The patient’s voice in the healthcare debate in the Netherlands

The last few weeks in the Dutch House of Representatives were dominated by healthcare. Various (new) measures with far-reaching consequences for the industry and the patient were announced. The House also met to debate medical prevention, the Dutch medical and aids policy and package management.

But attention seemed to wane: (trade) media hardly reported on it, the public gallery of the Troelstrazaal remained virtually empty and the drug debate ended an hour and a half earlier than planned. With the announced changes to the Drug Reimbursement System (GVS) and the negotiation scheme for expensive medicines (Sluis), one would expect the House and the field to be at full speed. In practice, members of the House debated specific issues, while other measures with major consequences were left undiscussed. The stakes are high for the industry, so it is crucial for them to be heard in the debate. Yet the patient’s voice (still) seems to determine the political agenda.

Who is being heard…
Members of parliament are leaving their ears to concrete appeals from those who are directly affected by a measure. In the run-up to the debate, several patient associations spoke out against the recent decision by Minister Kuipers (Health) to remove vitamin D from the basic health insurance package. With success: during the drug debate, several parties adopted this line of communication and engaged in a debate between supporters and opponents.

A similar voice from ‘the patient’ was heard in relation to the pilot project for making the HIV inhibitor PrEP available. The appeal for this also came from a vulnerable group in society. Two days prior to the debate on drug policy, a petition from Soa-Aids Nederland and others called for this drug to be made widely available. A large group of people waiting cannot use the drug in the current pilot. Under pressure from the House of Representatives, the government has decided to include as many people as possible from the vulnerable group in the current budget.

… and who is not?
The technically more complicated topics, such as the proposed modernization of the GVS, were mainly addressed in a written question round prior to the debate. This modernization should yield an annual savings of €140 million. And although some organizations indicated that patients will suffer as a result, this topic was discussed less than vitamin D or PrEP.

It does not help that not all the concrete consequences of the GVS modernization have been mapped out yet. Which drugs are involved exactly? And who is “the patient”? As a result, the debate now focuses on the doctor and the industry, which may make it less attractive for the House and the cabinet to engage in debate on these issues. Especially if the (media) attention stays away and the stands remain empty.

Find the patient’s voice
The last word has not yet been said on drug policy and the various policy intentions will continue to be fleshed out in the coming period. The House of Representatives will continue to look for connection with the patient. During the summer recess, parties in the field and industry could take stock of the concrete consequences of the proposed policy and where the effects will be felt the most. Tightening up communication and involving the patient could help to redress the slackening of attention in ‘The Hague’. Either way, the field will have to get creative in how they get their issues back on the Hague agenda.

Public Matters is the public affairs and lobbying consultancy specializing in policy advocacy and strategic communications.