The Rise of Corporate Chains in General Practitioner Care: Concerns and Supervision in Healthcare

Mar 04, 2024 at 12:34 Update: 28 minutes ago

Large companies can maintain general practitioner care by taking over practices. But there are also concerns about how large these chains can become and their influence on healthcare. Supervisors want to be able to keep a better eye on this.

That is the conclusion from the report published on Monday rapport The rise of corporate chains in general practitioner care.

The pressure on general practitioner care is great. There is little staff and at the same time people are demanding more and more care, partly due to the aging population.

In recent years, large companies have been responding to this by, for example, purchasing the practices of general practitioners who want to retire but cannot find a successor. This can be good for doctors and patients, because large companies can take away administrative tasks from general practitioners, among other things. This leaves more time for patients on paper.

But in practice there are also problems. For example, the Dutch Healthcare Authority (NZa) and the Healthcare and Youth Inspectorate (IGJ) received signals of practices that were difficult to reach or practices that mainly provided digital care. The supervisors do not write about which companies are involved.

In addition, the NZa and IGJ are concerned about how large these chains can become. Suppose such a company runs into financial problems, this could easily have consequences for general practitioner care in an entire region.

NZa wants to be able to assess acquisitions better

A takeover of a general practice, if it is large enough, must be approved by the NZa. It has a list of points that the takeover must meet. Is it well prepared, what are the financial consequences and are the plans well coordinated with employees and patients?

Such a check mainly concerns procedural matters, says the NZa. There are few options to prevent a takeover on substantive grounds, for example because a company has already taken over many other practices in the region.

This also became apparent last month when one of those chains, Co-Med, took over a general practice in Amsterdam. This organization now has thirteen practices in different cities and has already been reprimanded by the inspectorate because the practices are said to be difficult to reach. The NZa approved the takeover, but said at the time that “based on the test, it cannot draw any conclusions about the effects of this takeover on the quality, accessibility and affordability of care”.

Sanne Oving is a domestic reporter at NU.nl

Sanne follows major domestic themes for NU.nl, such as healthcare and asylum.

‘Running against the limits of supervision’

In addition to a more extensive check on takeovers, the IGJ and NZa also want to better monitor the business operations of these larger chains and the care they provide. “In practice, we are reaching the limits of supervision,” they write in the report.

Take digital care. There are currently no standards that this care must meet and when it may be used. The supervisors also point out that better standards are needed to determine how many staff are needed in a particular region to maintain good care.

The IGJ and NZa say they see that a lot is happening to innovate general practitioner care, but say that “this should not be at the expense of the accessibility, quality and affordability of care for patients”.

Pia Dijkstra, outgoing Minister for Medical Care, said in a response to the report that she will discuss the recommendations from this report in the coming period.

2024-03-04 11:34:32


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