Observation (CEACR) - adopted 2013, published 103rd ILC session (2014)

Medical Care and Sickness Benefits Convention, 1969 (No. 130) - Netherlands (Ratification: 2006)

Article 31 of the Convention. Participative management of the health insurance scheme. In its previous comments, the Committee noted that in the Netherlands the administration of health insurance is not entrusted to an institution regulated by the public authorities but is entirely in the hands of private insurance companies, which run it for profit. For such schemes, Article 31 of the Convention requires the national legislation to prescribe conditions for the participation of the representatives of the persons protected in the management of the scheme. To promote its management on a tripartite basis, the legislation may also provide for the participation of representatives of employers and of the public authorities. Article 30(2) requires the Government to accept general responsibility for the proper administration of the health insurance institutions and providers of medical services, ensuring that the national health insurance scheme is managed in a democratic and transparent manner, with the proper participation of the trade unions and other organizations representing the persons protected together with the professional associations representing care providers and the medical profession. In the light of these explanations, the Government was asked to supply full information on the application of Article 31 of the Convention in the Dutch health insurance scheme. In reply, the Government states that Article 31 “is not applicable to the Dutch health care system”. The Committee understands from this reply that the provisions of Article 31 are not applied in Dutch law and practice and that the Government has no intention of changing this situation. Noting this development with concern, the Committee cannot but observe that the position of the Government perpetuates the violation by the Netherlands of its obligations under a ratified international treaty, which is this Convention.

The Committee is raising other points in a request addressed directly to the Government.