Diederik Schrijvershof and Annabel Kingma have filed an enforcement request with the Dutch Healthcare Authority (NZa) on behalf of Stichting De Bevlogen Huisartsen (DBH) and 71 individual GPs.
The enforcement request relates to breach of the duty of care/care procurement duty by all the health insurers. This duty is described in Article 11 of the Zorgverzekeringswet (Health Insurance Act). Dutch citizens are obligated to take out basic health insurance and to pay health premiums to health insurers. Health insurers are therefore under a statutory duty to procure sufficient care, including GP care and mental healthcare.
Health insurers are procuring both insufficient mental healthcare and GP care. More than 100,000 people are on waiting lists in the mental healthcare sector in the Netherlands, for instance: more than 50,000 of them longer than the maximum acceptable waiting period (Treeknorm). An increasing number of people in the Netherlands furthermore do not have access to, or are unable to access, a (regular) GP, according to the NZa. In the fourth quarter of 2023, more than 5,000 people contacted their health insurer because they could not register with a new GP.
Health insurers are failing to procure sufficient mental healthcare and GP care for their policyholders in a timely manner and within a reasonable travel time. The NZa is not enforcing the duty of care/care procurement duty or is in any event doing so insufficiently. The lack of enforcement of the duty of care/care procurement duty affects not only the insured persons on the waiting list: their loved ones, other insured persons and GPs are also directly affected. On behalf of DBH and the 71 individual GPs, the NZa has therefore been requested immediately to take sufficiently effective and concrete action to enforce the duty of care/care procurement duty.
Maverick Advocaten is assisting GPs in various proceedings, for instance in obtaining realistic rates from the NZa (see here and here). But also in adequate enforcement of mandatory NZa rules for health insurers in healthcare procurement and in addressing excessive market power of health insurers (see here).
More information on the duty of care/care procurement duty and its enforcement can be found in this blog, this blog, this blog, and this interview in Zorgvisie. More information on the rights of healthcare providers in healthcare sales and the possibilities for their trade associations to support them in this regard can be found at www.zorgcontractering.com.
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