Dutch healthcare authority must be reformed: leaked report

The Dutch healthcare authority NZa needs strong reforms and better management, a report commissioned by Minister of Health, Welfare and Sport Edith Schippers (VVD) will reveal on Tuesday. The report, leaked to newspaper NRC, directs strong criticism at the dual mission of the organisation, which provides policy recommendations and the spervision of hospitals and insurers, claiming that the organisation is plagued by internal security leaks and undue managerial influence.

The committee began their investigations in April when NZa employee Arthur Gotlieb committed suicide. Prior to his death Gotlieb laid numerous claims against the NZa in a 600-page document including statements that he was neglected and ignored by his managers, and that the NZa was plagued by an inability to protect confidential information.

“Gotlieb has not been given the care and guidance that had been appropriate," the commission ruled. “From 2007, he was ‘neglected’ and ‘ignored’ by his managers. He was not offered guidance that would have been appropriate."

The committee, headed by State Council member Hans Borstlap, has strongly criticized the behaviour of the Authority, who only began an investigation into security leaks months after Gotlieb’s death, amidst pressure by the news media.

During their investigation, the committee also examined Gotlieb’s allegations of departmental interference with subsidies to the Rotterdam Eye hospital.

The committee found that NZa has too many responsibilities in its portfolio which has lead to conflict, the report says. The committee is proposing structural and organizational changes so that one department is not placed with the burden of regulation and enforcement.

"The appearance of undue influence is inflamed," said Borstlap. "For a pure relationship, it is necessary that the ministry as a whole is not involved with both regulatory and supervisory roles.”

Borstlap's committee has also found that the relationship between the factions of the NZa needs to change. The committee has proposed that the ministry's management board consist of three persons instead of two, and the establishment of a supervisory board. Contracts between the top levels of the Healthcare Authority and the NZa should be monitored by an independent administrative body, the report says.

A spokesman for the committee refused to comment Monday on the leaked report. The full report will be presented on Tuesday to parliament.