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

In December 2019, the Dutch Safety Board published its report in response to the bankruptcy of the MC Slotervaart and MC IJsselmeer hospitals. Following the bankruptcy, the handover of care proved chaotic and poorly controlled, thereby threatening patient safety. The recommendations of the Safety Board are therefore focused on amending the duty of care and the bankruptcy law, in order to place patient safety at the forefront, in such situations. Since that time, the Ministers who received recommendations have taken a series of measures, but at present, the guarantees specified by the Safety Board are not yet fully in place.

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.

Recommendations for guaranteeing individual healthcare

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.

Intention to fully comply with the recommendations

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. 

Full reaction and assessment by the Safety Board

The reaction of the Minister of Medical Care and Sport is available and the reaction from the Dutch Safety Board (both in Dutch) are available on the website, and discusses in detail all four recommendations, and the extent to which each recommendation has been complied with.