GPs sound alarm about bureaucracy with divorce scheme –

GPs from the action group #helpdehuisartsverzuipt presented a homemade tear card to the House of Representatives this afternoon. The calendar is full of strange examples of the day-to-day bureaucratic practices GPs have to deal with.

This is, for example, a patient who has a stoma and wants to get rid of his stool. But there is no permission from the municipality. First of all, the GP must write a statement that the patient in question does indeed have a stoma.

“It is none of our business,” says GP Daisy Pors from The Hague. “This is another example of unnecessary paperwork that an agency puts on the table and costs us time. Time we can’t spend on a patient.”

boring chronic

The program that Pors brought together with six general practitioners reads like the history of a boring bureaucracy. GPs, for example, routinely spend a lot of time referring a patient for a check-up by the Central Bureau for Fitness to Drive (CBR) in order to be in possession of a driver’s license.

That is not allowed at all, says Pors. The Association of Scientific Practitioners recommends that you do not examine your own patient in such a situation. Nevertheless, according to Pors, letters from the CBR regularly show that their practitioners carry out such an investigation. A conversation with a patient to make him understand that he went to the wrong address can easily take 20 minutes.

“Again, the time has come when we don’t have it because more and more orders are being given to us as GPs.”


Since the end of the Second World War, Dutch general practitioners have been the so-called guardians of health care. They usually see patients first and assess the care needed. The GP tries to treat himself as much as possible. However, when it becomes too complicated or life-threatening, a referral is made to the hospital. For example, relatively fewer people go to hospitals where treatment is more expensive.

This broad task of general practitioners has only expanded in recent years. The elderly must continue to live independently at home for longer as their care needs increase. That automatically means more work for general practitioners who care for more chronic patients.

Added to this were the overloaded mental health care institutions. Healthcare providers hope that GPs and their specialist nurses can prevent the onset of psychological complaints early, before these ‘minor’ cases escalate and the mental health care system has to take action because the waiting lists are already so long.

“General practitioner care is a big bucket of water that comes in from all sides,” says Pors. Now this bucket is in danger of overflowing.”

detachable calendar

Due to the high pressure on various healthcare facilities, it is not uncommon to try to transfer patients to other healthcare providers. For example, one of the timeline examples of how a mentally ill person is treated is as follows:

Mental Health Referral: Denied. “Madame has an alcohol problem. We have to treat him first.”

Referral to addiction treatment: rejected. “The woman has a psychological problem. That has to be addressed first.”

Pors: “These people then return to the GP because we are the last to be responsible.”


In addition, Pors believes that the goalkeeper function sometimes becomes an enormous burden for his leg.

In principle, for example, a patient can only go to a specialist doctor in a hospital if a general practitioner writes a recommendation. Otherwise, the health insurance will not reimburse the treatment. According to Pors, these experts regularly ask for a new referral if they want to do a follow-up investigation because they suspect there is more to it. Because the insurer will not pay out again without a referral.

“In this way we become a kind of administration office for hospitals,” says Pors. “Just because health insurers are suspicious of doctors. It seems they are afraid that without our referring doctors to hospitals they will flock to each other to make money. They’re too busy there. So if they need an internal reference. , they will have a good reason for that.”

The generals behind the calendar hope that the sad examples will make the House of Representatives think. “They really need to ask themselves whether this system can be sustained for long. The pressure on GPs is increasing. And we don’t have a safety net. What happens to the patient if we can no longer lead the raid?”

Source: NOS