Update 18 December 2025
2025 is almost winding down and it is time to wish you all a Merry Christmas and a Happy New Year. I look forward to bringing you more news about the Dutch healthcare sector in 2026. Instead of giving a final update (it has been relatively slow on the news front regarding Dutch healthcare the last few weeks), I thought it would be useful to provide you an overview of the key themes that I have presented to you in 2025.
The following text (with some minor tweaks) is what Perplexity (my favorite AI-tool) had made of the nineteen updates you have received from me. I hope that you have found the individual updates of interest, and find the “key messages” in the following text an interesting update on the year as a whole.
2026 will be a new year of challenges and opportunities and I look forward to staying connected with you.
Politics, regulation, and system programs
A constant thread is political and regulatory tightening combined with implementation trouble in national reform programs (IZA/ASWA, WOZO, AZWA, HLO). Parliament repeatedly pushes for more control over commercialization (dividend bans, PE bans, lower tariffs for clinics, limits on commercial primary care), while the Minister and EU law set hard limits on how far this can go. At the same time, attempts to realize macro changes via IZA/ASWA and WOZO/HLO stall or are reshaped, mainly due to municipal resistance over funding and coordination complexity, with the practical impact on serious commercial operators assessed as modest but process‑slowing.
Costs, fiscal pressure, and macro spending
Multiple updates stress the combination of rising healthcare expenditure, demographic ageing, and fiscal pressure (e.g., CPB election analysis, defense spending crowding out healthcare, and long‑term projections to 15% of GDP). Parties look to higher own‑risk/co‑payments, tighter package management and lower quality norms in nursing homes to curb growth, even as sector actors warn of underfunding and investment backlogs (real estate, sustainability). Municipal WMO spending and co‑payment reforms appear repeatedly as a lever to manage local budgets and demand for social services, especially housekeeping and mobility support.
Commercial providers, PE, and M&A
A core narrative is that, despite political noise, commercial participation and PE remain structurally embedded, though with cycles in sentiment and deal flow. The updates track:
- Ongoing consolidation and PE‑driven deals in clinics, mental health, home care, cosmetic treatments, and specialized providers (Yes We Can, Dovida, NOK, ABC Clinics, Equipe acquisitions, Bergman acquisitions, etc.).
- A temporary dip in PE and foreign real‑estate activity in 2024, followed by signs of renewed interest in 2025.
- Sector‑specific M&A dynamics (dental, pharmacies, maternity, cosmetic, long‑term care), and the gradual relaxation of ACM’s special healthcare unit versus new NZa powers over deals.
Your messaging consistently emphasizes commercial providers are integral to capacity, innovation, and access; political threats are unlikely to translate into sweeping anti‑commercial measures, but they increase complexity, timelines and the need for robust governance and communication from investors.
Subsector deep dives and case studies
The updates use detailed subsector snapshots to make broader points:
- Elderly care: strong 2024 financials in WLZ elderly care alongside flat investments and a policy‑driven shift of “complex” care into home/VPT/VPT‑like settings; critical journalism on “cowboys” versus solid chains like Dagelijks Leven; growing demand for hospices and the absence (yet) of commercial hospice operators.
- Mental health: structurally rising costs, capacity bottlenecks for complex patients, and a commission calling for fundamental reform across prevention, prioritization, capacity, and financing; at the same time, mental health providers show strong 2024 margins and attract PE and growth investments.
- Primary care: tension between failed commercial chain models (Co‑Med), supportive hybrids (Arts en Zorg, Buurtdokters, Flexdokters) and political moves to “de‑commercialize” GP care while still relying on private ownership and insurer‑backed start‑ups.
- Other niches (veterinary, informal care/mantelzorg companies, cosmetic treatments, disability insurance system, hospice and end‑of‑life care, maternity care) are used to illustrate general patterns: consolidation, regulation catching up, and blurred lines between social and medical domains.
Digitalization, data, and productivity
Another strong theme is digital transformation as a necessary but difficult route to productivity and capacity gains. The McKinsey report quantifying a potential €22 bn efficiency gain (about 20% of current spend) via EPD/health‑data exchange, teleconsultations, prevention tools, AI, and better capacity management is a key reference point. Against this potential, you repeatedly highlight: the Netherlands’ lagging performance on patient access to data, fragmented IT/vendor landscapes, Chipsoft’s dominance and AI partnerships, and the need for strong central coordination and aligned incentives to move beyond pilots.
Investment climate and international capital
Finally, many updates implicitly address the “is the Netherlands still investable?” question. The key messages are:
- Real‑estate: sharp decline in healthcare real‑estate investments since 2022, no foreign buyers in early 2025, and the strategic importance of players like Cofinimmo/Aedifica and their merger for funding capacity.
- Policy risk: Wibz, dividend and leverage restrictions, tighter oversight and political signals increase compliance requirements but are framed as manageable for “serious” international operators.
- Structural demand: demographics, staff shortages, shifting care to home, and under‑capacity in areas like hospices, complex elderly care at home and mental health continue to create long‑term opportunities, even as short‑term noise and regulation complicate execution.