Medical specialist subsidies failed: Health minister

Minister Edith Schippers' subsidy regulation to encourage medical specialists to work as an employee, has failed. Only in 3 of 67 hospitals did self employed specialists partnerships decide to disband in favor of permanent employment. This is evident from a tour of the Order of Medical Specialists along 67 of the 72 hospitals where self employed specialists are active. There are about 21 thousand medical specialists in the Netherlands. Almost half of them work as entrepreneurs, usually in a partnership. Their incomes have been under discussion for years. A series of ministers decided to bring down the bill for specialist medical care. As from January 1st, specialists can no longer claim their costs directly from the insurer. The idea was that this, combined with a subsidy, would make it more likely that specialists take employment at a hospital. It now appears that almost all specialists partnerships opt for a tax structure that allows them to retain their independence. According to Schippers, the specialists fear that as employees they would have to bring their salary under the norm - 228 thousand euro, including pension. There is "the perceived threat of the standardization law for top incomes". The Minister also concludes from her owns survey of the hospitals that the number of specialists who chose permanent employment, get left behind. According to Janko de Jonge, vice president of the Order of Medical Specialists, the motive for not choosing employment is not money, but the desire to keep control over the business. As self employed the specialists can consult with the hospital management on an equal basis. De Jonge calls the free establishment one of the cornerstones of the high quality Dutch healthcare system. A spokesperson for Minister Schippers stressed that the subsidy is meant to allow a balanced choice for specialists between free establishment or employment.