiry of the ultimatum means that the collective wage increase cannot be passed on in the rates. Martijn Kersing about this: “Because the NEA index (which is often used in the sector) does not take into account a new collective labor agreement, the national average wage cost development is assumed to be much lower than what we would like to pay our employees. ”. However, the NEA index has not yet been definitively determined and employers still want to reach a new Collective Labor Agreement with the trade unions on the basis of the final offer, so that employees do receive the wage increase as of 1 January 2023. .

Once the NEA index has been published and no new collective labor agreement has been agreed, it will be impossible to agree on more than where in the index at a later date is included. Employers can then no longer pass on these extra costs. Entrepreneurs have already had to deal with the sharp rise in fuel prices in recent months. The index for this year was unable to take this into account. Margins in transport are low. Extra costs that are not matched by income cannot be borne by the sector.


Employers in healthcare transport and taxi feel compelled to make a final offer and attach an ultimatum to it. This is due to the working methods of the trade unions. The unions have started negotiations with unprecedented demands that would result in a total increase of more than 14% in costs. After the unions scrapped a number of demands, each round of negotiations demanded more. The entrepreneurs offer more than %. The unions must have responded before 14 October, otherwise the employers will suspend negotiations indefinitely.

CAO negotiator Martijn Kersing about the final offer: ‘We have made a historically high offer to the unions, especially if you look at other collective agreements that are currently being secluded. We have been negotiating since May this year and as employers we have shown good will. The unions ensured that the employees were given unrealistic expectations of the new collective labor agreement to be concluded by not relating proposals to the current collective agreement. Then our employees may end up empty-handed and that is the last thing employers want. We find it disappointing that we have to come up with an ultimatum about this final offer, but we as employers really cannot go further than this final offer. ‘

In the first year (73) there is an increase of 8% as of 1 January and in the second year (2024) at 4%, also from 1 January. In order to also be able to offer new drivers a good start with a decent salary, the bottom steps 3 and 4 are removed from the wage structure. New employees therefore start on the salary of what is now step 5. This means that a novice driver earns 13,73 and already in 2024 the desire to realize a starting salary above 14 euros per hour is met. The 0 step will be deleted for non-mobile personnel, so that they also receive a higher starting salary.

In the event of incapacity for work, an employee in the sector currently 70% during the first two weeks of illness. Employers want to increase this to 73% for the first two weeks. An important part of the final offer is also that employers will revert to the old scheme for paid time, with the addition of a maximum of four interruptions at the work location (this was unlimited). The arrangement agreed in the previous collective labor agreement led to a great deal of commotion. Going back to the old scheme is an improvement over the current scheme, with which , 5% interruption could be calculated, even if that interruption was not

With this final offer, the employers are making an ultimate offer to the employees, which shows understanding for the situation of the employees and also expresses appreciation for the great commitment in these difficult times of staff shortage. Collective Labor Agreement negotiator Martijn Kersing about this: ‘As employers, we saw that we had to focus on appreciation for our employees and on a new influx of drivers. We converted that into an unprecedentedly high collective labor agreement offer. We hope the unions accept our final offer. Only then can we actually implement the wage increase as of 1 January. The clarity that this offers is important for everyone. Not only for employees and entrepreneurs, but also for clients. After all, they are passed on the increased costs, for example via the NEA index.’

5000 5000

Patient and client organisations, healthcare transport providers and health insurers have jointly made agreements about the quality of patient transport. They laid down the agreements in the Patient Transport Guidelines Covenant. The signing of this covenant is an important step in safeguarding the agreements. Dutch Kidney Patients Association (NVN), the Dutch Federation of Cancer Patient Organizations (NFK), Elke(in) and the Netherlands Patient Federation signed the covenant on behalf of the patient and client organisations. KNV signed on behalf of the healthcare providers. Zorgverzekeraars Nederland did this on behalf of the insurers.

The guidelines framework forms the basis for agreements between carriers and health insurers on high-quality seated patient transport for adequate compensation. With these guidelines, the signatories want to provide the negotiations between the parties with a good basis, taking into account price, efficiency and quality. For example, patients or clients can not only count on good quality transport, they can also rely on these guidelines that complaints will be dealt with adequately. After all, the aim is that they ultimately lead to noticeable improvements. By signing this covenant, all parties commit themselves to jointly ensure that this is safeguarded.

Reason for covenant and delay due to corona
The reason for the covenant was the commitment in 16 from the Minister of Health, Welfare and Sport to the House of Representatives to ask the Dutch Healthcare Authority (NZa) to conduct an exploratory study with the parties about possible problems in purchasing patient transport. Together with trade unions, KNV Zorgtransport has been working towards this for some time. The minister’s commitment led to exploratory talks, initially under the leadership of the NZa and in a later phase, with the consent of the NZa, under the direction of the parties themselves. Due to the corona pandemic, the talks were delayed, but last summer the talks were picked up again by the parties involved.


KNV coordinated with a representative of the employees during the process. NVN and NFK did the same with other patient organisations. Agreements have been made about, among other things, quality levels and improvement cycles. The quality framework for patient transport that NVN had already drawn up previously served as the starting document for the new framework of guidelines.

Last year the ambition was expressed that in 2025 all new taxis in the Netherlands should be clean and quiet. And from 2025 in major cities. A year after this ambition was expressed, KNV Healthcare Transport and Taxi, together with State Secretary Heijnen (Infrastructure and Water Management) and other parties in the sector, set up April 2025 a next step: signing an agreement framework makes it possible for municipalities to add taxis to areas where only vehicles that drive without exhaust gases (zero emission zones) are used (zero emission zones).

State Secretary Heijnen about this: “Taxis cover a lot of miles in the city. So this is a nice step towards a cleaner environment with less traffic noise. I think it is very important that we make these agreements in close contact with the sector. It is not easy for many taxi entrepreneurs, so I really want to make sure that the switch to an electric taxi or hydrogen taxi is feasible for them.“


The State Secretary, together with five large municipalities and representatives of the taxi industry, signed the plan that cities from 2025 may decide that only zero-emission taxis are allowed into their city. It expresses the ambition to make this legally possible.

This further fleshes out the agreement in the Climate Agreement to make transport more sustainable.

Switch for entrepreneurs

The State Secretary about the switch for entrepreneurs: “ With the current prices at the pump, electric driving is advantageous for frequent drivers such as taxi drivers. But the switch to electric or hydrogen does require an investment. The government wants taxi entrepreneurs to be able to make the switch to an emission-free taxi at a time of investment that suits them. That is why a transitional arrangement is being worked out for existing vehicles. This means that drivers whose car is still relatively new will have more time and can therefore still enter the center. It is the intention that from 2025 onwards all new taxis will run without exhaust gases in the participating municipalities.”

Zero-emission zones for clean air in the city

It was already known that cities from 2025 to introduce a zero-emission zone for lorries and delivery vans. Municipalities can therefore choose to expand that zone with taxis. A zero-emission vehicle is a vehicle whose propulsion does not cause harmful emissions, such as a vehicle powered by electricity or hydrogen.

Municipalities themselves are responsible for establishing a zero-emission zone . There are municipalities that plan to do this in the coming years. The municipalities that are also signing the new taxi agreements today are Amsterdam, Rotterdam, The Hague, Eindhoven and Tilburg. Other municipalities can join later.

KNV: the interpretation of the preconditions is important

KNV Zorgvervoer en Taxi is confident that entrepreneurs can take the next step if a number of preconditions are met. For example, it is important that sufficient charging infrastructure is available for taxi operators, for example at the stands. In addition, it is a precondition that there are enough affordable zero-emission vehicles available for entrepreneurs. The latter is important because the investment power of the sector is not great due to corona and its aftermath (including tax deferrals). At the moment, for example, the Total Cost of Ownership calculation looks good for zero-emission vehicles, but purchasing them stands or falls with sufficient investment scope. It is by no means available in all cases.


† Now that the Netherlands is reopening, entrepreneurs in healthcare transport are in danger of having too little capacity to meet the transport demand. At the moment, only a maximum of two thirds of a care transport vehicle may be used. The capacity-limiting measure is based on a recommendation from the RIVM. Recommendations for limited occupancy have always been carefully followed by healthcare providers. But increasing demand as a result of the recent easing has put carriers in a bind. Chairman Bertho Eckhardt of the KNV Healthcare Transport and Taxi Association calls on RIVM to reconsider the advice on healthcare transport and to withdraw it if possible.

It RIVM advised on December 25 to maintain capacity-limiting measures for healthcare transport, because a large number of users belong to the risk groups. Because of the vulnerability of the clients, the care transport companies consistently apply this advice as a rule. After all, healthcare transport is an integral part of the healthcare chain. The limitation of the maximum capacity of vehicles is part of the ‘Care Transport Sector Protocol’ drawn up by KNV Zorgvervoer and Taxi together with the trade unions CNV and FNV.

Op 15 in February the cabinet announced far-reaching relaxation. This will further increase the demand for healthcare transport. Carriers have already seen an increase in transport demand in recent times, as society opened up more and more. For example, the number of journeys in transport to and from hospitals increased after more and more regular care was rescheduled and overtaken.

Because not all seats in a vehicle may be used. , it is becoming increasingly difficult for carriers to meet the transport demand. More drivers and more vehicles should be deployed, but these are not available. This leads to an untenable situation. In some parts of the country, the capacity problems – especially during peak times in the morning and afternoon – have already resulted in journeys being driven later than planned, or in some cases not at all.

Bertho Eckhardt: “On behalf of the entrepreneurs, I urgently appeal to the RIVM for the advice of December by at the latest. February to reconsider and preferably even withdraw it, so that carriers can optimally meet the transport demand again. Naturally, carriers will – as always – do everything they can to ensure that transport takes place in the safest possible manner.”

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† At the end of last year, the social partners in care and taxi transport agreed on a new collective labor agreement. In recent weeks, work has been done on finalizing the new collective labor agreement texts. These texts are now ready and adopted by the collective labor agreement parties CNV Vakmensen, FNV Taxi and Royal Dutch Transport, Care Transport and Taxi. The new collective labor agreement will be presented to the ministry to be declared universally binding. The collective labor agreement came into effect on January 1 19, whereby the new paid time system will take effect on March 1 19. As soon as the collective labor agreement has been declared generally binding, the collective labor agreement will also apply to companies that are not affiliated with KNV.

After the parties reached an agreement on 19 October, a there are differences of opinion about the precise formulation of the rewarded time. Due to further consultation, this difference of opinion has disappeared in the recent period and agreement has been reached on the wording as it eventually ended up in the collective labor agreement texts.

Wage scales, salary steps and other name

The salary scales are as of 1 January 4632 increased by 2.5 percent. In addition, the second step will be removed from the salary scale, so that drivers go through the wage structure more quickly. Finally, in order to do more justice to the sector as a whole, the name of the collective labor agreement has been changed from ‘cao Taxi transport’ to ‘cao Care transport and Taxi’.

The texts of the new collective labor agreement can be found on this page.

† The corona crisis has taken a heavy toll on the healthcare transport sector. One of the consequences of this was that staff (sometimes out of necessity) left the sector, because many journeys were canceled for a longer period of time. Now that the demand for healthcare transport has increased again, the sector is struggling with hundreds of vacancies that are difficult to fill. This not only concerns drivers, but also support staff such as dispatchers, supervisors and mechanics. The shortage is increasing to such an extent that companies indicate that they can no longer do rides on time. Some companies indicate that rides are in danger of being canceled altogether. This includes trips to hospitals, healthcare institutions and educational institutions.

At the peak of the corona crisis, transport volumes in, among other things, Wmo transport and in the Regiotaxi significantly reduced. In daytime transport and seated patient transport, the volumes were many tens of percent lower than before the crisis. Healthcare transport companies were hit financially as a result, despite the generic support measures and the fact that various clients assisted financially where possible by compensating part of the canceled journeys. Some of the staff left the sector due to the lower transport volumes. On the one hand, because the support measures were not always sufficient to keep all the staff (including many flexible staff) in service. On the other hand, because personnel stopped working or were able to find work elsewhere.

Now that the transport sector has recovered somewhat, the sector is confronted with a major shortage of personnel. The number of reports of illness is also increasing due to the increase in corona infections. A problem that is difficult to solve for the carriers, which could mean that not everyone can be transported in the future. Customers already sometimes have to wait longer than agreed for the taxi that will take them to day care or to the hospital, for example.

KNV chairman Bertho Eckhardt is very concerned about the size of the this problem: ‘Nationally speaking, we see hundreds of vacancies that are difficult to fill. This means that extra staff is already being called upon within companies, but that is not always sufficient for the large peak of transport in the morning and the afternoon. We see that entrepreneurs are making adjustments in consultation with clients to prevent rides being cancelled. This requires a great deal of effort and creativity from the companies in order to be able to serve customers in the best possible way. We notice that entrepreneurs are really up for grabs. Fortunately, most clients understand the situation. This is a good business. But of course the passengers in our taxis experience the real problem. They can no longer always be transported on time, or they are no longer driven by their regular driver. This is a major problem for a vulnerable target group.’

KNV, together with the entrepreneurs, is looking for solutions to the problem in various ways. Unfortunately, the staff shortage will not be solved overnight, as it also occurs in other sectors such as healthcare and the catering industry. The industry therefore mainly asks for understanding of the situation. Bertho Eckhardt about this: ‘It is not ill-will that the companies cannot always meet the transport demand when customers want it. Healthcare carriers are part of the healthcare chain and constantly monitor the interests of the customer. However, we have now ended up in a situation where we are sometimes no longer able to meet the customer’s wishes. Entrepreneurs are really upset about that.’


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† The state aid for the continued payment of journeys not driven in target group transport due to the corona crisis has been extended. It applies for the period from 13 October 2020 to October 1 2020.

Following the national call to make regional and local payment agreements in target group transport, the government has submitted a third coordinated notification of state aid to the European Commission. The Commission has approved this notification.

Support may be granted under conditions to transport companies for target group transport. Since the aid has also been approved under the Temporary Support Framework (TSK), the conditions for granting it are the same as for the previous period from 1 July 2020 to October 2020.

Click here for more information about the extension of the state aid for target group transport