Here in the Netherlands the weather is a strange mixture of beautiful sunny days and days with non-stop rain and wind. However, temperatures are high and gas consumption is low. In this update we cover:

• Bergman Clinics signs another multi-year contract with an insurance company. Is this yet another sign of specialized clinics becoming an integral part of the Dutch healthcare sector?
• Clients for light homecare will pay an own contribution based on income. Is this a first step in limiting use of these services?
• Director of the NZA (Dutch Healthcare Authorities) claims that the sector needs total overhaul to meet ongoing challenges. Is her thinking in line with that of the government?

Here in the Netherlands the weather is still quite pleasant and gas usage is low. Let us hope that this continues and eases any issues we will face due to the limitations placed on gas imports from Russia. In this update we cover:

• Study highlights that specialized clinics have a positive effect on the Dutch healthcare sector. Will this help improve the overall situation of the commercial specialist clinics in the overall Dutch healthcare system?
• Bleak financial future for traditional Dutch elderly care operators. Will the government help?
• Senior living locations can help reduce the pressure on healthcare staffing. What can the government do to increase the roll-out speed of new locations?

I am just back from a great vacation in Greece with a fantastic combination of walking in the mountains, meeting old friends and being lazy on a beach. In the meantime, the Dutch healthcare sector has not stood still. In this update we cover:

• Buurtzorg expands into nursing homes. Will this be as successful as their homecare activities?
• Government announces sixty opportunities for reducing healthcare costs. Can they be implemented?
• A recent report highlights the Dutch healthcare real estate market as very attractive. What does this mean for potential new entrants?

The first signs of autumn are appearing. The days are getting shorter and there is a certain crispness to the air. As much as I enjoy summer (when it is not too hot) I also quite like the changing seasons. I hope that you are also enjoying the new season.

There are many things happening in the Dutch healthcare sector. In this update we cover:

• Issues in the homecare sector. How does this fit with the Government’s plans to restructure healthcare?
• 2021 was a good financial year for the healthcare sector. Will this continue?
• Planned restructuring of Dutch healthcare sector meets resistance. What will be the next steps?

From the automatic replies I see that many of you were still on vacation when I sent out my previous update. I assume that now schools have started and that most of you will be back in the office and ready for new challenges. Here in the Netherlands most people are now back from holidays and there is news from the healthcare sector. In this update we cover:

• Another hospitals with financial problems. Will this be a repeat of the hospital bankruptcies of 2018?
• Sanquin sells another subsidiary. What will be next piece of family silver to be sold?
• Personal budgets can still be used for the provision of live-in care. Why is this important?
• Technology update – Old technologies refuse to die

Many of you are now probably back from your well-deserved vacations. I hope that you have enjoyed your time away from the office. Here in the Netherlands many people are still on vacation, but there is still news to report. In this update we cover:

• Avinty sold to Main Capital. Will there be further consolidation in the Dutch healthcare IT-sector?
• Private equity focuses on veterinary services. Will the sector face the same process as the dental care sector?
• Employees on sick leave a growing problem in the Dutch healthcare sector. How can this be turned around?
• In our snapshot we give an overview of Arene, a provider of digital general practitioner services

From the “bounced” emails I am receiving I see that many of you are already enjoying your holidays. I expect that many more of you will be on leave in August. I hope that you are all enjoying your breaks.

Even though the summer is a quiet time here in the Netherlands as well, there is still news to report. In this update we cover:

• Consolidation continues in the Dutch healthcare sector. Who will be next to be acquired?
• Acquisitions in the healthcare sector to become easier. Why is the ACM against this move?
• High investment volume in the healthcare real estate sector in the first half of 2022. Will this continue?

I hope that you are enjoying nice summer weather (not too hot as in southern Europe and not too wet as in parts of northern Europe). Typically, updates cover between two and four different news items. However, this update will focus only on current developments and announcements from the government that will have a very large impact on the overall Dutch elderly care sector and will raise new strategic challenges for all types of organizations that are involved (directly or indirectly) with the sector. In earlier updates I have covered the plans of the government (see update of 12 April for an initial view on the plans to not build any additional nursing homes and the update of 1 June giving an overview of the government’s plans for reducing healthcare expenditure.

In recent statements the government has clarified some of the issues resulting from the earlier statements and has clearer plans for implementing many of the suggested changes. Based on this, it makes sense to present a broad overview of the plans presented by the government and give a first-cut view of what the suggested changes entail for the different types of organizations active in the sector.

It was great seeing many of you last week at the HBI conference in London. The presentations and discussions were (as always) good, but played a secondary role to meeting and talking face-to-face with old and new friends. A special welcome to the people I met in London and who are now receiving my updates on the Dutch

In this update on the Dutch healthcare sector, we cover:

• Actief Zorg continues growing through acquisitions. Is the strategy to become a national homecare provider?
• Hospitals had reasonable results in 2021. Do they have the financial strength to meet coming challenges?
• Government takes a more active role in developing interoperability between systems and data flows between healthcare operators. Will it help the sector solve key problems?

Dear <First name>,

I hope that you are all enjoying wonderful spring weather. In this update on the Dutch healthcare sector, we cover:

• Government is planning structural savings on healthcare expenditure. What will be the consequences?
• Minister wants to tighten rules regarding the use of personal budgets (PGBs). What will this mean for innovation?
• Increasing number of healthcare professionals choosing to leave jobs for an independent career. What are the reasons and what can be done?

Sorry for the long wait since my last update. The delay was due to a combination of a wonderful two-week vacation in Sicily and lots of work with ongoing projects. However, I have now been able to find the time to write a new update on the Dutch healthcare market with news about:

• Acquisition of Dutch laboratory by Eurofins. Will more consolidation follow?
• Major changes announced to financing of youth care. What will be the consequences for commercial operators?
• M&A activities in healthcare sector grow again. Will the growth continue?

At the beginning of 2017 I saw an increasing interest in the Netherlands from international healthcare operators and investors. In May 2017 I decided to provide my international contacts with a bi-weekly update on the Dutch (commercial) healthcare sector. The first update gave news about Acibadem entering the Dutch market with a new hospital, staffing issues in the elderly care sector, and a snapshot of Domus Magnus.

We are now five years further and the commercial nursing home sector is dominated by French providers, international private equity has made major investments  in mental healthcare (Mentaal Beter) and private clinics (Bergman and Equipe) and numerous smaller investments. In addition, international property funds are very active and there is ongoing interest in other types of healthcare related companies.

This is the 100^th update that I have published. Along the way the number of subscribers has steadily increased and now includes a mixture of senior executives from international healthcare operators, partners at private equity company, real estate investors, and a surprising number of Dutch readers (who clearly enjoy getting an external and more commercial view of the healthcare sector). Onwards to the next 100 updates.

In this update we cover:

• Problems in the Dutch mental healthcare sector lead to closures of locations. Good news or bad news?
• Minister claims that no additional nursing homes will be built. What are consequences for the sector?
• Technology update. What will be next?

The war in Ukraine continues and the news is filled with a strange combination of terrible pictures of homes bombed and people being forced to flee, and Ukrainians showing incredible bravery and resilience. I am a music fan, and a huge fan of The Clash. See here for an updated version of their most classic song by the Ukrainian band Beton.

Even in these strange times there is news from the Dutch healthcare sector. In this update we cover:

• Valuations and volume of acquisitions in the sector are rising. Will this continue?
• Actief Zorg continues to grow. When will profits catch up?
• Mental healthcare and psychedelics – what is the situation in the Netherlands?

Most news here in the Netherlands is focused on the terrible situation happening in Ukraine, so there is not a lot of news from the Dutch healthcare sector.

In this update we cover:

• Contracting between operators and healthcare insurance companies for 2022 still not signed. What are the key reasons?
• In our snapshot we give an overview of Zorggroep De Laren, one of the few remaining independent Dutch commercial nursing home providers.

Terrible news from Ukraine. I wish the brave fighters against Russian Tyranny all the best and hope that Europe manages to stay united and strong in its actions against Putin.

Even with the horrible things happening internationally there is also news from the Dutch healthcare sector. In this update we cover:

• Long waiting lists for mental care. More opportunities for commercial providers?
• Yet another hospital merger called off. Is the ACM (Dutch Authority for Consumers and Markets) showing its teeth again?
• Dutch healthcare sector does not earn enough to fund required investments. Can the trend be reversed?