The Dutch consumer and markets authority ACM is to give family doctors and other health practitioners more leeway to work together to negotiate fees with health insurance companies.

The ACM’s chairman Chris Fonteijn told the NRC at the weekend that doctors and physiotherapists can work together if it is in the interests of the patient. What they may not do is divide up areas between them, boycott a health insurer as a group or stop new doctors setting up practices, Fonteijn said.

In addition, doctors who do break competition laws will be given a warning before the ACM issues fines, he said.

Family doctors have complained they are powerless to negotiate contracts with health insurers on an individual level and feel they are forced to sign agreements even though they don’t agree with them.

Nine out of 10 family doctors are unhappy with the contract they have signed with health insurance companies, according to a survey by national association LHV in March.

In particular, doctors are unhappy that the association is not allowed to negotiate on their behalf because it would break anti-cartel legislation.

Doctors are supposed to compete with each other to ensure the Dutch health system operates as a proper market. Four insurance companies control 90% of the market.

There are almost 9,000 family doctors in the Netherlands, who are responsible for solving 94% of patients’ complaints. They do this on 5% of the total healthcare budget.