A damning leaked report has called for a major shake up in the way the Dutch health authority operates, saying the current set up is vulnerable to conflicts of interest and government interference.

The report comes from an independent commission set up to investigate the way the NZa works following revelations about the suicide of a whistleblower and other scandals, the NRC and Nos television said on Monday.

The commission says the NZa’s main roles – drawing up rules to cover health service treatment, and regulating hospitals and insurance companies – should be separated to avoid potential conflicts.

The NZa is not only responsible for deciding which drugs and treatment should be covered by the mandatory health insurance, but for supervising the advance of the private sector into the system.

Supervisory board

The NZA should also have a supervisory board and its two-man management board stretched to three. The two board members resigned in June after the NRC published a string of revelations about their expenses and hospitality agreements with insurance companies and drugs companies.

The organisation’s personnel policy needs a complete overhaul as does the relationship between it and the health ministry, the report says. 

Health ministry officials are also criticised for interfering in the NZa’s work, which, the report says, has given rise to claims of ‘unjustified interference’.
‘There should be no interference from the minister in individual cases,’ the report states.

Whistleblower

The report is particularly scathing about the treatment meted out to whistleblower Arthur Gotlieb, who had compiled an extensive dossier on privacy and other failures at the NZa.

It was only after Gotlieb killed himself that the NZa began an investigation into his claims.

The report, commissioned by health minister Edith Schippers is due to be formally presented on Tuesday.

MPs polled by Nos television said they were not surprised by the report’s criticism and have called for an emergency debate with the minister.

Socialist MP Renske Leijten said the fact that there is, in effect, no independent healthcare regulator in the Netherlands puts all decisions taken about the care system ‘in a dubious light’.