Patient safety better guaranteed following hospital bankruptcy, but not yet embedded in law

In the autumn of 2018, the MC Slotervaart hospital and the MC IJsselmeer hospital went bankrupt. During the downscaling and handover of care, the interest of good patient care came into conflict with other interests. In its investigation report, the Dutch Safety Board concluded that this led to increased risks for patient safety.

The recommendations issued by the Safety Board at the end of 2019 to the Minister of Medical Care and Sport were aimed at the controlled settlement of a hospital bankruptcy, so as to guarantee the continuity of individual patient care. One of the ways of achieving this was to recalibrate the duty of care for healthcare insurers, so that individual care and treatments for patients are guaranteed.

The Safety Board issued a recommendation to the Minister for Legal Protection to amend the bankruptcy law, by introducing a compulsory period of silent administration prior to a (possible) hospital bankruptcy, in order to guarantee the controlled settlement of that bankruptcy.

In their reaction, the affected Ministers have expressed their intention to comply with all recommendations from the Safety Board. A number of steps have also already been taken. Consultation has for example taken place between the Ministry and the Dutch Healthcare Authority (NZa) and the Dutch Healthcare Insurers (ZN) in order to clarify and to recalibrate the duty of care of healthcare insurers. The result is a document which indicates more clearly how healthcare insurers are required to fulfil their duty of care in the event of a hospital bankruptcy.

As concerns the amendment to bankruptcy law, the Minister for Legal Protection aims to have a silent preparation phase introduced as standard practice in the event of a threatened hospital bankruptcy. The Bill to settle these issues must still however be adopted in the Dutch Senate, and then implemented.

This means that more than one year following the publication of the report by the Safety Board, the recommendations have not yet been fully implemented, and as a consequence not all guarantees are yet in place for the controlled settlement of a hospital bankruptcy. If another hospital were now to unfortunately go bankrupt, patients can still not be certain that the continuity of their care is guaranteed.