The position of patients in the Dutch health care system
The aim of government policy is to have patients and clients make active choices about their care. However, from scientific literature it transpires that people do not always want this, or only partially; it also appears the choice process isn’t always followed through rationally and logically. NIVEL wants to gain a better understanding of the choice process, paying attention to the information people use (its quantity, shape and content) and the way this information is being used when considering and choosing a certain treatment or supplier. Other determinants influencing this process will also be studied, such as the degree of trust between the patient and the carer, and the patient’s ability to speak up for themselves.
The recent changes to Dutch health care system have led to more attention being given to the choices available to patients. In the last two decades a substantial number of laws concerning patients have come into effect, such as the Medical Treatment Contracts Act, the Clients' Right of Complaint Act, and the Participation by Clients of Care Institutions Act. These laws have strengthened the patient’s position in health care. At the moment the foundations are being laid for a new law on clients’ rights in health care [Wet Cliëntenrechten Zorg], clustering clients’ rights in a single piece of legislation. The Ministry for Health, Welfare and Sports has also started the ‘cliëntenrechten.nl’ campaign, aiming to further strengthen the patient’s position.
However, there is still work to be done. Where rights regarding complaints are concerned, a lot of improvements are possible, especially around the issue of how these rights can contribute to the satisfaction of those filing complaints, and around the issue of the right to appropriate care and care continuity.
A third topic is informed consent, both within the treatment relationship as in medical scientific research involving people.