Before moving into European health policy, EuroHealthNet's Chantal Verdonschot worked as a social worker. Drawing on experience from both sides of the system, she reflects on what those roles have taught her: health equity is about more than access to care. It is about whether the doors of our systems are truly open to the people who need them most.
I started my career as a social worker in a small, rural municipality in the Netherlands. Fresh out of university, I was handed a caseload of people who the labour market had left behind, many of them living with chronic illnesses, others recent refugees. I soon found out that the problem was not that they were unemployed. It was everything else.
The system was built around a simple idea: welfare comes with conditions. But in practice, those conditions could be punishing. I came across cases where a medical assessment concluded that someone living with chronic pain could work two hours a day, two days a week. That finding immediately became an obligation: the client now had to actively search for a job with those unusual hours. If they didn’t, their welfare was at risk. While they searched, they were sent to the municipality’s work facility to “prepare for employment.” In reality, they were doing unpaid work in exchange for the welfare they received.
I look back on this period with mixed feelings. I was 22, and I didn’t always understand what I was asking of people. Being “invited” to an appointment may sound neutral, but for some clients it may have taken an hour to get there, and the five-euro bus fare might have meant they were unable to have a proper dinner that night. There were power dynamics in play that I, in my naivety, was blind to.
But being young also meant I hadn’t yet learned to see people as cases. The system was built to reduce a person’s situation to an application form, conditions to be met, boxes to be checked. I watched a welfare application get rejected because a single field had been filled in incorrectly. The client was told they should just try again next month. Such a decision ignores what it means to have to get by without money that month - and what that might drive a person to do.
In another case, a client’s mother had bought him fifty Euros worth of groceries so he could enjoy a treat and eat healthily. He was required to declare those 50 Euros so they could be deducted from his welfare that month. If he didn’t, and his bank statements were ever reviewed, he risked a penalty. Such procedures turned a loved one’s kindness into a liability.
A 500-euro lesson
Perhaps being new to all of that, I was more inclined to learn about the person’s story and seek solutions, instead of following protocol. One of the cases I think about most was Rose, a great mom and a hard-working, sweet woman. Rose was dealing with depression and a range of physical health problems, and for months, we couldn’t quite figure it out.
Then we did. Rose had severe dental problems, several teeth were missing, and the ones she had were causing her a lot of pain. She couldn’t afford proper care and was forced to eat cheap and processed food that was easy to chew. Rose was heavier than she wanted to be and constantly felt tired and ashamed. As she felt self-conscious about her smile, she had stopped smiling altogether.
Once we found out, we had something to work with. It took some convincing, but my supervisor agreed to let Rose see a dentist for a quote. The cost to fix her teeth came to just under 500 euros, and the municipality agreed to pay.
On our next appointment, just one month later, I saw a different person. Now that the pain of the procedure was gone, she was eating healthily and losing weight, and her mental health had improved: she felt happy, smiling again. Within weeks, she found a job. Five hundred euros had done what months of appointments and conditions had not. It was the most concrete example I had ever seen of the link between poverty and health — and proof that the system could bend, if someone was willing to push it.
From bottom up to top down
Just as I decided the job was not for me, I got an internship at the EU institutions: something I had dreamed about. Contributing to a more social and healthy Europe felt like the natural next step, a way to work on the same problems but at a scale where the answers would stick.
I spent time evaluating the impact of EU health projects that worked with groups in vulnerable situations, such as people who were homeless or who were in prison, people with chronic health conditions, and refugees: people not unlike those I had met as a social worker. My colleagues and I looked at whether projects had delivered what they promised: reports produced, events held, partners involved. Not enough attention was paid to whether the intervention had actually made a difference in the lives of the people it was designed for, and I wondered how they could have more of a voice in shaping them.
Right on the intersection
After the internship, I had a choice to make. Did I want to continue working on international policy, or did I want to go back to the local level? I chose the intersection.
I joined EuroHealthNet, where I work at the crossroads of policy, practice, and research, not just engaging with EU institutions but also actively fostering the exchange of knowledge between local, national, and European actors. Because of our close ties with local actors, we can connect what happens in a small Dutch municipality to inform a European strategy and translate European commitments into something meaningful for people on the ground. And perhaps unexpectedly, I found my place not in policy, but in communications.
How we talk about things and people matters. The gap between a European policy document and Rose’s dental pain is not just a gap in resources or political will. It’s a gap in the language used and whose reality gets centred when decisions are made. In my work, I try to bridge that gap: to make sure that the messages we put out into the world reflect what people live through, not just what is convenient or comfortable to say.
I still think about Rose. About the 500 euros that changed her life. About the client whose welfare application was rejected over a single incorrect field. I can’t fix those systems from where I sit. But I can help make sure that the people who shape them remember who those decisions are about.
In focus
- See the whole person – people’s challenges rarely fit into one category or service.
- Remove barriers, not just symptoms – effective support starts by understanding what is holding people back.
- Make systems work for people – bureaucracy should not become another obstacle to overcome.
- Connect local realities with wider policy – meaningful change happens when practice informs decision-making.
- Listen to those most affected – lived experience is essential for building fairer systems.
Chantal Verdonschot
Chantal’s studies and career reflect a deep commitment to advancing health and social equity. She holds an academic background in European public health, human rights, and international public administration. Prior to joining EuroHealthNet, she worked as a social worker in the Netherlands, where she supported migrants and people in vulnerable situations as they entered or re-entered the workforce. She gained her first experience working on international public health matters as a trainee at the European Commission.