Care organisations have called for immediate action following a confidential police report warning that criminal gangs have infiltrated the Dutch community healthcare system “on a large scale” by using fake qualifications or setting up their own care agencies.

Police said gangs are increasingly setting up care agencies, taking advantage of vulnerable elderly people, youngsters with problems and people with serious mental disabilities who are less likely or take longer to report insufficient care or abuse.

Some €10 billion of the total €100 billion health budget is pocketed by fraudsters. and that includes millions raked in by criminal gangs, the police report said.

The Netherlands has thousands of small companies offering care services, ranging from community nursing operations to psychiatric services, youth coaching, and residential care.

They are funded by local authorities and health insurance companies, often via PGBs, or personal care budgets which allow people who need care to buy in services themselves.

Healthcare minister Fleur Agema who in August announced measures against criminal infiltration in the healthcare system following MPs questions, said “her blood boiled” at the report.

Agema repeated her intention to set up a “healthcare fraud information point” and a licensing system for healthcare agencies which she said “would remove the rotten apples”.  Both measures will become effective from January 1.

But Agema also said the matter was “complex”. “This will effect change, but these people are ruthless and certain to find new ways and means. I will look at more measures to prevent that,” she said.

Shamir Ceuleers of the centre for people trafficking CKM said the report required immediate and close cooperation between politicians, care institutions and monitoring bodies. “We cannot afford to abandon vulnerable patients in institutions where they are meant to be safe,” she told RTL Nieuws.

Long standing

The CKM pointed out a report which said the problem is of long standing and that between 2019 and 2023 one in five victims of sexual and criminal exploitation was recruited by a care institution.

In 2021, research carried out on behalf of the health ministry in Twente found that several small care organisations had forced their vulnerable clients – often troubled youngsters or people with psychological or addiction issues – to work on marijuana plantations and even trafficked them for sex.

The national audit office also said in 2022 that efforts to combat fraud in the healthcare system are failing and the chance of being caught is extremely low.

Nothing had changed since then, said board member Ewout Irrgang. “The organisations involved in monitoring fraud seem unable to do anything about it,” he said.