overview
The Netherlands Ministry of Health, Welfare and Sport is responsible for the development of policies to ensure the health and social wellbeing of the residents in this small densely populated country. The Netherlands is similar to the United States in having a health system based on private providers with government responsibility for the accessibility, affordability and quality of health care. Health insurance is compulsory and the government contributes for those unable to pay.
General practices are private businesses which enter into a contract with insurers to supply services to the customers of the insurance company. GPs are paid a capitation fee per patient registered with their practice, a fee per consultation and a negotiable reimbursement for practice costs, depending on services offered, staff employed, and the achievement of quality and efficiency indicators. These fees are paid to the GPs by the insurance companies.
Most GPs are independently established and self-employed. Patients in The Netherlands choose their own family physician, but are required to register with a practice. Many practices employ a practice nurse to provide chronic disease management and most GPs employ doctor's assistants who can perform simple medical procedures such as taking blood pressure, syringing ears, giving injections and performing vein punctures under instruction from GPs. Out-of-hours centres or cooperatives provide access to PHC services from GPs, nurses or doctor's assistants from 5pm to 8am.
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More information on the PHC System in the Netherlands
 Website: Primary Health Care in the Netherlands Netherlands Ministry of Health Welfare and Sport (2008).
This web page contains a link to the PDF of 'Primary Health Care in the Netherlands: The nature, structure, financing, regulation, supply of, and training and demand for primary health care in the Netherlands'. Poorter, J. (2005). Ministry of Health,Welfare and Sport.
This publication contains valuable workforce statistics on general practice, however, given the changes that occurred in 2006, some of the information on health insurance and remuneration has been superseded.
The new care system in the Netherlands: durability, solidarity, choice, quality, efficiency Netherlands Ministry of Health Welfare and Sport (2006).
Describes in detail the Dutch health system and insurance system and the roles of the government and the health insurance companies.
Health Policy Monitor
The International Network Health Policy & Reform brings together health policy experts from 20 industrialized countries to report and comment on health policy trends. Their reports are available here.
Health care systems in transition: Netherlands Exter A, Hermans H, et al. (2004). WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies. Observatory E-Bulletin, February 2005: Item 4.
An explication of the Dutch health care system prior to the 2006 changes to the health insurance system.
Evaluation and analysis
'Dutch Doctors and Their Patients — Effects of Health Care Reform in the Netherlands' Knottnerus J & ten Velden G. (2007). New England Journal of Medicine Dec 13;357(24):2424-6.
Gives an overview of the impact of the 2006 changes to the health system on general practice.
Quality Development in Health Care in the Netherlands Grol R. (2006). Commonwealth Fund 21(March 28).
Discusses Dutch initiatives in health care.
After-hours care in the United Kingdom, Denmark, and the Netherlands: new models Grol R, Giesen P, et al. (2006). Health Aff (Millwood) 25(6): 1733-7.
European after-hours care is shifting away from individual and group practices with local after-hours call schedules toward large-scale after-hours care services.
Development of out-of-hours primary care by general practitioners (GPs) in The Netherlands: from small-call rotations to large-scale GP cooperatives van Uden CJ, Giesen PH, et al. (2006). Fam Med 38(8): 565-9.
This literature review synthesizes evaluations of the new model
Canada-Netherlands Seminar on Health Care Dudgeon N. (2007). The Hague, Netherlands, Canadian College of Health Service Executives.
Summary of a joint Canadian-Dutch seminar on Health Care Reform to study recent policy and program initiatives in the Netherlands toward improving health system quality, safety and efficiency.
Developing a national performance indicator framework for the Dutch health system ten Asbroek AHA, Arah OA, et al. (2004). International Journal for Quality in Health Care 16(Supplement 1).
Reports on the first phase of the development of a national performance indicator framework for the Dutch health system.
Dutch Health Care Performance Report 2006 Westert G & Verkleij HE. (2006). Centre for Prevention and Health Services Research, Public Health and Health Services Division, National Institute for Public Health and the Environment, Netherlands.
This evaluation of the Dutch health care system was completed in 2004.
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