Update 16 September 2025

I hope that you are doing well and enjoying the last days of summer and/or the first days of fall (depending on your local weather and your view of the world). Here in the Netherlands, the weather is flexible, one moment beautiful sun and the next moment pouring rain. Whatever the weather, there is always news concerning the Dutch healthcare sector. In this update we cover:

• Private equity acquires innovative mental healthcare provider. What is the story?
• Overall strong financial results in the Dutch healthcare sector, but challenges remain. What is going on?
• Consolidation in EPD sector. What are the key reasons?
• Upcoming Dutch elections. What are possible consequences for commercial healthcare?

Private equity acquires Yes We Can

In 2023 we described Yes We Can in a snapshot. Yes We Can was started in 2010 by Jan Willem Poot with the goal of providing mental healthcare to young people (age between 13 and 27)  with severe problems that have not been solved by other providers. Yes We Can claims that 74% of its patients do not require further complex mental healthcare after a combination of a short and intensive seven-week in-house program followed by 10-week ambulant follow-up treatment.

The company has been financially successful as well. Revenues have grown from €22 million in 2021 to €56 million in 2024 (€2.2 million net profit). The success in treating young people with severe mental healthcare issues has resulted in interest from other countries, and the company has advanced plan for locations in the UK and Switzerland. The plans for international growth have resulted in a change of ownership. Dutch PE-company Holland Capital has been a 50% owner of the company since 2021. Bencis is now purchasing Holland Capital’s shareholding and also the shares owned by Jan Willem Poot.

Overall strong financial results in Dutch healthcare sector, but…….

In previous updates we have written about the excellent financial results in the elderly care sector and the mental healthcare sector. EY has recently published an analysis looking at the financial results of 658 healthcare providers across all sectors with revenues of at least €10 million. EY’s findings are in line with the earlier analytics per sector. For the sector as a whole net profits were 2.4% of revenues. This is the highest level ever, and 1%-point higher than 2023.

The improvement in results is due to a number of operational factors detailed in the specific sector analytics. The main worry of EY  is that when looking at the overall healthcare sector the key reason for the high results is lower capital costs (interest on loans) and higher interest income than in earlier years. This again is due to lower investment levels for the past few years and low interest levels. Many parts of the healthcare sector, such as elderly care, have a sizeable backlog of investments in real estate and sustainability and will need to carry these out in the near future. It is therefore unlikely that the financial results will remain at the current elevated levels.

Consolidation in EPD sector

M&I/Partners have recently published an overview of electronic patients’ dossiers (EPD) suppliers in the Dutch long-term care sector. The study is based on 189 large healthcare providers, so might miss EPD providers focusing on smaller operators. A key finding is that a structural consolidation is taking place, in 2019 there were seventeen suppliers active. Currently there are only thirteen active suppliers and one of these (PinkRoccade) appears to be closing down its EPD product for long-term care.

It is interesting to see that all the EPD providers are local companies (sometimes owned by international investors), and that one provider (Nedap) dominates the market with 120 clients, while the second biggest EPD provider only has 22 clients. Chipsoft dominates the market for EPDs in the hospital sector with a 70% market share, but is only present at three long-term care providers. It can be expected that this market will see further consolidation as it is unlikely that smaller providers will be able to compete on new AI-based improvements to EPD systems.

Possible consequences of upcoming elections

The previous Dutch elections for Parliament in 2023 resulted in right-wing populist PVV getting the highest number of seats in Parliament. More than 220 days of negotiations resulted in a coalition consisting of four parties with a total of 88 of the 150 seats in Parliament but no majority in the Senate. Two of the parties in the coalition (NSC and BBB) were new with little experience in governing and the non-political Prime Minister was a senior bureaucrat who used to run the Dutch spy agency.

As can be imagined, this was a difficult situation  and the coalition fell in June this year due to PVV leaving the coalition after not getting its will concerning immigration/ asylum politics. Currently, the caretaker government is reduced to  two parties as NSC also left the government due to discussions regarding how best to react to Israel’s actions in Gaza. New elections have been set for 25 October.

Current polls show that getting to a new coalition government will not be easy. PVV will lose seats, but is still likely to be the largest party in the new parliament. However, a repeat of the previous 4-party coalition is highly unlikely due to two factors : 1) in an optimistic scenario the four parties will have a total of 51 seats (compared to 88 in the old Parliament) where especially the two new parties (BBB and NSC) are expected to lose dramatically and go from 27 to 4 seats; 2) it is highly unlikely that any party will be willing to enter a coalition with PVV again.

Based on the current polls, the only “logical” majority coalition involves four parties ranging from the conservative VVD to the labor-oriented GL-PvdA and including two other centrist parties. The current leader of the VVD has said that she will not enter a coalition with the GL-PvdA, so it can be expected that any process leading to a new government will be time consuming. Hopefully, it will be shorter than the last time as the parties will not need to spend two months before agreeing that they will follow the Constitution.

What are the possible consequences for commercial healthcare operators and investors? Looking at the individual party programs, it is clear that healthcare is not the primary issue in the upcoming elections. All the big parties agree on general themes such as improving primary care, youth care and mental healthcare, and improving the working conditions for healthcare staff (higher salaries, less bureaucracy, etc.). Some parties are explicit in their support of  full-service regional hospitals while some want to reduce patients’ own-risk payments.

GL-PvdA is the only party with a fighting chance to become the largest party, and it has a clear negative position towards commercial healthcare. Key goals include increasing limits on payments of dividends, more power to regulators, more focus on cooperation than competition, centralizing of all data/IT related to healthcare, etc. However, two of the parties it would need in a coalition (CDA and VVD) are quite positive to commercial healthcare. Getting to a coalition agreement will require compromise from all parties on most issues. While potential change will to a certain extent depend on which party gets the Minister of Health dramatic change to the current structure is unlikely as there are sufficient pressing issues to keep the Minister and Ministry busy for the coming years.