Patients suing Dutch State over long waiting lists in mental healthcare

Patients, loved ones, and providers in mental healthcare, united in the foundation Recht op GGZ, are preparing a joint lawsuit against the Dutch State and health insurers. According to them, the government and health insurers violate patients’ right to life and right to access healthcare with the unacceptably long waiting lists in healthcare, NOS reports.

At the end of 2023, there were almost 100,000 people on waiting lists in mental healthcare, according to the Dutch Healthcare Authority (NZa). The NZa expects that about one in five people are on more than one waiting list, bringing the total number of waiting patients to around 78,000. Just over half of this group has had to wait longer than the applicable standards.

The NZa partly blamed the waiting lists in mental healthcare on staff shortages. But psychiatrist Manon Kliejweg of the Recht op GGZ disagrees. A recent study by the Consumentenbond showed that at the start of 2024, thousands of psychologists and psychiatrists had not been contracted by health insurers. Kleijweg believes that the long waiting lists are caused by the “turnover ceiling” health insurers impose on mental healthcare institutions. Since 2012, insurers had approximately 300 million euros per year left over from the mental health macro budget as a result, the Court of Audit previously confirmed.

Mental healthcare providers constantly experience the consequences of these turnover ceilings, Kleijweg told NOS. “Sometimes, practitioners hear from their employer as early as May that they are no longer allowed to accept new patients from a certain insurer for the rest of the year because that ceiling is in sight. This leads to such distressing situations that consultations are initiated with the insurer so that you can help some additional patients. And that is sometimes three times a year with different insurers. That is also a waste of time.”

According to Recht op GGZ, health insurers neglect their duty of care by purchasing insufficient mental healthcare, and the government does not put enough money into mental healthcare. Kleijweg is convinced the waiting lists will disappear if health insurers fully spend their macro budget for mental healthcare. When the Minister added 30 million euros to the budget, it had an immediate effect, she said.

The consequences of the waiting lists are enormous for the patients and society, the foundation said, referring to a study by the VU University Amsterdam. It showed that every month on a waiting list for mental healthcare reduces the chance of the patient eventually returning to work by 2 percent. Reducing waiting lists by one month would yield over 300 million euros per year, researcher and PhD candidate Roger Prudon calculated.

Asked for a response, a spokesperson for Health Insurers Netherlands told NOS: “We believe it is very important that mental healthcare is easily accessible to everyone who needs care. Health insurers take their duty of care extremely seriously and work hard every day with providers, institutions, municipalities, governments, and the social domain to ensure the accessibility of mental healthcare. In the Integrated Care Agreement, we have made important agreements that contribute to reducing waiting lists.”

A spokesperson for outgoing Medical Care Minister Conny Helder said the waiting lists in mental healthcare are a “point of concern” but added that work is being done to “get a grip” on them.