Belgian PAB Crisis Leaves Families of Disabled in Crisis

Belgian families caring for children with severe disabilities are facing an escalating crisis as the promised Personal Assistance Budget (PAB) remains out of reach for thousands, leaving parents in increasingly desperate financial and emotional circumstances. Despite existing for over two decades, the Flemish government program that provides direct financial support to families of children with disabilities has been plagued by persistent waiting lists that show no signs of shrinking.

What Is the PAB?

The Personal Assistance Budget (Persoonlijk Assistentiebudget) is a Flemish government program that provides annual financial support ranging from €12,873.81 to €60,077.72 (2026 figures) to parents of minor children with recognized disabilities. Unlike institutional care, the PAB allows families to organize assistance themselves—hiring personal assistants, paying for specialized care, or purchasing services tailored to their child’s specific needs. The program has existed since December 2000, as confirmed by official Flemish government information.

A Crisis of Unfulfilled Promises

According to a recent investigation by De Morgen, parents describe situations of extreme hardship. Anicia Coucke, mother of Eithan—a child with autism and Down syndrome—told the newspaper that “the care for Eithan puts a lot of pressure on our family.” Her story is one of many highlighting the human toll of a system that promises support but delivers years of waiting.

The core of the crisis lies in the program’s chronic underfunding. The PAB uses a priority classification system: Priority group 1 (highest care needs) was largely addressed through extra investments by 2022. However, as of that year, Priority group 2 still had 3,473 people waiting, and Priority group 3 had 11,200 waiting, according to reporting by VRT NWS.

A Long-Standing Problem

Official statistics from Statistiek Vlaanderen show that in 2024, approximately 2,643 children and young people held a PAB—a 59% increase from 2021. While this growth demonstrates increased access for some, it also underscores the vast unmet need. The number of families waiting remains far higher than those receiving support.

In 2025, Gazet van Antwerpen reported on Davy Koninckx and Annelies Leemans, parents of five-year-old Matthy, who has Angelman syndrome. Facing years of waiting for a PAB, they resorted to organizing fundraising to cover care costs—a stark illustration of how families are forced to find alternative solutions while the state fails to deliver.

Political Responsibility and Advocacy

The PAB falls under the Flemish government’s Welfare department, led since May 2022 by Minister Hilde Crevits (CD&V). Upon taking office, Crevits acknowledged the scale of the challenge, stating, “We need a major action plan to get more people into care.” In 2022, she noted progress on the highest-priority group but conceded that “the work is not yet done; we also want to offer perspective to the other priority groups,” as reported by Trends/Knack.

Flemish parliament member Maurits Vande Reyde (Open VLD) has been a vocal critic, pointing out that partial budgets were promised for Priority group 2 but never materialized. “In priority group 2 there are still 3,473 people waiting. Partial budgets were promised, but that system still does not exist,” he told VRT NWS in 2022.

Systemic Challenges

The PAB crisis is not an isolated issue but part of broader systemic failures in Belgium’s care infrastructure. Chronic staff shortages in the care sector make it difficult for families to find qualified personal assistants even when budgets are approved. The application process, though simplified in recent years, remains burdensome for already-stressed families. Additionally, budget amounts, while indexed annually, may not keep pace with actual care costs.

Advocacy groups such as De Ouders VZW, GRIP, and Onafhankelijk Leven continue to push for systemic change, faster processing, and adequate funding. They argue that the crisis undermines Belgium’s commitment to the UN Convention on the Rights of Persons with Disabilities, which emphasizes community-based care and independent living.

What’s Next?

As the Flemish government faces mounting pressure, the question remains whether Minister Crevits will announce new funding commitments or structural reforms to address the waiting lists for Priority groups 2 and 3. For families like Anicia Coucke’s, the urgency could not be greater. Each year of delay means another year of burnout, financial hardship, and diminished quality of life—for both the children who need care and the parents who provide it around the clock.

The coming months will be critical. Advocacy groups are calling for concrete action, not promises. Whether the Flemish government will deliver on its commitments to vulnerable families remains to be seen.