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Country profiles of health system responses to the crisis | The Netherlands
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good such as bandages and out-of-date medication particularly in care homes
and ambulatory care.
Salaries and motivation of health sector workers
• An agreement on specialists' salaries was reached in 2012, increasing the
average annual salary by around 17% to €300 000.
• Provider compensation for annual salary adjustments was reduced
(2013); however, salary increases are still possible.
Payment to providers
• Price reductions received from pharmaceutical companies (bonuses) were removed
as part of wider changes to purchasing by SHI funds (2010). Pharmacists now
only receive a pre-defined fee for each service (from the government).
• A new ex-post payment enforcement mechanism was included for overruns
for provision of acute care by providers of inpatient care (hospitals and
mental health institutions) with the aim of lowering growth in volume to
2.5% per year (2012). In 2013, the rate of growth was set at 1.5% (2.5%
for GPs) in 2014 and 1% (2.5% for GPs) in 2015, 2016 and 2017.
Overhead costs: restructuring the Ministry of Health and purchasing agencies
• Since the reform in 2006, the role of the Ministry of Health within
the health care system is to be “lean and mean” (i.e. ensuring the key
performance of the health care system). Although the Ministry of Health
is limited to interventions in case of market failures, the primary goal of
the Ministry is to ensure the accessibility, quality and cost-efficiency of
health care for all citizens. Driven by the goal of reducing the government
deficit, the Ministry of Health is forced to keep overhead costs as low as
possible and cut budgets where possible.
Provider infrastructure and capital investment
• From 2010, the private market was further stimulated to invest in the
health care sector through the introduction of a system of regulated profit
creation.
• The Ministry of Health and hospital boards decided that hospitals should
be more specialized and will serve larger areas for certain specialties, in
order to improve the quality and reduce costs through increased volumes
of provided care (2011).
• The Minister of Health sent a proposal to the parliament on new legislation
with respect to private health care investments (2013). The new legislation
will make it easier for private investors to invest in hospitals, but with strict
conditions.