Update 21 October 2025

Excuses for the long break since the last update. This is due to a combination of vacations (sailing in Turkey), a busy schedule, and a period of relatively little interesting news related to the Dutch healthcare sector. However, this is no longer the case and in this update we cover:

• Reduced spending on healthcare is likely outcome of upcoming elections. What is the story?
• Government report concludes that Dutch mental healthcare requires fundamental change. What are the options?
• Belgian private equity busy in the Dutch market. What are new investments?

Reduced spending on healthcare is likely outcome of upcoming elections

In our previous update we wrote about the upcoming elections, described the most likely process leading to a new government, explained that healthcare was not a major theme in the elections and concluded that likely effects for commercial providers will be minimal. Since then, The Netherlands Bureau for Economic Policy Analysis (CPB) has conducted a study analyzing the economic effects of the published programs of each party. The analysis is intended to give voters a neutral view of the economic consequences of the promises that the parties make before the election. This is popularly known as exposing the “free beer” promises that political parties tend to make.

A key challenge facing all the parties is the need to finance the required growth in defense expenditure to meet the goals of 5% of GDP. Most parties want to finance this growth by (among other choices) reducing the expected growth in government healthcare related expenses. In the base case situation, spending on healthcare would increase from €120 billion in 2026 to €136 billion in 2030. In the plans of the parties with the largest reductions (VVD and D66) government spending on healthcare in 2030 will be reduced to between €126 and €128 billion.

Details on how the reduced growth in spending will be achieved are scarce, but key ideas include increasing patients’ own-risk and other co-payments. In addition, parties mention freezing the current content of the basic healthcare insurance package (i.e., not including new treatment options and pharmaceuticals) and decreasing the quality of care in nursing homes.

Reactions from the healthcare sector and unions have been very negative and healthcare has now become a key theme in the elections. The left-of-center party that had not included any reduction in growth of healthcare spend is accruing other parties of “lying”, and the parties who were most aggressive in their savings are busy back-pedaling. It will be an interesting nine days until the elections on 29 October. We will provide an analysis of the results and consequences for healthcare in the next update.

Report on Dutch mental healthcare concludes that system needs fundamental change

A new report from a government commission highlights the challenges facing the overall mental healthcare sector in the Netherlands and provides suggestions for how the system can be reformed. Key problems and challenges highlighted by the report include:

• An increasing number of people require psychiatric assistance, and mental healthcare related issues are estimated to cost society between €17-51 billion per year
• Patients / clients with complex psychiatric problems face increasingly long waits before being helped or are unable to find the help they require
• Quality of care and effects of individual treatment processes are difficult to define as there is little systematic outcome information available
• Strong growth in costs associated with mental healthcare. The costs for curative mental health have grown from €3.3 billion in 2015 to €5.6 billion in 2024. The costs for long-term mental healthcare has also had robust growth

Based on these problems and challenges the commission concludes that the current structure for providing mental healthcare is not sustainable and needs to be fundamentally changed. The commission provides 37 reform proposals structured into four principal areas:

• Prevention – these are proposals focusing on improving the mental resilience of the Dutch population and thereby reducing the demands on medicalized mental healthcare
• Prioritization – these are suggestions to the government to prioritize / limit the use of mental healthcare. Examples include reducing both the right to get treatment and the reduction of treatment duration
• Managing to ensure that provision of (especially) complex mental healthcare services is increased in order to be more aligned with demand. This can include changes to tariffs and focused investments
• Reducing walls between different financing systems and increasing cooperation between providers

The report also suggests changes to how mental healthcare is purchased. Four alternatives have been developed ranging from the transfer of light mental healthcare to the municipalities (WMO) to central / regional purchasing and coordination. The report does not include any financial consequences of the different proposals and models and also accepts that making any of the suggested changes will require several years and coordinated activities across different governments. It will be interesting to see how this develops as the suggested changes could have considerable impact on commercial mental healthcare providers such as Mentaal Beter.

Belgian private equity makes more investments in Dutch healthcare

In 2024 it seemed as private equity had lost faith in the Dutch healthcare sector. In the update at the beginning of September we described how the sentiment seems to have turned and described three recent deals where private equity have played a key role. One of the deals we described was the acquisition of Nederlandse Obesitas Kliniek (NOK) by Vendis Capital. Vendis Capital certainly seems to have a strong belief in the inherent strength of the Dutch healthcare sector and is not worried about political risks related to private equity investments in the sector. This is based on Vendis making yet another investment in the sector. The newest investment is ABC Clinics specializing in cosmetic surgery. The clinic has eight plastic surgeons and eight cosmetic doctors.