Update 6 January 2022

Best wishes for 2022. Let us hope that it will be a year in which we learn how to deal / live with COVID19, and that pleasant things such as eating out in restaurants and travelling again become possible. After a quiet period at the end of last year there has recently been a fair amount of healthcare related news here in the Netherlands:

• The Netherlands now has a new government with interesting candidates for healthcare related ministers. What will be the consequences for the sector?
• The Dutch anti-competition watchdog has recently stopped two healthcare-related acquisitions. Is this a new trend?
• Mentaal Beter to acquire HSK. What does this mean for the commercial mental healthcare market?

The Netherlands finally has a new government

In March last year the Netherlands had elections in which the sitting 4-party coalition gained two seats. It has still taken the same four parties until now to decide on the terms for a new coalition and the ministers for the new government (a record for the Netherlands).

In the document outlining the coalition agreement four of the forty-seven pages are given over to healthcare related issues. The biggest news is no news – the coalition parties clearly agree that the current system is working relatively well and that it does not need any major changes. Suggested changes are fairly minor and do not come as a surprise. Key examples of plans mentioned are:

• More activities with the goal of keeping the elderly out of expensive nursing homes and longer “at home” for as long as possible. This will be realized by reducing central financing of the hotel component of nursing homes (i.e., making clients pay directly for accommodations) and proactively helping the sector develop alternative housing solutions for the elderly
• A move in the opposite direction is to move away from the standard (and low) co-payment for domiciliary care towards a “fairer” system of co-payments (very probably dependent on income and wealth),

Healthcare will get two ministers and both candidates are non-politicians with broad healthcare experience. Ernst Kuipers is a MD and professor who is currently the managing director of the largest hospital in the Netherlands (Erasmus in Rotterdam). He has played a very prominent role in advising the government during the COVID19 outbreak and will be the minister responsible for the cure-sector.

Conny Helder has had a career as a manager in the elderly care sector and has also been a board member of Actiz (the trade organization of the incumbent long-term care organizations). She will become the minister for long-term healthcare. Both the new ministers have expressed clear political views on themes such as the need to radically change elderly care and the need to reduce the number of hospitals providing emergency care. It is good news that we have minsters with relevant real-life experience, and it will be interesting to see how much change they will be able to implement.

Dutch anti-trust authorities stop two acquisitions

All mergers and acquisitions above a certain size in the Netherlands must be approved by the Dutch Authority for Consumers and Markets (ACM). The ACM has recently stopped two healthcare related acquisitions:

• Bergman Clinic’s acquisition of Mauritskliniek has been stopped because the ACM believes that the acquisition will strengthen Bergman’s negotiation position towards the insurance companies and lead to higher prices
• Mediq’s acquisition of Eurocept Homecare has been stopped because the combined companies would have an excessive market share in the Dutch market for tube feeding and infusion pumps.

This level of proactive control of the healthcare market is new for the ACM. Does this signal a stricter policy that will make it less easy to develop strong companies through a buy-and-build strategy?

Mentaal Beter to acquire HSK

A company that does not appear to be worried about a new and stricter policy from the ACM is Mentaal Beter. Mentaal Beter has in recent years grown strongly through a combination of many smaller acquisitions and internal growth. In January 2021 Mentaal Beter was acquired by Apax France.

Mentaal Beter has recently announced that it is acquiring HSK. HSK is one of the biggest commercial competitors to Mentaal Beter in adult mental healthcare. HSK currently has fifty locations throughout the country, and the merged company will be by-far the largest commercial provider in this sector. The first step will be to get the approval of the ACM.