Healthcare providers are increasingly the victims of verbal or physical aggression from both patients and their relatives, according to the NRC.

Rijnstate Hospital in Arnhem received 430 reports of aggression by patients or visitors in 2024, one hundred more than in 2023. Leiden University Medical Centre (LUMC) has also seen an increase in reported aggression: in 2021, there were 378 reported incidents; 442 in 2022 and 682 in 2023.

“The reports that come in are just the tip of the iceberg,” Mike Wijngaarden, who provides hospital training in how to deal with aggression, told the NRC. “I know university hospitals where the number of reports reaches almost 2,000 per year.”

In 1995, Rijnstate Hospital had four security guards. Now it has 34.

Visitors, who often violate visiting hour rules and limits to how many people can visit at a time, have physically attacked staff, spat at them and thrown chairs. Some employees receive intimidating messages on their Facebook or Instagram accounts from patients who felt they had to wait too long for care or didn’t get their way.

Many hospital departments now have emergency buttons, and staff are allowed to leave their last names off their name tags. They are also advised to contact security at the first sign of trouble.

Targeted aggression
Although aggression sometimes arises from patients with dementia or other mental disorders or from fear and misunderstanding, it’s the targeted aggression—behaviour intended to intimidate or threaten—that hospital employees say is the most alarming.

Trade union NU’91 conducted a national survey this year among more than 1,200 healthcare professionals. Of the 266 hospital staff that responded, 43% indicated they had experienced aggression in 2024—both verbal and physical. Of these, almost half indicated that the aggression was the result of a disagreement about a treatment plan and a third was due to a (supposed) excessively long waiting time.

Although there is no clear cause for the increased aggression, those affected mention everything from a hardened society to declining trust in doctors due to online self-diagnosis and even the aftermath of coronavirus.

Punitive measures can offer some relief for repeat offenders. That includes a red card, where a hospital can temporarily deny someone access as long as they don’t require emergency care.

In 2017, six red cards were issued at Rijnstate. Last year, there were 24.