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You are here: Home Health & Fitness Healthcare The Dutch healthcare system
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07/03/2014The Dutch healthcare system

The Dutch healthcare system Here’s a guide to the Dutch healthcare system, including health insurance, doctors, dentists and pharmacies in the Netherlands.

One of the many great things about living in the Netherlands is the excellent standard of Dutch healthcare, rated as the best in Europe. The Netherlands tops the list of 34 nations in the 2012 Euro Health Consumer Index (the ‘industry standard’ of modern healthcare) and spends 11.9 percent of GDP on health, second only to the United States. Plus, almost all the doctors speak excellent English, making healthcare in the Netherlands very accessible to expats.

Health insurance in the Netherlands is mandatory

Healthcare in the Netherlands is covered by two statutory forms of insurance:

  • Zorgverzekeringswet (Zvw), often called ‘basic insurance’, covers common medical care. 
  • Algemene Wet Bijzondere Ziektekosten (AWBZ) covers long-term nursing and care.

While Dutch residents are automatically insured by the government for AWBZ, everyone has to take out their own basic healthcare insurance (basisverzekering), except those under 18 who are automatically covered under their parents' premium. If you don’t take out insurance, you risk a fine.


Insurers have to offer a universal package for everyone over the age of 18 years, regardless of age or state of health – it’s illegal to refuse an application or impose special conditions.

Health insurance for temporary visitors

If you are staying in the Netherlands for less than a year, your stay is usually classed as temporary and you don’t need to take out the compulsory insurance but you will need health insurance of some kind. If you already have an international health insurance, contact the College for Health Insurances (College voor Zorgverzekeringen) on 020 797 8555 to see if it will be accepted – and what healthcare it will cover – in the Netherlands.

If you hold the European Union Health Insurance Card (EHIC) you will be covered while your stay is temporary (as decided by the insurer in your home country). If your stay is not temporary or as soon as you have a residence permit, you must take out a Dutch healthcare insurance policy.

Students

Students from the EU/EEA/Switzerland are exempt from paying health insurance – unless they are working, even part time, or as part of a paid internship. Non-working students will be given an European Health Insurance Card (see below), or an international declaration form instead.

Students from outside the EU need insurance like everyone else.

Sometimes colleges and companies have a contract with a health insurer so that students and employees can enjoy discounted premiums.

You can read more information on different aspects of the Dutch healthcare system on Expatica's healthcare page for the Netherlands.

Dutch health insurance for expats

What does Dutch health insurance cover? 

The basic insurance package covers all costs for the most common medical care. Depending on your health insurance, it can include:

  • GP consultations;
  • Treatments from specialists and hospital care;
  • Certain mental health care;
  • Medication;
  • Dental care up to 18 years;
  • Care from certain therapists, such as speech therapists;
  • Dieticians; and
  • Maternity care.


You will need extra coverage for extensive dental treatments, physiotherapy or anything else the government considers to be your own responsibility, and it is in these additional areas that companies compete. It is possible to purchase the additional coverage (aanvullende packet) from a different insurer than your basic insurer. This may make things more complicated when processing bills, but it can sometimes lower your overall costs, or allow you to purchase additional coverage tailored for the needs of international persons residing in the Netherlands.

For maternity care, it is worthwhile to check what your Dutch health insurance will cover – there are generally a range of helpful services for mothers-to-be. For information about pregnancy and birth in the Netherlands, see our guide to having a baby in the Netherlands.

How much does Dutch healthcare cost?

Your employer will pay 7.75 percent of your salary for you for the Zvw component, and deduct 12.65 percent from your pay for the AWBZ part (up to EUR 33,363/year if you are under 65). The self-employed pay slightly less Zvw, at 5.65 percent.

In addition, you will generally have to pay monthly contributions to your health insurer, which in 2013 amounted to around EUR 1,291 a year (it varies slightly from insurer to insurer). Online websites help you to compare general health insurance packages and costs from different insurers.

The insurance policy will also have an ‘excess’. This means that you have to pay the first EUR 350 (as of 2013) of some treatments. You don’t pay the excess on services supplied by GPs, obstetric and post-natal care: these are completely free.

Help with costs

You may be able to get help towards the cost of your insurance premiums in the form of a ‘care allowance’ (zorgtoeslag) by applying to the Dutch Tax Administration (Belastingdienst). To be eligible, you must be over 18, have a residence permit and be paying health insurance. You need to earn less than EUR 30,939/year as a single person or EUR 42,438/year as a couple. The amount you get depends on your income.

Once you’re insured

You need to present your ID and a health insurance chip card when you use any of the health services. Depending on whether your insurer has a contract with the particular provider (check your policy), you can pay at the time and be reimbursed, pass the bill onto your insurer, or do nothing as the health service provider and insurer will deal with the bill between themselves.

Your European Health Insurance Card

The Netherlands is part of an EU-wide (and Swiss) healthcare scheme. Your insurance company will give you a European Health Insurance Card (EHIC) which means that if you need medical treatment while you are elsewhere in the EU, you don’t have to pay for it – the insurance company will. Remember to take the card with you when you travel within the EU or Switzerland.

Finding a doctor in the Netherlands for expats
Going to the doctor in the Netherlands

The huisarts (GPs) are responsible for gathering all your medical records and are the gatekeepers to all the other types of medical treatment, so they are the first point of contact when you have a health problem (unless it’s an emergency, of course). They can deal with routine health issues, perform standard gynaecological and paediatric examinations, and refer you onto other services, including hospitals, specialists, home midwifery and physiotherapy.

Finding a doctor – and registering

First, you need to register with a huisart, preferably one nearby. Almost all of them will speak English. Not all practices will be taking on new patients, however, or they may have long waiting lists. As such, it's worthwhile to register before you become ill. You can make an appointment to meet the doctor before registering, to assess their suitability for your needs.

You can find a list of local doctors by checking:

  • The gemeentegids (community guide) available at the town hall;
  • The Yellow Pages of the phone book under ‘Artsen – huisartsen’,
  • Via the Centrale Doktersdienst helpline on 020 592 3434;
  • By personal recommendation – ask friends, family or even post a thread on Expatica's forum.
  • Online sites listing doctors in the Netherlands (Dutch language website).


Appointments: What to expect

You normally have to make an appointment in advance and may have to wait a few days to get a slot. Appointments often run late, so expect to wait, and they only last around 15 minutes, so be succinct when you’re in front of the doctor. Many doctors have daily first-come, first-served sessions (inloop spreekuur) for short phone or drop-in consultations. These days, it’s rare for doctors to make house calls.

Dutch healthcare is generally non-interventionist in nature, so don’t expect to leave the consultation with a prescription.  Dutch doctors tend not to hand out antibiotics or anti-depressants lightly.

You might also see the doctor’s assistant (for blood pressure readings, urine testing, injections) or practice nurse (for monitoring chronic conditions like asthma or diabetes).

You may have to pay the doctor at the time and use the receipt to reclaim the money from your insurer; the doctor may send you an invoice for you to pass onto the insurance company – or send it direct. What you need to do varies from insurance company to insurance company, so check your policy for your payment conditions.

There is 24-hour healthcare coverage in the Netherlands; out of hours, you’ll usually hear a recorded message on the huisart's telephone telling you how to contact on-call medical services. Telephone messages are usually in Dutch, so it helps to get familiar with Dutch numbers early on. Alternatively, you can call 020 592 3434 for medical advice from a central doctor’s service (Centrale Doktersdienst).

Going to see a specialist

You can’t go directly to a specialist for treatment, you have to be referred by a huisarts. Most specialists work within a hospital setting – as ‘contractors’ instead of employees – rather than a specialist clinic, and waiting lists can be long.

Hospitals

There are lots of excellent hospitals (ziekenhuis) with high standards of care all over the Netherlands. Each hospital used to offer a range of specialisms but they are becoming more specialised.

There are different types of hospital. Those attached to universities and carrying out medical research unsurprisingly have the most advanced medical equipment and treatments, and can offer the most specialised care. Teaching hospitals, training medics and nurses, also offer some specialised treatments. General hospitals deal with more routine conditions.

For information on hospital locations, see Expatica's listing of hospitals in the Netherlands.

Going to the hospital in the Netherlands

Unless it’s an emergency, you will need a referral letter from our GP. You will be asked to provide details about your medical history and lifestyle, and be registered on the hospital database.

You’ll be given a registration card (ponsplaatje) which you’ll have to show each time you visit – it’s a means of bringing up your details and passing on bills to your insurance company. 

Hospital admission

If you are admitted as an in-patient (and unless it’s an emergency, this could take months from your initial appointment), you may find yourself in a shared room or ward of up to six beds (mixed sex). You’ll probably have a TV and phone line but there will be a charge. Bring your own clothes and toiletries. Strictly enforced visiting hours vary from hospital to hospital.

Pharmacies: drogist and apotheek

A drogist sells non-prescription medications, toiletries, cosmetics and baby essentials; an apotheek sells prescription-only drugs as well as over-the-counter meds, vitamins, baby items, homeopathic products and medical equipment for home use, and can also advise on medications and minor ailments. 

There will always be an apotheek open 24 hours somewhere in the area. To find the closest out-of-hours pharmacy, you can:

  • Check the list displayed in the pharmacy window;
  • Call 020 694 8709;
  • Look under ‘medische diensten’ (medical assistance) in one of the free local newspapers;
  • Visit this online list of pharmacies (in Dutch) – just click on zoek een apotheek and enter your postcode to find the nearest one.


If you have a consultation with a huisarts (GP), you can sometimes collect your medicine right away from the apotheek as they’re often connected electronically. If the pharmacy has a contract with your insurer you won’t have to pay for your prescription at the time; if they do not, you’ll have to pay and claim it back. Your insurance company may also specify which types or brands are covered by your policy, and which are not.

Medications that can be bought over the counter back home may need a prescription in the Netherlands, plus medicines in the Netherlands might not be the same as you’re used to back home. If you’re taking medication prescribed in another country, show the pharmacist or doctor first.

Visiting the dentist

You need to register with a tandarts (dentist). You can find one in the same way as you would find a doctor (through the community guide, Yellow Pages or a personal recommendation) – there are over 9,000 of them. Traditionally, Dutch dentists have worked in single-dentist practices (and around 60 percent still do) but the developing trend is for dentists to work together in group practices.

Dutch dentist for expatsOnce registered, you will be invited for six-monthly check-ups. Your dentist may delegate certain routine tasks to dental hygienists, dental assistants and prevention assistants, and refer onwards if necessary to specialised orthodontists and oral surgeons, who are usually based in hospitals. Out of hours, call the surgery and a voice mail will direct you to an emergency service.

You may have to take out additional insurance to cover the cost of dental treatment (check what your policy offers); under 18s are automatically covered. 

Alternative treatments and therapies

Homeopathy, acupuncture, chiropractic, osteopathy, traditional Chinese medicine and other complementary therapies are widely used. The different types of therapy are grouped together in associations and you’ll find a list of regulated practitioners (in Dutch only) at the Association of Alternative Medicine.

Health insurers now cover many alternative therapies, so check what different insurers offer if you require alternate therapies or treatments.

Mental health

There are lots of good English-speaking counselors, psychologists, psychiatrists and alternative practitioners on hand to help with mental health issues in the Netherlands. However, costs vary and not all will be covered by your health insurance.

In an emergency

Go to the spoedeisende hulp or eerste hulp bij ongelukken (EHBO) department of your local hospital for medical emergencies or first aid.

Call 112 for urgent medical help if you think that a person’s life may be at risk. The operator will answer in Dutch but will be fluent in several languages, including English. Explain what has happened and an operator will pass you onto the correct service: ambulance, fire and police all use the same number. Don’t hang up! Your number will appear on the operator’s screen so if you are cut off, the operator can call you back. The 112 number is toll-free.

If you have a speech or hearing problem, call 0800 8112 and you can type a message to the emergency call centre. You should write where you are, where the help is needed and the service you need.

Call 020 694 8709 for pharmacies open outside normal working hours.

Call 020 592 3434 for urgent medical advice from a central doctor’s service.

Useful medical phrases
Call an ambulance: Bel een ambulance
Call a doctor: Haal een dokter
I am ill: Ik ben ziek

More information

For general details on the Dutch healthcare system, the Health Insurance Information Centre has information in English, as does the Ministry of Health, Welfare and Sport.

You can also visit Expatica's healtcare channel for information about insurance cover for different types of emergency care.

Bupa International health insurance: Find out more



Expatica


It’s now simple to get international medical insurance for yourself and your family, wherever you are in the world: Get a free quote from Now Health insurance, which offers award-winning international health care with local expertise.


Updated from 2012

Photo credits: Hang_in_there (doctor and patient), Dr Alper (dentistry), Images of Money (Pills and money).




18 reactions to this article

osita posted: 2012-07-26 19:12:34

It's unlikely to change either until they introduce a system which allows them to select medical students based on the highest grades.

At the moment, they prefer the draw-out-of-the-hat lottery system which allows a college leaver with a six-point-five-average to get a place at the expense of a person with a nine-point-nine average.

If they were barely smarter than average at school, it's astounding that the Dutch system thinks they'll be able to cope with sheer amount of knowledge they have to cram to keep patients alive, or even to bother reading and keeping up to date in their own field (I've met plenty of doctors here who so obviously don't).

When it comes to saving people's lives and maintianing their quality of life, it's morally reprehensible for a country to spend a fortune on the education of someone who simply isn't the best candidate for the job.

Anna posted: 2012-08-08 14:44:58

@ ostia, very true. The problem in NL is that doctors are too "specialistic" as one student told me and he was going to Germany to work when qualified.

This means a specialist ONLY knows about his specialism, kidney, heart, liver, gynae. etc NOTHING else. I have experienced this to my shock and horror. Now this is a FACT.

Here they will also.i.e scan you when pregnant, but only the baby. I had a child in the UK too and there they scanned all around the stomach. I asked what she was doing ( being used to NL) and she answered" Just looking as I might as well while busy. Don't they do that in Holland?" I said "no, they just look at the baby" "but they did after your operation surely"? "no", I said just that area". She was shocked I noticed, but said nothing. After I told all the horror stories of living in this country she said "I thought Holland was a first world country"?
I could go on but I would need to write a book.

Anna posted: 2012-08-08 14:50:42

The only thing I care about is my experience and that of others. The BMA will have their statistics etc from the Dutch themselves so as they always hide the nasty stuff no-one will be the wiser. Even some of their own publications warn about the health care. Their "consumenten bond" ran articles on the fact over 100.000 Dutch die per year (and maybe more they reckon as not all cases made known) because their GP's don't send them to a specialist on time. I asked my specialist ( a good one, they are around by the way but not many !) if this was true and he nodded saying "and we have to deal with the mess once they are here and get the blame if we can't help them" So I dont listen to medical journals..written by doctors FOR doctors If you ever and I hope you don't ever go into hospital here what else can I say but "all the best "(hopefully you will fare better than I. They ruined my health here through incompetence) I see doctors now in London and Germany for various problems and am improving somewhat, but terrified of ever having to go into hospital here again. [Edited by moderator]

pepe posted: 2012-08-09 11:22:16

@Anna, in 2011 135.516 people died in the Netherlands. So your claim that over 100.000 die because they are not sent to a specialist on time, seem very unlikely,

Anna posted: 2012-08-11 18:00:00

They are not my statistics. Refer please to the consumenten Bond. It was a few years ago.I may have indeed got the figures wrong, sorry if made a mistake, if so you are correct to correct me as you are right 100.000 could hardly be correct !
Having said that ,I was shocked at the article and as I mentioned my specialist confirmed a lot to me.But I do not have the publication anymore (2009 I think) . it was on the cover of the magazine. At the same time the Dutch "Readers Digest "ran an article advising people here stay healthy by eating well, exercising and taking supplements so you and your kids don't have to go into a Dutch hospital .
Not my research nor my words.
It was shocking to say the least.
. I have had my own experiences and those of many others.Some years back they did not even have hospices here for the terminally ill .

Nancy posted: 2012-09-11 16:04:42

Hello, I agree with most posts I read so far: being a French citizen, having lived years in the US, and now being in the NL for a bit less than a year (and pregnant), I feel so disappointed with the Dutch health care. I changed general practitioner, I went to a well-known hospital (Bronovo in the Hague), and despite that, I feel so frustrated by the lack of knowledge of "huisarts" in this country. I learned enough of medicine and biology in grad school to believe that I can tell when some obvious medical ******** are being told. And yes, you are compelled to pay for a Dutch insurance: they are expensive FOR WHAT THEY COVER, in particular, as in my case, if you are pregnant and does NOT want to give birth at home and want pain relief medication during labor without serious medical grounds. Not talking about the fact that, when your pregnancy is not "high risk", you can only meet with midwives (mine were extremely kind but totally lacked any kind of medical knowledge; even after bleeding at 28 weeks, i still was not referred to an OB; and i am not talking about the stress i had around my poorly treated UTI... you don't need an extra load of stress during pregnancy...). Despite the cost, we decided to go abroad for obstetrical care and childbirth. Best decision of the year. I get great care now and that's ok if i pay more for it and barely get a 10% reimbursement despite subscribing to the highest insurance policy: it's my choice. However, even if i wanted to pay more in the NL, I would not find that quality of care, and i blame the Dutch system for that. I am not looking forward to go back to the NL: what kind of pediatrician will i find there? To conclude, if you are healthy, not pregnant and/or dislike medical interventionism, the NL will be just fine for you. Otherwise, I would not recommend it.

ps posted: 2012-10-22 13:34:05

I am also disappointed with Dutch doctors. I have a cyst on my left ovary. According to most doctors (not the one from my country), because the cyst is small I only have to do regular checks. So my 1st GP sent to me a specialist, who told during the consulation that I could have endometriose and that's all he said (why? because I was there for the cyst only). Something about the Ducth doctors is for each consukation we should only cover 1 complain.Maybe that is why he didn't continue the conversation.. Because there was no further discussion, I though, this is not an issue.. A few months later we (I and my husband) decided to have children, so I went to the doctor to ask advice. He only told me to take folic acid.I forgot to mention the endometriose (after the specialist consulation I found out that this could cause infertiliy). By the way, I forgot because, as always the consulations take 10 minutes only and you are not suppose to mention more than 1 subject. When I left he promissed to call me the following week as I was waiting for some lab tests results. When I realized I forgot to mentioned the endometriose, i though well, it's good that the doctor has to call me with regards the tests results. then I can ask him for a referral to go to the specialist. The doctor never called, so I called the assistant and asked if the doctor could give me a call back (the practice allows 1 hour per week for phone appointments). I expressed my concern and said that it was urgent for me. He never called.. After 1 week I decided to chang GP. The same day I changed GP, i received a phone call from the assistance asking if I had changed GP so that she could send my medical records to him. I confirmed and she said...by the way, the doctor tried to call twice you but it didn't work (can you imagine, she was now caling me because I had changed GP but giving the excuse that there was something wrong with my number). Anyway, I asked for my tests results, she said the doctor would call me (although the doctor told me the assistance could also inform me). But the doctor never call. 2 days later I called again, this time only to ask if they had sent my record to the new doctor. She said yes (although she was extremelly rude). But the truth is, 2 weeks have passed and the new doctor never received my records. I have a new GP, until now, no complains, I went to a specialist who told me: endometriose can only be checked by means of surgery (it is not just infertility, it causes extremelly severe period pains). And from what I read, with a surgey it can be checked and partially removed improving fertility and reducing pain. But the specialist wants to wait 9 months to see if you can get pregant. If not we will check for infertility and check if you have endometriose.I cannot believe, also becasue according to what, even if a woman gets preganat, with endometriose, it is very likely to have miscarriages. [Edited by moderator. Please post (elaborate) questions on Ask the Expert or on our Forums. If you have questions for the Expatica staff, please contact us directly.] I think there is nothing I can do, only going back to my country and asked them to check it. With all these things I called my country's doctor and she confirmed the reason why she wanted me o remove the cyst was beacsue it could be related to endometriose

Steve posted: 2012-11-18 11:23:59

Just like my experience PS. I also went to change doctors because mine is so useless, and THEN they were suddenly all over me with lots of attention. The rest of the time they are too busy to see me without an appointment a week ahead, and quietly obnoxious if I mention more than one topic, probably thinking 'huh I've fixed the problem and now he wants something for free!' [Edited by moderators] I have to demand antibiotics sometimes or it's just the standard 'come back in a week and we'll see how it's going'. They just want to clock up another consult!

Peter L in leiden posted: 2013-02-20 16:13:51

Health care is worse than depicted in some surveys and even going over th2 abyss. Example based on Eurostats statistics: Holland in 2010 (most recent stat) scores 5th worst in mortality for two leading cancers and for many others it is also abysmal. They ration care here like in no other country, not even the UK is as bad. In 2013 a law will be passed that patients won't be choosing their own doctors and clinics anymore. Insurers will. So they will impose the cheapest, most second rate ones. For my cancer I cannot even get MRI's here in the Netherlands, while I can in other countries. They only allow ultrasounds and that means spreading gets detected too late to treat properly. The know how here of many cancers is also subpar. There are South-American countries where they know more. Clinical trials are mostly done to satisfy the government's demands for proof, not to do real innovative research, so those trials are like reinventing the wheel already researched in the USA or the rest of Europe. Ypu cannot get into a private clinic of with a private doctor either, since there is no true dual private/public system here with different standards. Everyone has to abide by government edicts. Better get your care in the dual system in Germany, just across the border, if you can. By the way, Dutch health care will not reimburse any foreign care, unless it is man emergency and then only at ridiculously low Dutch care rates.

Linda posted: 2013-06-06 08:49:25

After reading so many comments about the Dutch healthcare system and living in Amsterdam for nearly two years, I had to break down and visit a GP for a nasty cough. It sounds like a broken record but I received the same reception as many people here. Although I had been experiencing a 'crunchy' cough for more than 2 weeks already, the doctor said my lungs were normal after checking with the steth. She then proceeded to tell me that it could possible carry on for another 4 or 5 weeks and her only advice was to drink plenty of water. If the cough hadn't cleared in another month I should come back for another check. I'm from the US and at the very least a doctor there would have given me some kind of cough supressant recommendation or prescription to keep the cough at bay so my partner and I could sleep at night, but no, non was offered here. Something as simple as Robitussin is banned over the counter here and doctors are not so open to prescriptions. My partner told me I need to fight and speak up for what I need from the doctor, but I'm not the one who went to med school and for what I pay in insurance every month, I shouldn't have to diagnose myself and then suggest and fight for the best medication. It's ridiculous! If you read stats about mortality rates here in Holland it's even more frightening. A country that has one of the highest rates of of death from curable cancer in the EU coupled with one of the highest rates of smoking. Non-interventionist indeed. I'm just hoping that nothing major happens to me while living here which is stressful to think about.

AudMar posted: 2013-08-22 11:59:42

I was so happy to join my Dutch partner in the Netherlands. Having experienced unemployment an what I thought sub-par insurance during that time in the US, I was happy to be in a country where everyone received care....until I went to the dr. First apt: was a "substitute dr." She told me about the 10 min 1 subject rule. I explained my issues and explained that I needed a refill on a prescription. She said she would only give me 2 weeks because my "permanent" dr might wan to give me something different. After 20 useless minutes, I was back in the office scheduling another apponintment with the permanent doctor the following week. I even left them a book of my medical files to review before the next appointment. Arrived today for 2nd appointment. Dr was 30 minutes late. Completely frazzled. She hadn't even reviewed my files and didn't know why I was there! I had to go over the same stuff(which I mostly forgot bc I was SOOO shocked since I already explained my "complaints" the previous week. She barely listened to me and then said I needed to make another appointment the following week! Good thing I don't yet have a job or I would never make it to work dealing with these people! I have decided to try out another doctor in the next town over. I shiver thinking about going back to that chaotic place with incompetent people that call themselves doctors.

Adam posted: 2013-09-16 23:10:18

Although I have few complaints about life in the Netherlands in general, the healthcare sucks, and I have seen it firsthand. I live in the Hague.
Most recently, I got a referral from my huisarts to see a sleep specialist for suspected apnea.
Seeing a specialist relies on an antiquated system of waiting for an envelope to be sent from the specialist, mailing the referral back to them, and then waiting for *another* letter with the appointment date.
I never received the letter with an appointment date. I called the sleep center several times, and they told me to wait a bit longer. They then informed me after a few weeks that they had never received my referral letter, although they still somehow knew my name and address.
They advised me to go back to the huisarts and get another letter!
There was already going to be a two-month wait for a sleep study. They wanted me to pay for another appointment with the huisarts and start over with the wait because they lost my referral letter. Amazing.

In another instance, my regular huisarts was on vacation and had an acupuncture specialist as a substitute. I have nothing against acupuncture per se, but I go to a doctor for medical care and not for acupuncture.
The acupuncturist lectured me on the medication I was taking and advised me to stop taking it. This seemed insanely unprofessional, especially coming from a substitute doctor.
His advice? I should get acupuncture!
What a joke.

I am very fortunate to have international insurance, and I got an appointment for a sleep study in Belgium with a minimum of hassle and a short wait time.
I would advise anybody with serious medical complaints to cross the border and get treated in Germany or Belgium. The level of incompetence I've seen here has been astonishing.

Franc posted: 2013-09-30 08:28:46

Anna please get your fact straight
http://www.consumentenbond.nl/test/voeding-gezondheid/gezondheid/patientenrechten/extra-informatie/medische-fouten/
Unfortunately i can only find a ducth article.
But the consumentebond talks about 1950 people who die, not 100.000
40.000 have some form of damage due to errors.

Looking at these surveys http://www.longwoods.com/content/20967
http://www.truthfulpolitics.com/http:/truthfulpolitics.com/comments/medical-errors-in-the-u-s-vs-other-countries/
the dutch seem to score similar to other countries.

Mel posted: 2013-12-18 15:13:34

I have lived in 5 countries and this is by far the worst in the medical area. Recently our daughter need her appendix removed. We took her to the hospital and they only did a blood test and sent us home. We returned the next day and they tried to send us home again. We insisted they do a proper scan. They did not want too but we demanded one. Once a scan was done they sent her to surgury but we had to wait 16 hours. By the time they did the surgury the appendix was so inflamed she had to stay 4 extra days in the hospital. So their attemp to save money by dening us the scan intially resulted in a 5 day hospital stay rather than the traditional one.

Deedee posted: 2014-01-05 14:04:28

I read all your posts here and it is really sad. My story comes with an ankle surgery after I broke my bones leading to 3 fractures, torn ligament and unstable ankle. They fixed it with a plate and some screws in both of my bones and the irony is that in 2 weeks after the surgery they removed my cast, a fact that unexpectedly happened. And trust me, I have read everywhere in the medicine literature (though I am not a doctor) about the ankle surgery rehabilitation and that the cast should imobilise the foot for 6 weeks per total after surgery. I looked everywhere for a case like mine (only 2 weeks with the cast after surgery) cause I couldn't believe my eyes and my ears. At first, I thought maybe I was having a very good recovery of my bone according to what they said as well, but I kept on researching and noone got his foot out of the cast in 2 weeks post-op. I am amazed what happens here and at the moment I am waiting what is gonna happen at the next check-up and if they will send me to physiotherapy or just ridiculously saying that I have to start walking by myself. That would be impressive to hear!

sue posted: 2014-04-02 04:16:31

I spent 14 years in the Netherlands and complained about the lack of service and quality of care only to return to Canada where I could die before getting in to even see a specialist. A routine procedure in the Netherlands that took one doctor visit and one specialist visit that involved a scan took me three weeks. I had to have this repeated (normal for this type of problem), took me 2 doctor visits, 2 specialist visits, 2 scans, one xray and almost 6 months. I actually miss the quality of medical care in the Netherlands.

g.voigt douglas posted: 2014-04-14 02:58:21

In 1968 I spent at least seven months in zuiderziekenhuis rotterdam as a patient, almost an entire pregnancy I eventually gave birth to a healthy son surrounded by all the amazing and caring doctors and nursing team who had cared for me throughout a seriously threatened pregnancy at the time I was unaware but years later was diagnosed with a rare collagen disease Ehlers Danlos Syndrome in retrospect the reason for my difficulties during the necessary hospital stay. I have to say I have nothing but praise for my experience of netherlands healthcare so am amazed and concerned as to the comments I have just readand find it hard to believe that healthcare has deteriorated so much as is indicated over the past 46years. II have lived in Canada and England. I am a defender of the nhs and do hope that plans to destroy and privatise the uks health service will be prevented for surely in any civilised society and countries which consider themselves advanced peoples health should along with education be not for profit and available to all. Not rationed and allowed to

g.voigt douglas posted: 2014-04-14 03:09:43

deteriorate or become rationed. Amazing advances are made in medicine science without education that would not be possible and the health and wellbeing of human beings from the cradle to the grave is paramount in importance to humanity.

18 reactions to this article

osita posted: 2012-07-26 19:12:34

It's unlikely to change either until they introduce a system which allows them to select medical students based on the highest grades.

At the moment, they prefer the draw-out-of-the-hat lottery system which allows a college leaver with a six-point-five-average to get a place at the expense of a person with a nine-point-nine average.

If they were barely smarter than average at school, it's astounding that the Dutch system thinks they'll be able to cope with sheer amount of knowledge they have to cram to keep patients alive, or even to bother reading and keeping up to date in their own field (I've met plenty of doctors here who so obviously don't).

When it comes to saving people's lives and maintianing their quality of life, it's morally reprehensible for a country to spend a fortune on the education of someone who simply isn't the best candidate for the job.

Anna posted: 2012-08-08 14:44:58

@ ostia, very true. The problem in NL is that doctors are too "specialistic" as one student told me and he was going to Germany to work when qualified.

This means a specialist ONLY knows about his specialism, kidney, heart, liver, gynae. etc NOTHING else. I have experienced this to my shock and horror. Now this is a FACT.

Here they will also.i.e scan you when pregnant, but only the baby. I had a child in the UK too and there they scanned all around the stomach. I asked what she was doing ( being used to NL) and she answered" Just looking as I might as well while busy. Don't they do that in Holland?" I said "no, they just look at the baby" "but they did after your operation surely"? "no", I said just that area". She was shocked I noticed, but said nothing. After I told all the horror stories of living in this country she said "I thought Holland was a first world country"?
I could go on but I would need to write a book.

Anna posted: 2012-08-08 14:50:42

The only thing I care about is my experience and that of others. The BMA will have their statistics etc from the Dutch themselves so as they always hide the nasty stuff no-one will be the wiser. Even some of their own publications warn about the health care. Their "consumenten bond" ran articles on the fact over 100.000 Dutch die per year (and maybe more they reckon as not all cases made known) because their GP's don't send them to a specialist on time. I asked my specialist ( a good one, they are around by the way but not many !) if this was true and he nodded saying "and we have to deal with the mess once they are here and get the blame if we can't help them" So I dont listen to medical journals..written by doctors FOR doctors If you ever and I hope you don't ever go into hospital here what else can I say but "all the best "(hopefully you will fare better than I. They ruined my health here through incompetence) I see doctors now in London and Germany for various problems and am improving somewhat, but terrified of ever having to go into hospital here again. [Edited by moderator]

pepe posted: 2012-08-09 11:22:16

@Anna, in 2011 135.516 people died in the Netherlands. So your claim that over 100.000 die because they are not sent to a specialist on time, seem very unlikely,

Anna posted: 2012-08-11 18:00:00

They are not my statistics. Refer please to the consumenten Bond. It was a few years ago.I may have indeed got the figures wrong, sorry if made a mistake, if so you are correct to correct me as you are right 100.000 could hardly be correct !
Having said that ,I was shocked at the article and as I mentioned my specialist confirmed a lot to me.But I do not have the publication anymore (2009 I think) . it was on the cover of the magazine. At the same time the Dutch "Readers Digest "ran an article advising people here stay healthy by eating well, exercising and taking supplements so you and your kids don't have to go into a Dutch hospital .
Not my research nor my words.
It was shocking to say the least.
. I have had my own experiences and those of many others.Some years back they did not even have hospices here for the terminally ill .

Nancy posted: 2012-09-11 16:04:42

Hello, I agree with most posts I read so far: being a French citizen, having lived years in the US, and now being in the NL for a bit less than a year (and pregnant), I feel so disappointed with the Dutch health care. I changed general practitioner, I went to a well-known hospital (Bronovo in the Hague), and despite that, I feel so frustrated by the lack of knowledge of "huisarts" in this country. I learned enough of medicine and biology in grad school to believe that I can tell when some obvious medical ******** are being told. And yes, you are compelled to pay for a Dutch insurance: they are expensive FOR WHAT THEY COVER, in particular, as in my case, if you are pregnant and does NOT want to give birth at home and want pain relief medication during labor without serious medical grounds. Not talking about the fact that, when your pregnancy is not "high risk", you can only meet with midwives (mine were extremely kind but totally lacked any kind of medical knowledge; even after bleeding at 28 weeks, i still was not referred to an OB; and i am not talking about the stress i had around my poorly treated UTI... you don't need an extra load of stress during pregnancy...). Despite the cost, we decided to go abroad for obstetrical care and childbirth. Best decision of the year. I get great care now and that's ok if i pay more for it and barely get a 10% reimbursement despite subscribing to the highest insurance policy: it's my choice. However, even if i wanted to pay more in the NL, I would not find that quality of care, and i blame the Dutch system for that. I am not looking forward to go back to the NL: what kind of pediatrician will i find there? To conclude, if you are healthy, not pregnant and/or dislike medical interventionism, the NL will be just fine for you. Otherwise, I would not recommend it.

ps posted: 2012-10-22 13:34:05

I am also disappointed with Dutch doctors. I have a cyst on my left ovary. According to most doctors (not the one from my country), because the cyst is small I only have to do regular checks. So my 1st GP sent to me a specialist, who told during the consulation that I could have endometriose and that's all he said (why? because I was there for the cyst only). Something about the Ducth doctors is for each consukation we should only cover 1 complain.Maybe that is why he didn't continue the conversation.. Because there was no further discussion, I though, this is not an issue.. A few months later we (I and my husband) decided to have children, so I went to the doctor to ask advice. He only told me to take folic acid.I forgot to mention the endometriose (after the specialist consulation I found out that this could cause infertiliy). By the way, I forgot because, as always the consulations take 10 minutes only and you are not suppose to mention more than 1 subject. When I left he promissed to call me the following week as I was waiting for some lab tests results. When I realized I forgot to mentioned the endometriose, i though well, it's good that the doctor has to call me with regards the tests results. then I can ask him for a referral to go to the specialist. The doctor never called, so I called the assistant and asked if the doctor could give me a call back (the practice allows 1 hour per week for phone appointments). I expressed my concern and said that it was urgent for me. He never called.. After 1 week I decided to chang GP. The same day I changed GP, i received a phone call from the assistance asking if I had changed GP so that she could send my medical records to him. I confirmed and she said...by the way, the doctor tried to call twice you but it didn't work (can you imagine, she was now caling me because I had changed GP but giving the excuse that there was something wrong with my number). Anyway, I asked for my tests results, she said the doctor would call me (although the doctor told me the assistance could also inform me). But the doctor never call. 2 days later I called again, this time only to ask if they had sent my record to the new doctor. She said yes (although she was extremelly rude). But the truth is, 2 weeks have passed and the new doctor never received my records. I have a new GP, until now, no complains, I went to a specialist who told me: endometriose can only be checked by means of surgery (it is not just infertility, it causes extremelly severe period pains). And from what I read, with a surgey it can be checked and partially removed improving fertility and reducing pain. But the specialist wants to wait 9 months to see if you can get pregant. If not we will check for infertility and check if you have endometriose.I cannot believe, also becasue according to what, even if a woman gets preganat, with endometriose, it is very likely to have miscarriages. [Edited by moderator. Please post (elaborate) questions on Ask the Expert or on our Forums. If you have questions for the Expatica staff, please contact us directly.] I think there is nothing I can do, only going back to my country and asked them to check it. With all these things I called my country's doctor and she confirmed the reason why she wanted me o remove the cyst was beacsue it could be related to endometriose

Steve posted: 2012-11-18 11:23:59

Just like my experience PS. I also went to change doctors because mine is so useless, and THEN they were suddenly all over me with lots of attention. The rest of the time they are too busy to see me without an appointment a week ahead, and quietly obnoxious if I mention more than one topic, probably thinking 'huh I've fixed the problem and now he wants something for free!' [Edited by moderators] I have to demand antibiotics sometimes or it's just the standard 'come back in a week and we'll see how it's going'. They just want to clock up another consult!

Peter L in leiden posted: 2013-02-20 16:13:51

Health care is worse than depicted in some surveys and even going over th2 abyss. Example based on Eurostats statistics: Holland in 2010 (most recent stat) scores 5th worst in mortality for two leading cancers and for many others it is also abysmal. They ration care here like in no other country, not even the UK is as bad. In 2013 a law will be passed that patients won't be choosing their own doctors and clinics anymore. Insurers will. So they will impose the cheapest, most second rate ones. For my cancer I cannot even get MRI's here in the Netherlands, while I can in other countries. They only allow ultrasounds and that means spreading gets detected too late to treat properly. The know how here of many cancers is also subpar. There are South-American countries where they know more. Clinical trials are mostly done to satisfy the government's demands for proof, not to do real innovative research, so those trials are like reinventing the wheel already researched in the USA or the rest of Europe. Ypu cannot get into a private clinic of with a private doctor either, since there is no true dual private/public system here with different standards. Everyone has to abide by government edicts. Better get your care in the dual system in Germany, just across the border, if you can. By the way, Dutch health care will not reimburse any foreign care, unless it is man emergency and then only at ridiculously low Dutch care rates.

Linda posted: 2013-06-06 08:49:25

After reading so many comments about the Dutch healthcare system and living in Amsterdam for nearly two years, I had to break down and visit a GP for a nasty cough. It sounds like a broken record but I received the same reception as many people here. Although I had been experiencing a 'crunchy' cough for more than 2 weeks already, the doctor said my lungs were normal after checking with the steth. She then proceeded to tell me that it could possible carry on for another 4 or 5 weeks and her only advice was to drink plenty of water. If the cough hadn't cleared in another month I should come back for another check. I'm from the US and at the very least a doctor there would have given me some kind of cough supressant recommendation or prescription to keep the cough at bay so my partner and I could sleep at night, but no, non was offered here. Something as simple as Robitussin is banned over the counter here and doctors are not so open to prescriptions. My partner told me I need to fight and speak up for what I need from the doctor, but I'm not the one who went to med school and for what I pay in insurance every month, I shouldn't have to diagnose myself and then suggest and fight for the best medication. It's ridiculous! If you read stats about mortality rates here in Holland it's even more frightening. A country that has one of the highest rates of of death from curable cancer in the EU coupled with one of the highest rates of smoking. Non-interventionist indeed. I'm just hoping that nothing major happens to me while living here which is stressful to think about.

AudMar posted: 2013-08-22 11:59:42

I was so happy to join my Dutch partner in the Netherlands. Having experienced unemployment an what I thought sub-par insurance during that time in the US, I was happy to be in a country where everyone received care....until I went to the dr. First apt: was a "substitute dr." She told me about the 10 min 1 subject rule. I explained my issues and explained that I needed a refill on a prescription. She said she would only give me 2 weeks because my "permanent" dr might wan to give me something different. After 20 useless minutes, I was back in the office scheduling another apponintment with the permanent doctor the following week. I even left them a book of my medical files to review before the next appointment. Arrived today for 2nd appointment. Dr was 30 minutes late. Completely frazzled. She hadn't even reviewed my files and didn't know why I was there! I had to go over the same stuff(which I mostly forgot bc I was SOOO shocked since I already explained my "complaints" the previous week. She barely listened to me and then said I needed to make another appointment the following week! Good thing I don't yet have a job or I would never make it to work dealing with these people! I have decided to try out another doctor in the next town over. I shiver thinking about going back to that chaotic place with incompetent people that call themselves doctors.

Adam posted: 2013-09-16 23:10:18

Although I have few complaints about life in the Netherlands in general, the healthcare sucks, and I have seen it firsthand. I live in the Hague.
Most recently, I got a referral from my huisarts to see a sleep specialist for suspected apnea.
Seeing a specialist relies on an antiquated system of waiting for an envelope to be sent from the specialist, mailing the referral back to them, and then waiting for *another* letter with the appointment date.
I never received the letter with an appointment date. I called the sleep center several times, and they told me to wait a bit longer. They then informed me after a few weeks that they had never received my referral letter, although they still somehow knew my name and address.
They advised me to go back to the huisarts and get another letter!
There was already going to be a two-month wait for a sleep study. They wanted me to pay for another appointment with the huisarts and start over with the wait because they lost my referral letter. Amazing.

In another instance, my regular huisarts was on vacation and had an acupuncture specialist as a substitute. I have nothing against acupuncture per se, but I go to a doctor for medical care and not for acupuncture.
The acupuncturist lectured me on the medication I was taking and advised me to stop taking it. This seemed insanely unprofessional, especially coming from a substitute doctor.
His advice? I should get acupuncture!
What a joke.

I am very fortunate to have international insurance, and I got an appointment for a sleep study in Belgium with a minimum of hassle and a short wait time.
I would advise anybody with serious medical complaints to cross the border and get treated in Germany or Belgium. The level of incompetence I've seen here has been astonishing.

Franc posted: 2013-09-30 08:28:46

Anna please get your fact straight
http://www.consumentenbond.nl/test/voeding-gezondheid/gezondheid/patientenrechten/extra-informatie/medische-fouten/
Unfortunately i can only find a ducth article.
But the consumentebond talks about 1950 people who die, not 100.000
40.000 have some form of damage due to errors.

Looking at these surveys http://www.longwoods.com/content/20967
http://www.truthfulpolitics.com/http:/truthfulpolitics.com/comments/medical-errors-in-the-u-s-vs-other-countries/
the dutch seem to score similar to other countries.

Mel posted: 2013-12-18 15:13:34

I have lived in 5 countries and this is by far the worst in the medical area. Recently our daughter need her appendix removed. We took her to the hospital and they only did a blood test and sent us home. We returned the next day and they tried to send us home again. We insisted they do a proper scan. They did not want too but we demanded one. Once a scan was done they sent her to surgury but we had to wait 16 hours. By the time they did the surgury the appendix was so inflamed she had to stay 4 extra days in the hospital. So their attemp to save money by dening us the scan intially resulted in a 5 day hospital stay rather than the traditional one.

Deedee posted: 2014-01-05 14:04:28

I read all your posts here and it is really sad. My story comes with an ankle surgery after I broke my bones leading to 3 fractures, torn ligament and unstable ankle. They fixed it with a plate and some screws in both of my bones and the irony is that in 2 weeks after the surgery they removed my cast, a fact that unexpectedly happened. And trust me, I have read everywhere in the medicine literature (though I am not a doctor) about the ankle surgery rehabilitation and that the cast should imobilise the foot for 6 weeks per total after surgery. I looked everywhere for a case like mine (only 2 weeks with the cast after surgery) cause I couldn't believe my eyes and my ears. At first, I thought maybe I was having a very good recovery of my bone according to what they said as well, but I kept on researching and noone got his foot out of the cast in 2 weeks post-op. I am amazed what happens here and at the moment I am waiting what is gonna happen at the next check-up and if they will send me to physiotherapy or just ridiculously saying that I have to start walking by myself. That would be impressive to hear!

sue posted: 2014-04-02 04:16:31

I spent 14 years in the Netherlands and complained about the lack of service and quality of care only to return to Canada where I could die before getting in to even see a specialist. A routine procedure in the Netherlands that took one doctor visit and one specialist visit that involved a scan took me three weeks. I had to have this repeated (normal for this type of problem), took me 2 doctor visits, 2 specialist visits, 2 scans, one xray and almost 6 months. I actually miss the quality of medical care in the Netherlands.

g.voigt douglas posted: 2014-04-14 02:58:21

In 1968 I spent at least seven months in zuiderziekenhuis rotterdam as a patient, almost an entire pregnancy I eventually gave birth to a healthy son surrounded by all the amazing and caring doctors and nursing team who had cared for me throughout a seriously threatened pregnancy at the time I was unaware but years later was diagnosed with a rare collagen disease Ehlers Danlos Syndrome in retrospect the reason for my difficulties during the necessary hospital stay. I have to say I have nothing but praise for my experience of netherlands healthcare so am amazed and concerned as to the comments I have just readand find it hard to believe that healthcare has deteriorated so much as is indicated over the past 46years. II have lived in Canada and England. I am a defender of the nhs and do hope that plans to destroy and privatise the uks health service will be prevented for surely in any civilised society and countries which consider themselves advanced peoples health should along with education be not for profit and available to all. Not rationed and allowed to

g.voigt douglas posted: 2014-04-14 03:09:43

deteriorate or become rationed. Amazing advances are made in medicine science without education that would not be possible and the health and wellbeing of human beings from the cradle to the grave is paramount in importance to humanity.

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